Fig. 3
Masked patients with LDDs. a A patient with SCV LDD on V3 due to loose fixation point between upper arm and neck. SCV dose improved on V7 and V13 after the fixation point was secured. b The patient with IMN LDD on V3 due to inconsistent gap between mask and patient on P-CT and V-CT. Replan improved IMN dose for V9, V12, and V17. c A patient with increased gap between mask and skin on V-CTs compared to P-CT due to reduced CW tissue swelling, which caused lung and heart LDD. Replan improved lung and heart dose on V22. P-CT, planning computed tomography; V-CT, verification computed tomography; Vx, V-CT at fraction x; SCV, supraclavicular node; DVH, dose volume histogram; Rx: prescription; GyRBE, Relative-Biological-Effectiveness dose in Gray; IMN, internal mammary nodes; CW, chest wall; CTV, clinical volume; OAR, organ at risk; RP, replan; LDD, large dose deterioration