Application of Continuous Positive Airway Pressure for Thoracic Respiratory Motion Management: An Assessment in a Magnetic Resonance Imaging-Guided Radiation Therapy Environment.
Application of Continuous Positive Airway Pressure for Thoracic Respiratory Motion Management: An Assessment in a Magnetic Resonance Imaging-Guided Radiation Therapy Environment.
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DOI：
10.1016/j.adro.2021.100889
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发表时间：
2022-05
影响因子：
2.3
通讯作者：
Glide-Hurst CK
中科院分区：
文献类型：
--
作者：
Liang E;Dolan JL;Morris ED;Vono J;Bazan LF;Lu M;Glide-Hurst CK
患者对磁共振（MR）引导的放射治疗输送的耐受性受到重复深吸气屏气（DIBH）需求的限制。这项志愿者研究评估了在使用MR直线加速器（MR直线加速器）进行放射治疗期间，使用和不使用DIBH的持续气道正压通气（CPAP）进行呼吸运动管理的可行性。首先通过将CPAP器械放置在MR安全柜中并通过波导管将管路配置到磁体孔来解决MR成像安全性问题。评估了最终构型的重现性和线性。6名健康志愿者在0.35T磁共振直线加速器中进行胸部成像，在0至15 cm-H2O的5种压力下获得1次自由呼吸（FB）和2次DIBH采集。记录肺和心脏体积和位置;通过比较2次连续DIBH扫描来评估可重复性。设盲审查员使用3分制分级量表对图像的运动伪影进行分级。参与者在成像会议之前和之后完成了舒适度和感知调查。与单独FB相比，FB-10、FB-12和FB-15 cm H2O显著增加肺容积（+23%，34%，44%;均P <0.05），并使心脏移位（0.86 cm，0.96 cm，1.18 cm;均P <0.05）。05）。与FB-15 cm H2O相比，DIBH-0 cm H2O的肺体积显著更大（+105% vs +44%，P = .01），DIBH-15 cm H2O产生额外的体积增加（+131% vs +105%，P = .01）。在DIBH中添加CPAP可降低连续屏气之间的肺容量差异（15 cm H2O时相关系数为0.97，0 cm H2O时相关系数为0.00）。与FB相比，增加15 cm H2O CPAP降低了伪影评分（P = .03）;所有DIBH图像（0-15 cm H2O）的伪影较少（P < .01）。这项工作证明了在健康志愿者的MR直线加速器环境中集成CPAP的可行性。将这项工作扩展到更大的患者队列是必要的，以进一步确定CPAP作为MR引导放射治疗中DIBH的替代和并发方法的作用。
Patient tolerability of magnetic resonance (MR)–guided radiation treatment delivery is limited by the need for repeated deep inspiratory breath holds (DIBHs). This volunteer study assessed the feasibility of continuous positive airway pressure (CPAP) with and without DIBH for respiratory motion management during radiation treatment with an MR-linear accelerator (MR-linac). MR imaging safety was first addressed by placing the CPAP device in an MR-safe closet and configuring a tube circuit via waveguide to the magnet bore. Reproducibility and linearity of the final configuration were assessed. Six healthy volunteers underwent thoracic imaging in a 0.35T MR-linac, with one free breathing (FB) and 2 DIBH acquisitions being obtained at 5 pressures from 0 to 15 cm-H2O. Lung and heart volumes and positions were recorded; repeatability was assessed by comparing 2 consecutive DIBH scans. Blinded reviewers graded images for motion artifact using a 3-point grading scale. Participants completed comfort and perception surveys before and after imaging sessions. Compared with FB alone, FB-10, FB-12, and FB-15 cm H2O significantly increased lung volumes (+23%, +34%, +44%; all P <.05) and inferiorly displaced the heart (0.86 cm, 0.96 cm, 1.18 cm; all P < . 05). Lung volumes were significantly greater with DIBH-0 cm H2O compared with FB-15 cm H2O (+105% vs +44%, P = .01), and DIBH-15 cm H2O yielded additional volume increase (+131% vs +105%, P = .01). Adding CPAP to DIBH decreased lung volume differences between consecutive breath holds (correlation coefficient 0.97 at 15 cm H2O vs 0.00 at 0 cm H2O). The addition of 15 cm H2O CPAP reduced artifact scores (P = .03) compared with FB; all DIBH images (0-15 cm H2O) had less artifact (P < .01). This work demonstrates the feasibility of integrating CPAP in an MR-linac environment in healthy volunteers. Extending this work to a larger patient cohort is warranted to further establish the role of CPAP as an alternative and concurrent approach to DIBH in MR-guided radiation therapy.
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影响因子：
5.7
作者：
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