{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T11:05:39Z","timestamp":1771153539084,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Respiratory motion poses a significant challenge in radiation therapy for thoracic and abdominal malignancies. For tomotherapy machines, it is even more challenging due to the 10\u2010s warm\u2010up time before initiating the treatment beams. A recent tomotherapy system upgrade has reduced this warm\u2010up time to 0.5 s for the TomoDirect delivery mode, enabling the feasibility of performing breath\u2010holding treatments. In this study, we investigated the feasibility of performing breath\u2010holding treatments on a tomotherapy machine with spirometry technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A patient with gastric mucosa\u2010assisted lymphoid tissue lymphoma was treated with deep inspiration breath holding (30\u00a0Gy in 20 fractions) on a tomotherapy machine with Active Breathing Coordinator\u2122. An in\u2010house visual system, featuring a compact 7\u2033 LCD monitor, was implemented to provide visual feedback, allowing the patient to self\u2010monitor their breathings and adhere to the prescribed pattern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patient tolerated the breath\u2010hold well for the entire treatment. The number of breath\u2010holds for treatment was 9. The beam\u2010on time for each field ranged from 12.4 to 19.7 s, average 15.2 s.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We have shown that BH treatment is feasible using an upgraded tomotherapy machine (Radixact v3.5) with Active Breathing Coordinator. Our proposed workflow includes an in\u2010house visual system that allows patients to visualize their breathing patterns on\u2010screen. This technique provides a practical solution for patients with thoracic and abdominal malignancies, addressing respiratory motion while minimizing radiation exposure for certain diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70270","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T03:10:58Z","timestamp":1759201858000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Breath\u2010holding treatments in tomotherapy with active breathing coordinator: A first case report"],"prefix":"10.1002","volume":"26","author":[{"given":"April Meikwan","family":"Chow","sequence":"first","affiliation":[{"name":"Medical Physics Division Department of Medical Innovation &amp; Technology CUHK Medical Centre  Shatin Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley Chi 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