MedPath

Impact of Continuous Positive Airway Pressure on Breathing Motion Amplitude

Early Phase 1
Completed
Conditions
Cancer
Interventions
Other: Continuous Positive Airway Pressure
Registration Number
NCT02852473
Lead Sponsor
Mayo Clinic
Brief Summary

This study involves a breathing motion assessment in healthy subjects before and after continuous positive airway pressure (CPAP) administration using MRI images.

The hypothesis for this study is that CPAP administration will significantly reduce breathing motion. This may help cancer patients who are undergoing proton radiotherapy, so they possibly will not have to hold their breath during the procedure.

Detailed Description

Minimally invasive techniques for tumor motion reduction that involve free-breathing patients have significant relevance in the context of radiation therapy, in particular proton radiotherapy. Tumor motion reduction has favorable implications for reduction of radiation doses to adjacent healthy organs, radiation plan robustness (accuracy/quality) and for treatment efficiency (reduction of treatment times). Using non-ionizing MRI with volunteers, the investigators will determine the extent to which continuous positive airway pressure (CPAP) reduces breathing motion (diaphragmatic excursion). The researchers will also investigate the parameter space associated with breathing motion reduction versus the amount of pressure applied, as well as timing of initiation of CPAP in relation to the imaging time point (to address whether an initial transient breathing state exists).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria
  1. Healthy adult female and males
  2. Subject meets routine MRI safety criteria
Exclusion Criteria
  1. Age <18
  2. Known history of chronic obstructive pulmonary disease (COPD), asthma, or other chronic pulmonary illness
  3. Pregnancy
  4. Any safety risk identified via MRI safety screening

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Continuous Positive Airway PressureContinuous Positive Airway PressureContinuous Positive Airway Pressure (CPAP) will be administered using FDA-approved equipment.
Primary Outcome Measures
NameTimeMethod
Change in Breathing Motion Characteristics at High CPAP SettingData acquisition for this portion of the study will require approximately 30 minutes.

Breathing motion at baseline and at initial (higher but tolerable) CPAP settings will be characterized using fast multi-slice, multi-phase 2D gradient-echo or spin-echo MRI sequences in the sagittal or coronal imaging planes over a large field of view covering the thoracic and upper-abdominal region. Specifically "4D-MRI" (or time-resolved MRI) will be generated from retrospective sorting of multi-slice 2D MRI. For these analyses, anatomic reference points (e.g., bright vessels) in multiple organ systems will be identified on the images, contoured or segmented; subsequently 3D motion patterns will be extracted for all anatomical references/features. Numerical simulations will be performed to determine hypothetical radiation target volume changes (cm\^3) at these anatomic locations assuming spherical tumors with a given set of tumor diameters (cm).

Secondary Outcome Measures
NameTimeMethod
Change in Breathing Motion Characteristics at Lower CPAP SettingApproximately 45 minutes into visit.

Time permitting, the CPAP setting will be reduced to approximately half of the nominal/tolerable/high CPAP setting. Using the same MRI sequences and retrospective sorting technique, 4D-MRI will be generated for this lower CPAP setting. Analogous motion characterization analyses (to outcome measure 1) will be carried out for the lower CPAP setting (relative to baseline 4D-MRI).

Trial Locations

Locations (1)

Mayo Clinic in Rochester

🇺🇸

Rochester, Minnesota, United States

© Copyright 2025. All Rights Reserved by MedPath