title: Abdominal organ motion during inhalation and exhalation breath-holds: pancreatic motion at different lung volumes compared.
abstract: Contrary to what is commonly assumed, organs continue to move during breath-holding. We investigated the influence of lung volume on motion magnitude during breath-holding and changes in velocity over the duration of breath-holding.
  
  
  
  Sixteen healthy subjects performed 60-second inhalation breath-holds in room-air, with lung volumes of ∼100% and ∼70% of the inspiratory capacity, and exhalation breath-holds, with lung volumes of ∼30% and ∼0% of the inspiratory capacity. During breath-holding, we obtained dynamic single-slice magnetic-resonance images with a time-resolution of 0.6s. We used 2-dimensional image correlation to obtain the diaphragmatic and pancreatic velocity and displacement during breath-holding.
  
  
  
  Organ velocity was largest in the inferior-superior direction and was greatest during the first 10s of breath-holding, with diaphragm velocities of 0.41mm/s, 0.29mm/s, 0.16mm/s and 0.15mm/s during BH100%, BH70%, BH30%and BH0%, respectively. Organ motion magnitudes were larger during inhalation breath-holds (diaphragm moved 9.8 and 9.0mm during BH100%and BH70%, respectively) than during exhalation breath-holds (5.6 and 4.3mm during BH30%and BH0%, respectively).
  
  
  
  Using exhalation breath-holds rather than inhalation breath-holds and delaying irradiation until after the first 10s of breath-holding may be advantageous for irradiation of abdominal tumors.
authors: Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, The Netherlands. Electronic address: e.lens@amc.uva.nl.
authors: Eelco
authors: E
authors: Lens
authors: Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, The Netherlands; Department of Radiology, Academic Medical Center/University of Amsterdam, The Netherlands.
authors: Oliver J
authors: OJ
authors: Gurney-Champion
authors: Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, The Netherlands.
authors: Daniël R
authors: DR
authors: Tekelenburg
authors: Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, The Netherlands.
authors: Zdenko
authors: Z
authors: van Kesteren
authors: School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, UK; National Institute for Health Research (NIHR)/Wellcome Trust Birmingham Clinical Research Facility, University Hospitals Birmingham NHS Foundation Trust, UK.
authors: Michael J
authors: MJ
authors: Parkes
authors: Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, The Netherlands.
authors: Geertjan
authors: G
authors: van Tienhoven
authors: Department of Radiology, Academic Medical Center/University of Amsterdam, The Netherlands.
authors: Aart J
authors: AJ
authors: Nederveen
authors: Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, The Netherlands.
authors: Astrid
authors: A
authors: van der Horst
authors: Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, The Netherlands.
authors: Arjan
authors: A
authors: Bel
mesh_terms: D000328:Adult; D062485:Breath Holding; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000502:physiology; D045853:Exhalation / Q000502:physiology; D005260:Female; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D008168:Lung / Q000000981:diagnostic imaging / Q000502:physiology*; D008176:Lung Volume Measurements / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009068:Movement / Q000502:physiology*; D010179:Pancreas / Q000000981:diagnostic imaging / Q000502:physiology*
keywords: Breath-hold; MRI; Motion; Radiotherapy; Upper-abdomen