PMID- 35597956
OWN - NLM
STAT- MEDLINE
DCOM- 20220524
LR  - 20220716
IS  - 1748-717X (Electronic)
IS  - 1748-717X (Linking)
VI  - 17
IP  - 1
DP  - 2022 May 21
TI  - Quantifying the reduction of respiratory motion by mechanical ventilation with 
      MRI for radiotherapy.
PG  - 99
LID - 10.1186/s13014-022-02068-5 [doi]
LID - 99
AB  - BACKGROUND: 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. 
      METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. TRIAL REGISTRATION: Medical 
      Ethics Committee protocol NL.64693.018.18.
CI  - (c) 2022. The Author(s).
FAU - van Kesteren, Z
AU  - van Kesteren Z
AD  - Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, 
      Meibergdreef 9, Amsterdam, The Netherlands. z.vankesteren@amsterdamumc.nl.
FAU - Veldman, J K
AU  - Veldman JK
AD  - Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, 
      Meibergdreef 9, Amsterdam, The Netherlands.
FAU - Parkes, M J
AU  - Parkes MJ
AD  - Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, 
      Meibergdreef 9, Amsterdam, The Netherlands.
FAU - Stevens, M F
AU  - Stevens MF
AD  - Department of Anesthesiology, Amsterdam UMC Location University of Amsterdam, 
      Meibergdreef 9, Amsterdam, The Netherlands.
AD  - Department of Anesthesiology, Amsterdam UMC Location Vrije Universiteit 
      Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
FAU - Balasupramaniam, P
AU  - Balasupramaniam P
AD  - Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, 
      Meibergdreef 9, Amsterdam, The Netherlands.
FAU - van den Aardweg, J G
AU  - van den Aardweg JG
AD  - Department of Pulmonology, Amsterdam UMC Location University of Amsterdam, 
      Meibergdreef 9, Amsterdam, The Netherlands.
FAU - van Tienhoven, G
AU  - van Tienhoven G
AD  - Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, 
      Meibergdreef 9, Amsterdam, The Netherlands.
FAU - Bel, A
AU  - Bel A
AD  - Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, 
      Meibergdreef 9, Amsterdam, The Netherlands.
FAU - van Dijk, I W E M
AU  - van Dijk IWEM
AD  - Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, 
      Meibergdreef 9, Amsterdam, The Netherlands.
LA  - eng
GR  - 12900/KWF Kankerbestrijding/
GR  - 894619/H2020 Marie Sklodowska-Curie Actions/
PT  - Journal Article
DEP - 20220521
PL  - England
TA  - Radiat Oncol
JT  - Radiation oncology (London, England)
JID - 101265111
SB  - IM
EIN - Radiat Oncol. 2022 Jun 28;17(1):113. PMID: 35765010
MH  - Breath Holding
MH  - Humans
MH  - Lung
MH  - Magnetic Resonance Imaging/methods
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - *Respiration
MH  - *Respiration, Artificial
PMC - PMC9123684
OTO - NOTNLM
OT  - Breathing control
OT  - MRI
OT  - Mechanical ventilation
OT  - Radiotherapy
OT  - Respiratory motion
COIS- AB is involved in several collaboration projects with Elekta AB, Stockholm, 
      Sweden and Varian, Palo Alto, USA, outside of this work. ZK is collaborating in 
      research of several Varian and Philips Healthcare sponsored projects outside of 
      this work. These companies had no involvement in study design, data collection 
      and analysis, or writing of the manuscript. The other authors have no relevant 
      conflicts of interest to disclose.
EDAT- 2022/05/22 06:00
MHDA- 2022/05/25 06:00
PMCR- 2022/05/21
CRDT- 2022/05/21 23:36
PHST- 2022/02/16 00:00 [received]
PHST- 2022/05/12 00:00 [accepted]
PHST- 2022/05/21 23:36 [entrez]
PHST- 2022/05/22 06:00 [pubmed]
PHST- 2022/05/25 06:00 [medline]
PHST- 2022/05/21 00:00 [pmc-release]
AID - 10.1186/s13014-022-02068-5 [pii]
AID - 2068 [pii]
AID - 10.1186/s13014-022-02068-5 [doi]
PST - epublish
SO  - Radiat Oncol. 2022 May 21;17(1):99. doi: 10.1186/s13014-022-02068-5.