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Audiovisual Biofeedback Guided Respiratory-Gated MRI: An Investigation of Tumor Definition and Scan Time for Lung Cancer

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D Lee

D Lee1*, P Greer2, C Lapuz2, J Ludbrook2, S Pollock1, T Kim3, P Keall1, (1) University of Sydney, Sydney, NSW, ,(2) Calvary Mater Newcastle, Newcastle, NSW, ,(3) Virginia Commonwealth University, Glen Allen, VA,


MO-FG-CAMPUS-JeP2-2 (Monday, August 1, 2016) 5:00 PM - 5:30 PM Room: ePoster Theater

Purpose: Breathing consistency variations can cause respiratory-related motion blurring and artifacts, and increase in MRI scan time due to inadequate respiratory-gating and discarding of breathing cycles. In a previous study, the concept of audiovisual biofeedback (AV) guided respiratory-gated MRI was tested with healthy volunteers and it demonstrated image quality improvement on anatomical structures and scan time reduction. This study tests the applicability of AV-guided respiratory-gated MRI for lung cancer in a prospective patient study.
Methods: Image quality and scan time were investigated in thirteen lung cancer patients who underwent two 3T MRI sessions. In the first MRI session (pre-treatment), respiratory-gated MR images with free breathing (FB) and AV were acquired at inhalation and exhalation. An RF navigator placed on the liver dome was employed for the respiratory-gated MRI. This was repeated in the second MRI session (mid-treatment). Lung tumors were delineated on each dataset. FB and AV were compared in terms of (1) tumor definition assessed by lung tumor contours and (2) intra-patient scan time variation using the total image acquisition time of inhalation and exhalation datasets from the first and second MRI sessions across 13 lung cancer patients.
Results: Compared to FB, AV-guided respiratory-gated MRI improved image quality for contouring tumors, with sharper boundaries and less blurring, resulted in the improvement of tumor definition. Compared to FB, the variation of intra-patient scan time with AV was reduced by 48% (p<0.001) from 54 s to 28 s.
Conclusion: This study demonstrated that AV-guided respiratory-gated MRI improved the quality of tumor images and fixed tumor definition for lung cancer. These results suggest that audiovisual biofeedback breathing guidance has the potential to control breathing for adequate respiratory-gating for lung cancer imaging and radiotherapy.

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