MRI Only Radiation Therapy With CPAP
The goal of this imaging study is to evaluate and improve the treatment planning techniques for abdominal radiation therapy. To accurately treat a tumor with radiation, Computed Tomography (CT) and Magnetic Resonance Images (MRI) are used to distinguish a tumor from normal, healthy tissue. However the quality of these images can be distorted by motion from breathing. To decrease motion, a patient may be asked to hold their breath or compress the abdomen, but currently there is no standard or best management option for all patients. This study will explore the use continuous positive airway pressure (CPAP), a pressurized breathing mask, during MRI or CT imaging to decrease motion in the abdomen and produce higher quality images. With these additional images, we will also explore the feasibility of creating treatment plans using the CPAP MRI images alone.
- Carcinoma Liver
- Carcinoma, Pancreatic
- Eligible Ages
- Over 18 Years
- Eligible Genders
- Accepts Healthy Volunteers
- Patients have liver or pancreas tumors (either primary tumors or metastases) and are scheduled to be treated with radiotherapy (either 3D conformal or intensity-modulation radiotherapy (IMRT) with conventional or hypo- fractionation).
- KPS > 70
- If a biopsy is performed, the patient is at least 1 week post-biopsy.
- The patient's age must exceed 18 years.
- The patients must be able to commit to T1-weighted, T2-weighted, Dixon fat and water, ultrashort-TE, and other clinical or research MR sequence images prior to treatment.
- CPAP Eligibility: CPAP is a safe, effective form of therapy with rare complications. Relative contraindications include patients with bullous lung disease, fibrotic lung disease, Claustrophobia and recurrent sinus or ear infections. The absolute contraindications include obtundation /unconsciousness, chest wall trauma, suspected pneumothorax, persistent nausea/vomiting, active upper GI bleeding, history of recent gastric surgery, facial anomalies/trauma [15,16]. If there is any question about the above history and medical problems, the subject will be referred to a pulmonologist for consultation.
- The patients with above contraindications are not CPAP eligible and are enrolled in Arm 1 for the protocol without CPAP
- The eligible patients are enrolled in Arm 2 for the protocol with CPAP.
- Any medical condition, which would make the imaging studies unsafe or poorly tolerated
- Known allergic reaction to contrast or shellfish
- Implanted metal devices or foreign bodies that serve as a contraindication to MR imaging
- Creatinine > 1.4 mg/dl and Creatinine clearance < 20 mg/dl.
- Uncontrolled, clinically significant cardiac arrhythmias
- Severe claustrophobia
- Pregnant female
- KPS <70
- Study Type
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Supportive Care
- None (Open Label)
standard breath hold
- Albert Einstein College of Medicine
Study ContactAlyssa Asaro