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Purpose <p>This study aimed to evaluate the clinical feasibility and efficacy of a&#xa0;novel abdominal compression airbag (ACA) for respiratory motion management and setup reproducibility in upper abdominal radiotherapy and to compare its performance against free breathing (FB) and the standard abdominal compression plate (ACP).</p> Methods <p>A&#xa0;total of 54&#xa0;patients with upper abdominal malignancies were retrospectively analyzed in three groups based on the FB, ACP, and ACA motion management strategies. Respiratory motion amplitude was quantified by calculating the displacement of the liver centroid between the 0% and 50% phases of four-dimensional CT scans. Interfractional setup reproducibility was assessed by analyzing setup errors derived from pretreatment cone-beam CT (CBCT) scans. Statistical comparisons for the respiratory motion amplitude were performed using the Kruskal–Wallis test followed by Dunn’s post-hoc test. The analysis of setup stability utilized a&#xa0;linear mixed-effects model.</p> Results <p>Both ACP and ACA significantly attenuated respiratory motion compared to FB (<i>p</i> &lt; 0.001). The mean vectorial motion amplitudes were 0.88 ± 0.20 cm, 0.61 ± 0.24 cm, and 0.57 ± 0.19 cm for the FB, ACP, and ACA groups, respectively. No significant difference in motion restriction was found between ACA and ACP. In terms of setup reproducibility, the ACA group demonstrated superior stability in the anterior–posterior direction, with the lowest mean absolute error (0.15 ± 0.11 cm), but exhibited larger errors in the left–right direction (0.32 ± 0.22 cm) compared to both FB (0.18 ± 0.15 cm) and ACP (0.19 ± 0.15 cm).</p> Conclusion <p>The ACA achieved a&#xa0;motion restriction performance comparable to the standard ACP, but it was associated with increased uncertainty in the left–right direction. The ACA could serve as a&#xa0;practical alternative with potential workflow and compatibility advantages, preferably coupled with robust image-guided verification to maintain setup stability.</p>

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Evaluation of a novel abdominal compression airbag for respiratory motion management and setup reproducibility in upper abdominal radiotherapy

  • 期刊论文

  • 发表日期：

    2026年7月24日

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  • Yinghua Shi,
  • Huidong Wang,
  • Lijuan Ding,
  • Minghui Sun,
  • Peilin Li,
  • Wei Hou,
  • Yu Li,
  • Yan Gao,
  • Wuji Sun

摘要

Purpose

This study aimed to evaluate the clinical feasibility and efficacy of a novel abdominal compression airbag (ACA) for respiratory motion management and setup reproducibility in upper abdominal radiotherapy and to compare its performance against free breathing (FB) and the standard abdominal compression plate (ACP).

Methods

A total of 54 patients with upper abdominal malignancies were retrospectively analyzed in three groups based on the FB, ACP, and ACA motion management strategies. Respiratory motion amplitude was quantified by calculating the displacement of the liver centroid between the 0% and 50% phases of four-dimensional CT scans. Interfractional setup reproducibility was assessed by analyzing setup errors derived from pretreatment cone-beam CT (CBCT) scans. Statistical comparisons for the respiratory motion amplitude were performed using the Kruskal–Wallis test followed by Dunn’s post-hoc test. The analysis of setup stability utilized a linear mixed-effects model.

Results

Both ACP and ACA significantly attenuated respiratory motion compared to FB (p < 0.001). The mean vectorial motion amplitudes were 0.88 ± 0.20 cm, 0.61 ± 0.24 cm, and 0.57 ± 0.19 cm for the FB, ACP, and ACA groups, respectively. No significant difference in motion restriction was found between ACA and ACP. In terms of setup reproducibility, the ACA group demonstrated superior stability in the anterior–posterior direction, with the lowest mean absolute error (0.15 ± 0.11 cm), but exhibited larger errors in the left–right direction (0.32 ± 0.22 cm) compared to both FB (0.18 ± 0.15 cm) and ACP (0.19 ± 0.15 cm).

Conclusion

The ACA achieved a motion restriction performance comparable to the standard ACP, but it was associated with increased uncertainty in the left–right direction. The ACA could serve as a practical alternative with potential workflow and compatibility advantages, preferably coupled with robust image-guided verification to maintain setup stability.