Radiotherapy motion management using a CPAP device

  • Research type

    Research Study

  • Full title

    A proof-of-principle imaging study using Magnetic Resonance Imaging (MRI) to investigate patient compliance and comfort using a Continuous Positive Air Pressure (CPAP) device as a motion management technique

  • IRAS ID

    268920

  • Contact name

    Marianne Aznar

  • Contact email

    marianne.aznar@manchester.ac.uk

  • Sponsor organisation

    The University of Manchester

  • Duration of Study in the UK

    0 years, 5 months, 30 days

  • Research summary

    Background/importance – During normal breathing, the lungs and chest of the body move, leading to artefacts in magnetic resonance imaging (MRI) scans as consecutive images occur at differing phases of the breathing cycle. This results in errors in measurement of the size, shape, location and volume of the tumour, which has huge implications during radiotherapy delivery. Therefore there is a significant need to test methods to reduce breathing motion to enable use to more accurately see the tumour and therefore increase the accuracy of radiotherapy dose delivery.\n\nPurpose of study - This study will investigate patient comfort and compliance of using a CPAP machine (commonly used to treat sleep apnoea) while undergoing an imaging MRI scan to see whether use of the CPAP machine can reduce chest movement and therefore improve scan quality. \n\nStudy design - We will recruit 10 early stage lung cancer patients at the Christie Hospital undergoing stereotactic ablative radiotherapy (SABR) and image patients at 3 time-points during radiotherapy treatment (at the start, middle and end). Imaging at each time point will be performed both with and without a CPAP machine for direct comparison of the impact of the CPAP on tumour motion. Patients will be asked to complete an experience questionnaire at each imaging session to evaluate comfort. \n\nNo direct benefits to enrolled patient is expected.\n\nThe study is funded by the University of Manchester as part of their STFC Global Challenge Network+ in Advanced Radiotherapy Award. Grant Ref: ST/N002423/1. Patients will be recruited and imaged at the Christie Hospital.

    Lay Summary of Study:

    Radiotherapy is an important treatment for lung cancer, but breathing can cause the tumour and nearby organs to move during planning and treatment. This movement can make it harder to target the tumour accurately while avoiding healthy tissue. Continuous positive airway pressure, known as CPAP, is a device commonly used for sleep apnoea. It uses a face mask and gentle air pressure to keep the airways open. Previous research has suggested that CPAP may help reduce breathing-related movement during radiotherapy, but it was not known whether patients could comfortably wear a CPAP mask during longer MR-Linac (a newer form of radiotherapy) treatment sessions, or whether simply wearing the mask without air pressure would affect breathing motion.

    This study recruited six people receiving radiotherapy for lung cancer. One person withdrew before any scans were completed, and five people took part in the imaging study. Participants had MRI scans on an MR-Linac with and without wearing a CPAP mask. The CPAP machine was not connected, so no air pressure was applied. Some participants completed up to three scan sessions, each lasting around 60 minutes. Participants also completed questionnaires about comfort, anxiety, and willingness to use the equipment in future treatment.

    Overall, the CPAP mask was very well tolerated. Participants rated comfort highly both with and without the mask, and reported low levels of anxiety. They also gave high scores for willingness to use CPAP equipment in future radiotherapy. Breathing motion was similar with and without the mask: average movement was 1.39 cm with the mask and 1.47 cm without it. This suggests that wearing the mask alone did not increase breathing motion or cause a stress response, which is reassuring for future use, but it also did not consistently reduce motion. Movement varied between individuals and across scan sessions.

    These findings show that wearing a CPAP mask without air pressure is feasible and acceptable for patients during extended MR-Linac imaging sessions. The results support further research to test whether CPAP with applied air pressure can help manage breathing motion during MR-guided lung radiotherapy.

    Has the registry been updated to include summary results?: No
    If yes - please enter the URL to summary results:
    If no – why not?: Study is not on a registry
    Did you follow your dissemination plan submitted in the IRAS application form (Q A51)?: Pending
    If yes, describe or provide URLs to disseminated materials:
    If pending, date when dissemination is expected: 31/12/2026
    If no, explain why you didn't follow it:
    Have participants been informed of the results of the study?: Pending
    If yes, describe and/or provide URLs to materials shared and how they were shared:
    If pending, date when feedback is expected: 31/12/2026
    If no, explain why they haven't:
    Have you enabled sharing of study data with others?: No
    If yes, describe or provide URLs to how it has been shared:
    If no, explain why sharing hasn't been enabled: Data has not been shared in line with information included in our ethics application and PIS.
    Have you enabled sharing of tissue samples and associated data with others?: No
    If yes, describe or provide a URL:
    If no, explain why: No tissue samples were involved in this study
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  • REC name

    Yorkshire & The Humber - Leeds West Research Ethics Committee

  • REC reference

    20/YH/0031

  • Date of REC Opinion

    3 Feb 2020

  • REC opinion

    Favourable Opinion