Clinicians at Chinese medical center harness Active Breathing Coordinator and MotionView intrafraction monitoring to help spare organs-at-risk

本附属医院的放射治疗部 - 西安交通大学（陕西西安，陕西，中国）最近采用了先进的ELEKTA解决方案，可用于治疗左侧乳腺癌的呼吸和实时图像引导技术。bob体育网赌对于一些具有大呼吸运动振幅的患者，乳腺肿瘤可在呼吸循环期间具有显着的运动，这可以显着影响放射疗法的精度。管理这种呼吸运动以减少治疗期间对肿瘤位置的影响至关重要。

FAH-XJTU’s combined use of a moderate deep inspiration breath-hold (mDIBH) technique using Elekta’s Active Breathing Coordinator™ (ABC) and MotionView™ intra-fraction image guidance has created new opportunities for people with breast cancer in northwest China.

Moderate deep inspiration breath-hold

MDIBH技术用于治疗左侧乳腺癌以控制由呼吸运动引起的肿瘤运动。bob体育网赌该方法要求患者吸入某个阈值水平，然后在该水平上呼吸呼吸以进行成像，定位和治疗。根据每个患者的情况和能力来设定这种灵感阈值。

“ABC帮助患者在治疗过程中舒适地保持呼吸持有，帮助保持乳腺肿瘤几乎静止。”

“ABC helps patients comfortably maintain a breath-hold during beam delivery, helping keep the breast tumor almost static,” says FAH-XJTU Chief Physician Zhang Xiaozhi, MD. “The deep inspiration expands the thorax, increasing the distance between the breast and the heart. In this way, we can maximize the dose to the target, while protecting the surrounding normal tissues and critical structures. It has been reported that the average dose to the heart can be reduced by up to 62 percent and dose to the lung can also be decreased significantly.”¹

他补充说，在治疗过程中采用MotientView实时图像引导技术进一步确保了准确的剂量递送给目标。

主动呼吸协调员工作流程

ABC用于监测气流并跟踪患者的呼吸运动，将屏幕显示为曲线。在设置适当的吸入阈值后，患者准备好呼吸保持时按下按钮。操作员按下控制按钮，当患者吸入预设值时，空气阀被激活以关闭。

“这有助于患者屏住呼吸并确保他们的肺部量不会改变，”副主任医师副主任医师王淑文说。“Elekta的响应选通接口将信号发送到LINAC，其激活辐射束。当呼吸结束时，患者将其指关按钮，辐射束停止，阀门打开，患者可以再次自由呼吸。该过程在每个分数期间重复，直至所需的剂量递送。“

治疗左乳腺粘膜腺癌

Fah-XJTU临床医生对左侧乳腺粘液腺癌的48岁患者。哺乳手术后，临床医生决定使用MDIBH技术来对待她。

Before simulation, the patient received training on ABC to allow her to practice breathing and breath-holds, then her maximum tidal volume and breath-hold time were recorded.

FAH-XJTU Attending Physician Hui Beina, MD, used the CT images to contour the target and healthy organs. The prescribed dose was 50 Gy to the PTV and 60 Gy to the P-GTV, delivered over 25 fractions. A 6 MV High Dose Rate mode IMRT treatment plan was calculated using摩纳哥^®5.11.

在处理前，使用ABC精确地定位患者在处理表上，获得快速的XVI CBCT扫描，以确保处理加强物和计划的靶等离子化。在必要的矫正之后，患者准备好在Fah-XJTU上进行处理Versa HD™ system。

During treatment, department staff instructed the patient to push the ABC enable button. When the patient inhaled, the ABC curve on screen changed from red to green. The operator pressed the space bar and the threshold volume was displayed. When the patient inhaled to that value, the ABC control system became active to assist the patient’s breath-hold, which kept the patient’s organs stationary. Treatment delivery began during the breath-hold, with gating facilitated using the Response gating interface. During treatment, MotionView monitored the real-time movement of organs, such as the breast, thorax, diaphragm and heart. Apart from the heartbeat, there were no obvious anatomical changes, ensuring treatment accuracy.

肺部体积与米德比亚和自由呼吸计划中健康解剖学的比较。

Mdibh使用活跃呼吸协调员的优点

Elekta Active Breathing Coordinator was used successfully to manage respiratory movement and enhance treatment accuracy during left-sided breast radiotherapy, according to Dr. Xiaozhi.

“mDIBH技术也提供了重要的国际广播电台tical structure sparing during treatment, reducing dose to the left lung and heart,” he says. “At the same time, MotionView intrafraction image guidance technology enabled real-time monitoring of tumor and organ motion, which further enhanced our assurance of treatment accuracy. This technology offers similar benefits to a wide range of patients whose tumors are affected by respiratory movement.”

自第一Versa HD在Fah-XJTU开始治疗患者，放疗部门参与了研究和理解其不同的临床功能。先进的放疗设备和最新的相关技术的组合促进了精密放射医学的交付，帮助医院实现了最佳的临床目的，并确保了在西北地区患者的优质癌症治疗方法。bob体育网赌

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1. Eldredge-Hindy, H. et al (2015) Active Breathing Coordinator reduces radiation dose to the heart and preserves local control in patients with left breast cancer: Report of a prospective trial. Practical Radiation Oncology 5(1): 4-10