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- Title
Quantifying the reduction of respiratory motion by mechanical ventilation with MRI for radiotherapy.
- Authors
van Kesteren, Z.; Veldman, J. K.; Parkes, M. J.; Stevens, M. F.; Balasupramaniam, P.; van den Aardweg, J. G.; van Tienhoven, G.; Bel, A.; van Dijk, I. W. E. M.
- Abstract
<bold>Background: </bold>Due to respiratory motion, accurate radiotherapy delivery to thoracic and abdominal tumors is challenging. We aimed to quantify the ability of mechanical ventilation to reduce respiratory motion, by measuring diaphragm motion magnitudes in the same volunteers during free breathing (FB), mechanically regularized breathing (RB) at 22 breaths per minute (brpm), variation in mean diaphragm position across multiple deep inspiration breath-holds (DIBH) and diaphragm drift during single prolonged breath-holds (PBH) in two MRI sessions.<bold>Methods: </bold>In two sessions, MRIs were acquired from fifteen healthy volunteers who were trained to be mechanically ventilated non-invasively We measured diaphragm motion amplitudes during FB and RB, the inter-quartile range (IQR) of the variation in average diaphragm position from one measurement over five consecutive DIBHs, and diaphragm cranial drift velocities during single PBHs from inhalation (PIBH) and exhalation (PEBH) breath-holds.<bold>Results: </bold>RB significantly reduced the respiratory motion amplitude by 39%, from median (range) 20.9 (10.6-41.9) mm during FB to 12.8 (6.2-23.8) mm. The median IQR for variation in average diaphragm position over multiple DIBHs was 4.2 (1.0-23.6) mm. During single PIBHs with a median duration of 7.1 (2.0-11.1) minutes, the median diaphragm cranial drift velocity was 3.0 (0.4-6.5) mm/minute. For PEBH, the median duration was 5.8 (1.8-10.2) minutes with 4.4 (1.8-15.1) mm/minute diaphragm drift velocity.<bold>Conclusions: </bold>Regularized breathing at a frequency of 22 brpm resulted in significantly smaller diaphragm motion amplitudes compared to free breathing. This would enable smaller treatment volumes in radiotherapy. Furthermore, prolonged breath-holding from inhalation and exhalation with median durations of six to seven minutes are feasible.<bold>Trial Registration: </bold>Medical Ethics Committee protocol NL.64693.018.18.
- Subjects
COMPUTERS in medicine; LUNGS; MAGNETIC resonance imaging; ARTIFICIAL respiration; RESEARCH funding; RESPIRATION; RADIOTHERAPY; BREATH holding
- Publication
Radiation Oncology, 2022, Vol 17, Issue 1, p1
- ISSN
1748-717X
- Publication type
journal article
- DOI
10.1186/s13014-022-02068-5