Cardiac activity can induce dose–volume evaluation errors for cardiac structures. The purpose of this study was to quantify the variation in dose–volume parameters for the heart, pericardium and left ventricular myocardium (LVM) throughout the cardiac circle. The heart, pericardium and LVM of 22 patients were contoured on 20 phases of electrocardiography-gated 4D computed tomography (4DCT) images acquired during breath-hold. Radiotherapy plans were designed on 0% phase of the 4DCT images, and the dose distributions of the plans were imported ...
