Single Percussive Ventilation Breath-hold Imaging and Delivery in Lung Tumor Stereotactic Ablative Radiation Therapy: Initial Observations From a Prospective Clinical Trial.

Authors

Wilson X Mai, Kelly Z Huang, Joyce Kuo, Eefay Wang, Samantha Wong, Alyssa Yauger, Joshua Langer, Dwayne Free, Pilu Gebeyehu, Anoushka Kathiravan, Aneesh Swamy, Kevin Z Flores, Sarah Merrill, Danelia Sianez-Torres, Anthony Kokinos, Angela Pranoto, Onne Lao, Thomas Guerrero, Harmeet Bedi, Marina Sala, Jean Bourhis, André Durham, Lawrie Skinner, Lucas K Vitzthum, Noah Kastelowitz, Alexander Chin, Maximilian Diehn, Billy W Loo, Erik S Blomain

Published in

International journal of radiation oncology, biology, physics. Jul 02, 2026. Epub Jul 02, 2026.

Abstract

Tumor motion during respiration presents a challenge in delivering high-precision stereotactic ablative radiation therapy (SABR) for lung cancer. While inspiratory breath-hold techniques can minimize motion, they are often limited by the patients' ability to sustain prolonged breath-holds and the variability that comes with repeat breath-holds. We present the first-in-human demonstration of the feasibility and safety of percussive ventilation breath-hold (PVB) to eliminate the uncertainty of breath-hold reproducibility between confirmatory volumetric image guidance and delivery of lung tumor SABR by completing both within the same assisted breath-hold. Here, we report that 4 patients were successfully treated as initial observations from a prospective clinical trial of PVB-SABR.
Four patients with lung tumors were treated in a prospective, institutional review board-approved study in which they underwent an education and evaluation session to assess their tolerance for PVB, followed by treatment with PVB-SABR.
All 4 patients successfully completed PVB-SABR. The mean PVB duration per fraction from the beginning of the final cone beam computed tomography image verification to the end of SABR delivery was 6 minutes 56 seconds in a single PVB. Within that time, the mean delivery time per fraction was 2 minutes 22 seconds and the mean duty cycle was 93.5%.
These initial observations in a first prospective trial of PVB-SABR demonstrate the feasibility of PVB to enable completion of SABR delivery within the same effective breath-hold as confirmatory volumetric imaging, eliminating the uncertainty of interbreath-hold reproducibility.

PMID:
42397316
Bibliographic data and abstract were imported from PubMed on 03 Jul 2026.

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