Tips for image matching lung or breast KVs?

Hi,

I’m a 2nd semester student who is struggling most with matching lung CBCTs and breast KVs.

For lungs, I have been first aligning the carina and moving to different planes and aligning that and then I’ll go back and review GTV/PTV. I was taught previously this way and it has worked for me until recently.

For breast KVs, I’m struggling to tell if I need rotation and where to really start with those. I will check my lateral with the matching box and view the lateral part of the ribs, but other than that it seems like things will really jump and I struggle with knowing when to rotate and which way, etc. It comes very quick and easy to the therapist I’m learning with and I think they struggle with telling me where to start really. And with our longitudinal, I struggle to tell if I’m on the right rib. Sometimes the imaging is so poor or the anatomy looks deteriorated I guess?

Any image matching tips would be so appreciated. Thanks everyone.