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Feasibility Study: Auto-Triggered Consecutive-Short-Breath-Hold Control with ABC in Cancer Radiotherapy

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D Lee

D Lee*, J Lewis , S Kim , J Palta , T Kim , Virginia Commonwealth University, Richmond, VA


SU-I-GPD-T-80 (Sunday, July 30, 2017) 3:00 PM - 6:00 PM Room: Exhibit Hall

Purpose: Active Breathing Coordinator (ABC) is clinically used to control respiratory-related tumor motion and spare critical organs in gated radiotherapy. However, long breath-hold (~ 20 s) may cause patient discomfort and baseline shift, potentially causing unsatisfactory outcomes. To reduce breath-hold duration while maintaining the duty cycle, we proposed an auto-triggered consecutive short breath-hold integrated with ABC (cs-ABC). The proposed technique was compared with the conventional long ABC breath-hold (l-ABC) in terms of efficiency of breath-holds and the variation of lung volume.

Methods: The cs-ABC method was developed by utilizing the ABC display signal for lung volume data and visual guidance. In this feasibility study, one healthy volunteer with an ABC breath-hold threshold level at 1.5 l participated in 3 breath-hold sessions: two l-ABC sessions (10 breath-holds × 20 s) with verbal instruction and with visual guidance and a cs-ABC session with visual guidance (34 breath-holds × 6 s). l-ABC and cs-ABC were compared in terms of (1) efficiency of breath-holds assessed by measuring the total session time and (2) lung volume consistency during breath-holds. This study is ongoing for fifteen volunteers.

Results: Compared to l-ABC, cs-ABC improved the breath-hold efficiency by 33% from 600 s (Verbal l-ABC) to 400 s (Visual cs-ABC) and 20% from 500 s (Visual l-ABC) to 400 s (Visual cs-ABC). Compared to l-ABC, cs-ABC also improved the consistency of lung volume by 62% from 0.13 l (Verbal l-ABC) to 0.05 l (Visual cs-ABC) and 50% from 0.10 l (Verbal l-ABC) to 0.05 l (Visual cs-ABC).

Conclusion: This study demonstrated that an auto-triggered consecutive short ABC breath-hold can be utilized to improve the efficiency and consistency of breath-hold control in terms of lung volume and abdominal position, respectively. These results may provide a pathway to achieve more accurate cancer radiation treatment by utilizing the proposed breath-hold procedure.

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