Looking back…:
This second international Breathing Control for Motion Management Symposium was building on the success of Amsterdam meeting in 2024. Organised by the University Hospitals Birmingham, the symposium brought together about 120 professionals, including radiation oncologists, physicists, radiation therapists (RTTs), physiologists, researchers, and industry experts from across Europe, the Middle East, Asia, and North America.
The meeting focused on the growing role of non-invasive breathing control techniques in improving precision radiotherapy. Organ motion caused by respiration remains a major challenge in the treatment of thoracic and upper abdominal tumours, often requiring large treatment margins. The symposium highlighted approaches designed to reduce tumour motion and improve treatment reproducibility, including non-invasive mechanical ventilation (NIMV), continuous positive airway pressure (CPAP), oxygen-supported breath-hold techniques, gated radiotherapy, and MRI-guided motion management.
Day one was dedicated to the scientific and clinical foundations of breathing management. Presentations covered the historical development of ventilation techniques, and distinctions between various ventilation and breath-hold methods. Clinical presentations were given on the use of NIMV in lung stereotactic radiotherapy, prone positioning, supplemental oxygen strategies, and proton therapy applications. Proffered papers presented emerging research on supplemental oxygen during breath-hold, safety monitoring, and NIMV-supported high-frequency ventilation. The Michael Parkes award was given to Thomas Weststrate (Amsterdam UMC) on his proffered presentation about NIMV for stereotactic arrhythmia radiotherapy.
The online community BRIC (Breathing Management in Radiotherapy Consortium) was established following the Amsterdam symposium. Over the past two years, BRIC has evolved from an informal network of collaborators into an established international workgroup shaping the future of breathing management in radiotherapy. Dedicated presentations addressed the efforts of BRIC, including terminology standardisation, staff and patient training, practical implementation challenges, and collaborative research initiatives.
The second day focused on practical implementation and technology demonstrations. A panel discussed the radiotherapy-specific breathing-control systems. There appeared a clear need for ventilators that can be embedded in the radiotherapy workflow. Also legal, safety, and workflow considerations were discussed. The symposium was concluded with live demonstrations of ventilators to enable participants to evaluate various devices.
The abstracts and presentations are provided for reference, following the format of the program. When citing them, please mention the source via the hyperlink to the presentation and/or abstract, when available. (Presentations are converted to pdf, so animations are removed and some minor layout issues might exist.)
| Day 1 | |
| Titles | Presenters |
| Introduction to Symposium and Birmingham Abstract – Presentation | Sofia Parveen/Stuart Green |
| Non-invasive Mechanical Ventilation: Historical Overview Abstract – Presentation | Michael Parkes |
| Mechanical Ventilation, CPAP & Breath-Hold – What is what? Abstract – Presentation | Arjan Bel |
| NIMV Applications with MRI Abstract – Presentation | Pete Thelwell |
| NIMV in Routine Radiotherapy Abstract – Presentation | Genevieve Van Ooteghem |
| NIMV in Prone Position Abstract – Presentation | Vincent Vakaet |
| Is Supplementary Oxygen Required for Non-Invasive Ventilation for Radiotherapy Applications? Abstract – Presentation | Tabi Cox |
| Deep inspiratory breath hold assisted by continuous positive airway pressure ventilation for lung stereotactic body radiotherapy Abstract – Presentation | (Sarit Appel, replaced by:) Zvi Symon |
| Mechanical ventilation in radiotherapy for intrathoracic tumours: a hypothesis under pressure? Abstract – Presentation | Robin Wijsman |
| A Single-Centre Audit of High-flow Oxygen Use During DIBH Lung Radiotherapy Abstract – Presentation | Emily Pearson |
| To What Extent Can High Frequency Non-Invasive Mechanical Ventilation Reduce Breathing Motion for Liver Stereotactic Ablative Radiotherapy? Abstract – Presentation | Tabi Cox |
| Voluntary breath-hold monitoring: a comparison of an in-house laser-camera and an integrated gating system Abstract – Presentation | David Bernstein |
| Assessment of the benefit of hypnosis in reducing 4DCT scan artifacts: preliminary results from the Hypno-4D trial Abstract – Presentation | Fid-Daniel Nzedi-Mawangua |
| The potential clinical impact of breathhold radiation therapy in radical radiation therapy for non-small cell lung cancer Abstract – Presentation | Tai-Chung Lam |
| Clinical implementation of breath-hold with nasal high flow therapy for photons and protons. Abstract – Presentation | Stephanie Peeters |
| Breath-Hold with supplemental oxygen: The Birmingham experience Abstract – Presentation | Sofia Parveen |
| Supplemental Oxygen: The San Francisco experience Abstract – Presentation | Matthew Skinner |
| Breath-hold with supplemental oxygen: the Amsterdam UMC experience Abstract – Presentation | Irma van Dijk |
| CPAP and NIMV in clinical practice: Seoul experience Abstract – Presentation | Jee Suk Chang |
| CPAP in radiotherapy: Clinical experience in Tel Aviv Abstract – Presentation | Zvi Symon |
| Non-invasive mechanical ventilation reduces respiratory motion and increases heart-stomach separation for stereotactic arrhythmia radiotherapy a healthy volunteer study Abstract – Presentation | Thomas Weststrate |
| Training Lung Cancer Patients to Tolerate Mechanical Ventilation for Breathing Regularisation and Extended Breath-Hold Abstract – Presentation | Sofia Parveen and Geoff Heyes |
| Functional Lung MRI Using Inhaled Hyperpolarised Xenon-129 for Personalised Radiotherapy Planning and Longitudinal Treatment-induced Lung Injury Assessment: Preliminary Findings Abstract – Presentation | Salha Alshoaibi |
| Tumor Position Stability with MANIV-DIBH: Is Repeated Intra-Fraction Imaging Necessary? Abstract – Presentation | Alicia Hidoud |
| Phased gating decision pathway for large lung SABR lesions (Write up for phased gating) Abstract – Presentation | Roeum Butt |
| Motion management experiences at Rosemere Cancer Centre Abstract – Presentation | Safdar Hassan |
| The Breathing Control for Radiation Therapy Consortium (BRIC): Origin, Progress, and Path Forward Abstract – Presentation | Arjan Bel |
| BRIC working group: terminology Abstract – Presentation | Nicolas Audag |
| BRIC working group: practical aspects of NIMV Abstract – Presentation | Sofia Parveen |
| Training of staff & patients Abstract – Presentation | Michael Parkes & Irma van Dijk |
| Parkes Award Ceremony: awarded to Thomas Weststrate | Michael Parkes & Committee |
| Day 2 | |
| Demystifying mechanical ventilators: what’s under the hood? Abstract – Presentation | Ben Pippard |
| Hamilton Ventilator (T1/MR1) Abstract – Presentation | Michael Parkes |
| Hamilton Ventilator (T1) Abstract – Presentation | Nick West |
| Philips Ventilator Respironics Bipap A40 Abstract – Presentation | Robin Wijsman |
| BellaVista Ventilator Abstract – Presentation | Genevieve van Ooteghem & Nicolas Audag |
| Philips Ventilator (Trilogy EV300) Abstract – Presentation | Jee Suk Chang |
| Löwenstein (Luisa) ventilator Abstract – Presentation | Michael Parkes |
| Löwenstein (Prisma Vent40) for CPAP Abstract – Presentation | Zvi Symon |
| Fischer & Paykel AirVo Nasal High System Abstract – Presentation | Richard Canters |
| Legal and practical aspects of using NIMV: a Dutch perspective Abstract – Presentation | Irma van Dijk |
| Panel pro/con discussion: Do we need RT-dedicated devices? Presentation | Irma van Dijk, Genevieve van Ooteghem |
| BRIC working group: contraindications of supplemental oxygen with specific drugs and COPD Abstract – Presentation | Thom Clutton Brock |