1. Purpose of the Interactive Breath-Hold Control System To improve CT-guided biopsies of the lung or upper abdomen by allowing consistent, optimal visualization of the target lesion throughout procedures where is a problem. To improve CT-guided biopsies of the lung or upper abdomen by allowing consistent, optimal visualization of the target lesion throughout procedures where respiratory motion is a problem.

2. Significance of Respiratory Motion During normal breathing, lung and upper abdomen lesions can move 1-6 cm in SI direction

3. DEEPER BREATH Breath Hold - Assisted Lung Biopsy to Avoid Rib Nodule accessible through intercostal space SMALL BREATH Nodule behind rib

4. Breath Hold - Assisted CTF Biopsy (Previous unsuccessful biopsy at outside hospital due to motion) Diagnosis: Metastatic Melanoma 1 cm nodule

5. Breath Hold-Assisted Biopsy of Lesions in Difficult Locations 9mm Para-Aortic Lung Nodule Aorta

6. Potential Applications Tumor AblationTumor Ablation Radiation Therapy ProtocolsRadiation Therapy Protocols Robotic InterventionRobotic Intervention Intratumoral injections (gene rx)Intratumoral injections (gene rx) Fluid Aspiration and DrainageFluid Aspiration and Drainage Chest Imaging (reproducibility)Chest Imaging (reproducibility) MRI: Spectroscopy, FUS, MRCMRI: Spectroscopy, FUS, MRC PET/CTPET/CT CT perfusion studiesCT perfusion studies –Solitary Pulmonary Nodule –Liver –Pancreas –Renal

7. Clinical Benefits The Breath Hold is: –Sensitive and reliable for monitoring respiratory levels and providing patient feedback –Allows optimal visualization of the target lesion throughout the procedure –Enables procedures to be simpler to perform Benefits of the Breath Hold system include: –Statistically significant  in CTF exposure time, patient radiation dose, and needle puncture attempts –Fewer procedure-related complications, particularly a  in pneumothorax rate –  needle placement time and total procedure time