Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/28920
Title: A Prospective Trial Demonstrating the Benefit of Personalized Selection Of Breath-Hold Technique for Upper-Abdominal Radiation Therapy Using the Active Breathing Coordinator.
Austin Authors: Farrugia, Briana;Knight, Kellie;Wright, Caroline;Tacey, Mark A ;Foroudi, Farshad ;Chao, Michael ;Khor, Richard 
Affiliation: Olivia Newton-John Cancer Wellness and Research Centre
School of Molecular Sciences, La Trobe University, Melbourne, Australia..
Olivia Newton-John Cancer Research Institute
Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia..
Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia..
Radiation Oncology
Issue Date: 1-Dec-2021
Date: 2021
Publication information: International journal of radiation oncology, biology, physics 2021; 111(5): 1289-1297
Abstract: For upper abdominal tumors, our institutional-standard motion reduction method is the expiration breath-hold (EBH) technique, using Active Breathing Coordinator (ABC). However, an individual patient's breath-hold (BH) reproducibility (RBH) may be improved in deep inspiration or inspiration breath-hold (DIBH or IBH). This trial compared the tumor position RBH, stability (SBH), and breath-hold time (TBH) of 3 BH methods, using ABC, to personalize the selection of technique, by using a preplanning screening assessment. We invited patients planned for upper abdominal radiation therapy (kidney, pancreas, liver, or adrenal gland) to participate in this prospective trial. We conducted ABC education with the study participants, who then attempted EBH, DIBH, and IBH in randomized order. During 5 consecutive BH's for each method, we acquire kV fluoroscopy images of the diaphragm. We personalized the BH technique selection according to a decision matrix. We analyzed the EBH and the personalized technique cohort mean RBH and SBH. Between May 2019 and March 2020, we recruited 19 participants. Median age of participants was 68 years (range 32-81). Tumor sites included kidney (n = 1), adrenal gland (n = 5) and liver (n = 14). We excluded 1 participant due to poor BH compliance, leaving 270 images from 18 participants for analysis. Mean TBH was 22.1, 23.9, and 24.2 seconds for EBH, DIBH, and IBH respectively. Screening selected EBH for 44% (n = 8), IBH for 39% (n = 7), and DIBH for 17% (n = 3) of participants. The mean RBH was superior at 0.92 mm (0.79 mm SD) for the personalized technique, compared with EBH of 1.79 mm (1.49 mm SD) (P = .016). Preplanned subset analysis of participants whose personalized technique was not EBH showed improved mean RBH of 0.63 mm (0.29 mm SD) compared with their EBH RBH of 2.2 mm (1.7 mm SD) (P = .011). In 56% of participants, DIBH or IBH demonstrated superior RBH compared with EBH. Personalised BH screening can inform selection of an ABC BH method which provides optimal RBH with improved TBH for an individual's planning and treatment course.
URI: https://ahro.austin.org.au/austinjspui/handle/1/28920
DOI: 10.1016/j.ijrobp.2021.08.001
ORCID: 0000-0002-6152-2123
0000-0003-2948-8495
0000-0001-8387-0965
0000-0002-7057-2747
Journal: International journal of radiation oncology, biology, physics
PubMed URL: 34384855
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/34384855/
Type: Journal Article
Appears in Collections:Journal articles

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