Retrospective studies indicate that radiation damage to left anterior descending coronary artery (LAD) may be critical for late-stage radiation-induced cardiac morbidity. Developing a method that accurately depicts LAD motion and perform dose assessment is crucial. To construct a generalized cardiac surface motion model for LAD dose assessment in left breast cancer radiotherapy. Cine MRI of 25 cases were divided into training and testing sets for model construction, and five external cases were gathered for generalization validation. Motion prediction from average intensity projection images (AIP) surface point cloud to that of each phase was realized by mapping the relationship between datum points and corresponding points with statistical shape modeling (SSM). Root mean square error (RMSE) for predicted corresponding points and Euclidean distance (ED) for predicted surface point cloud were used to assess model's accuracy. LAD dose assessment for 10 left breast cancer radiotherapy cases was perform by model application. The RMSE in testing cases and external cases were 0.209±0.020mm to 0.841±0.074mm and 0.895±0.093mm to 1.912±0.138mm, respectively; while the ED were 1.399±0.029mm to 1.658±0.100mm, 1.571±0.080mm to 1.779±0.104mm, respectively, proving the generalized model's high accuracy. The volume of LAD characterizing motion range (WPLAD) (2.392±0.639 cm3) was approximately twice that of LAD from superimposed images (SPLAD) (0.927±0.326 cm3) with p<0.05, and the former's Dmax (3582.06±575.92 cGy) was significantly larger than latter's (3222.71±665.37 cGy) (p<0.05). While WPLAD's Dmean (1408.06±413.06 cGy) was slightly smaller than that of SPLAD (1504.15±448.03 cGy), the difference did not reach statistical significance (p>0.05). WPLAD's V20 (23.42%±16.62%) was less than SPLAD's (29.18%±21.07%) with p<0.05, but their comparison in V30 and V40 did not yield statistically significant results. It implies the conventional LAD dose assessment ignores motion impact and may not be justified. The generalized cardiac surface motion model informs LAD dose accurate assessment in left breast cancer radiotherapy.
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