1
|
Hargrave C, Deegan T, Bednarz T, Poulsen M, Harden F, Mengersen K. An image‐guided radiotherapy decision support framework incorporating a Bayesian network and visualization tool. Med Phys 2018; 45:2884-2897. [DOI: 10.1002/mp.12979] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/01/2018] [Accepted: 04/14/2018] [Indexed: 11/10/2022] Open
Affiliation(s)
- Catriona Hargrave
- Radiation Oncology Princess Alexandra Hospital – Raymond Terrace Queensland Health Brisbane 4101 Australia
- School of Mathematical Sciences Science and Engineering Faculty Queensland University of Technology Brisbane 4000 Australia
- School of Clinical Sciences Faculty of Health Queensland University of Technology Brisbane 4000 Australia
| | - Timothy Deegan
- Radiation Oncology Princess Alexandra Hospital – Raymond Terrace Queensland Health Brisbane 4101 Australia
| | - Tomasz Bednarz
- School of Mathematical Sciences Science and Engineering Faculty Queensland University of Technology Brisbane 4000 Australia
- Data 61 Commonwealth Scientific and Industrial Research Organisation Brisbane 4102 Australia
- Expanded Perception and Interaction Centre University of New South Wales Paddington 2021 Australia
| | - Michael Poulsen
- Radiation Oncology Princess Alexandra Hospital – Raymond Terrace Queensland Health Brisbane 4101 Australia
- Faculty of Medicine University of Queensland Brisbane 4072 Australia
| | - Fiona Harden
- School of Mathematical Sciences Science and Engineering Faculty Queensland University of Technology Brisbane 4000 Australia
- Hunter Industrial Medicine Maitland 2320 Australia
| | - Kerrie Mengersen
- School of Mathematical Sciences Science and Engineering Faculty Queensland University of Technology Brisbane 4000 Australia
| |
Collapse
|
2
|
Hargrave C, Deegan T, Poulsen M, Bednarz T, Harden F, Mengersen K. A feature alignment score for online cone‐beam
CT
‐based image‐guided radiotherapy for prostate cancer. Med Phys 2018; 45:2898-2911. [DOI: 10.1002/mp.12980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/22/2018] [Accepted: 04/14/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Catriona Hargrave
- Radiation Oncology Princess Alexandra Hospital – Raymond Terrace Queensland Health Brisbane 4101 Australia
- School of Mathematical Sciences Science and Engineering Faculty Queensland University of Technology Brisbane 4000 Australia
- School of Clinical Sciences Faculty of Health Queensland University of Technology Brisbane 4000 Australia
| | - Timothy Deegan
- Radiation Oncology Princess Alexandra Hospital – Raymond Terrace Queensland Health Brisbane 4101 Australia
| | - Michael Poulsen
- Radiation Oncology Princess Alexandra Hospital – Raymond Terrace Queensland Health Brisbane 4101 Australia
- Faculty of Medicine University of Queensland Brisbane 4072 Australia
| | - Tomasz Bednarz
- School of Mathematical Sciences Science and Engineering Faculty Queensland University of Technology Brisbane 4000 Australia
- Data 61 Commonwealth Scientific and Industrial Research Organisation Brisbane 4102 Australia
- Expanded Perception and Interaction Centre University of New South Wales Paddington 2021 Australia
| | - Fiona Harden
- School of Mathematical Sciences Science and Engineering Faculty Queensland University of Technology Brisbane 4000 Australia
| | - Kerrie Mengersen
- School of Mathematical Sciences Science and Engineering Faculty Queensland University of Technology Brisbane 4000 Australia
| |
Collapse
|
3
|
Takakura T, Ito Y, Higashikawa A, Nishiyama T, Sakamoto T. Verification of the dose attenuation of a newly developed vacuum cushion for intensity-modulated radiation therapy of prostate cancer. Radiol Phys Technol 2016; 9:270-6. [PMID: 27260347 DOI: 10.1007/s12194-016-0359-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 05/16/2016] [Accepted: 05/19/2016] [Indexed: 11/25/2022]
Abstract
This study measured the dose attenuation of a newly developed vacuum cushion for intensity-modulated radiation therapy (IMRT) of prostate cancer, and verified the effect of dose-correction accuracy in a radiation treatment planning system (RTPS). The new cushion was filled with polystyrene foams inflated 15-fold (Sφ ≒ 1 mm) to reduce contraction caused by air suction and was compared to normal polystyrene foam inflated to 50-fold (Sφ ≒ 2 mm). The dose attenuation at several thicknesses of compression bag filled with normal and low-inflation materials was measured using an ionization chamber; and then the calculated RTPS dose was compared to ionization chamber measurements, while the new cushion was virtually included as region of interest in the calculation area. The dose attenuation rate of the normal cushion was 0.010 %/mm (R (2) = 0.9958), compared to 0.031 %/mm (R (2) = 0.9960) in the new cushion. Although the dose attenuation rate of the new cushion was three times that of the normal cushion, the high agreement between calculated dose by RTPS and ionization chamber measurements was within approximately 0.005 %/mm. Thus, the results of the current study indicate that the new cushion may be effective in clinical use for dose calculation accuracy in RTPS.
Collapse
Affiliation(s)
- Toru Takakura
- Department of Radiation Therapy, Kyoto-Katsura Hospital, 17 YamadaHirao-cho, Nishikyo-ku, Kyoto, 615-8256, Japan.
| | - Yoshiyuki Ito
- Department of Radiation Therapy, Kyoto-Katsura Hospital, 17 YamadaHirao-cho, Nishikyo-ku, Kyoto, 615-8256, Japan
| | - Akinori Higashikawa
- Department of Radiation Therapy, Kyoto-Katsura Hospital, 17 YamadaHirao-cho, Nishikyo-ku, Kyoto, 615-8256, Japan
| | - Tomohiro Nishiyama
- Department of Radiation Therapy, Kyoto-Katsura Hospital, 17 YamadaHirao-cho, Nishikyo-ku, Kyoto, 615-8256, Japan
| | - Takashi Sakamoto
- Department of Radiation Therapy, Kyoto-Katsura Hospital, 17 YamadaHirao-cho, Nishikyo-ku, Kyoto, 615-8256, Japan
| |
Collapse
|
4
|
Team-based clinical simulation in radiation medicine: value to attitudes and perceptions of interprofessional collaboration. JOURNAL OF RADIOTHERAPY IN PRACTICE 2015. [DOI: 10.1017/s1460396915000060] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIntroductionSimulation has been effective for changing attitudes towards team-based competencies in many areas, but its role in teaching interprofessional collaboration (IPC) in radiation medicine (RM) is unknown. This study reports on feasibility and IPC outcomes of a team-based simulation event; ‘Radiation Medicine Simulation in Learning Interprofessional Collaborative Experience’ (RM SLICE).MethodsRadiation therapy (RTT), medical physics (MP) and radiation oncology (RO) trainees in a single academic department were eligible. Scheduled closure of a modern RM clinic allowed rotation of five high-fidelity cases in three 105-minute timeslots. A pre/post-survey design evaluated learner satisfaction and interprofessional perceptions. Scales included the Readiness for Interprofessional Learning Scale (RIPLS), UWE Entry Level Interprofessional Questionnaire (UWEIQ), Trainee Test of Team Dynamics and Collaborative Behaviours Scale (CBS).ResultsTwenty-one trainees participated; six ROs (28·57%), six MPs (28·57%) and nine RTTs (42·86%). All cases were conducted, resolved and debriefed within the allotted time. Twenty-one complete sets (100%) of evaluations were returned. Participants reported limited interaction with other professional groups before RM SLICE. Perceptions of team functioning and value of team interaction in ‘establishing or improving the care plan’ were high for all cases, averaging 8·1/10 and 8·9/10. Average CBS scores were 70·4, 71·9 and 69·5, for the three cases, scores increasing between the first and second case for 13/21 (61·9%) participants. RIPLS and UWEIQ scores reflected positive perceptions both pre- and post-event, averaging 83·5 and 85·2 (RIPLS) and 60·6 and 55·7 (UWEIQ), respectively. For all professions for both scales, the average change in score reflected improved IP perceptions, with agreement between scales for 15/20 (75·0%) participants. Overall, perception of IPC averaged 9·14/10, as did the importance of holding such an event annually.ConclusionsTeam-based simulation is feasible in RM and appears to facilitate interprofessional competency-building in high-acuity clinical situations, reflecting positive perceptions of IPC.
Collapse
|
5
|
Ung NM, Wee L. Cumulative sum method in nonzero fixed action level setup correction strategy: An application of statistical process control for targeted prostate radiotherapy. Med Phys 2012; 39:2746-53. [DOI: 10.1118/1.4705349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
|
6
|
Rosewall T, Bayley AJ, Chung P, Le LW, Xie J, Baxi S, Catton CN, Currie G, Wheat J, Milosevic M. The effect of delineation method and observer variability on bladder dose-volume histograms for prostate intensity modulated radiotherapy. Radiother Oncol 2011; 101:479-85. [PMID: 21864921 DOI: 10.1016/j.radonc.2011.06.039] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 06/17/2011] [Accepted: 06/18/2011] [Indexed: 11/16/2022]
Abstract
PURPOSE To quantify the effect of delineation method on bladder DVH, observer variability (OV) and contouring time for prostate IMRT plans. MATERIALS AND METHODS Planning CT scans and IMRT plans of 30 prostate cancer patients were anonymized. For 20 patients, 1 observer delineated the bladder using 9 methods. The effect of delineation method on the DVH curve, discrete dose levels and delineation time was quantified. For the 10 remaining CTs, 6 observers delineated bladder wall using 4 methods. Observer-based volume variation and intraclass correlation coefficient (ICC) were used to describe the dosimetric effects of OV. RESULTS Manual delineation of the bladder wall (BW_m) was significantly slower than any other method (mean: 20 min vs. ≤ 13 min) and the dosimetric effect of OV was significantly larger (V70 Gy ICC: 0.78 vs. 0.98). Only volumes created using a 2.5mm contraction from the outer surface, and a method providing a consistent wall volume, showed no notable dosimetric differences from BW_m in both absolute and relative volume. CONCLUSIONS Automatic contractions from the outer surface provide quicker, more reproducible and reasonably accurate substitutes for BW_m. The widespread use of automatic contractions to create a bladder wall volume would assist in the consistent application of IMRT dose constraints and the interpretation of reported dose.
Collapse
Affiliation(s)
- Tara Rosewall
- Princess Margaret Hospital and Department of Radiation Oncology, University of Toronto, Canada.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Kron T, Eyles D, Schreiner LJ, Battista J. Magnetic resonance imaging for adaptive cobalt tomotherapy: A proposal. J Med Phys 2011; 31:242-54. [PMID: 21206640 PMCID: PMC3004099 DOI: 10.4103/0971-6203.29194] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2006] [Accepted: 08/01/2006] [Indexed: 11/04/2022] Open
Abstract
Magnetic resonance imaging (MRI) provides excellent soft tissue contrast for oncology applications. We propose to combine a MRI scanner with a helical tomotherapy (HT) system to enable daily target imaging for improved conformal radiation dose delivery to a patient. HT uses an intensity-modulated fan-beam that revolves around a patient, while the patient slowly advances through the plane of rotation, yielding a helical beam trajectory. Since the use of a linear accelerator to produce radiation may be incompatible with the pulsed radiofrequency and the high and pulsed magnetic fields required for MRI, it is proposed that a radioactive Cobalt-60 ((60)Co) source be used instead to provide the radiation. An open low field (0.25 T) MRI system is proposed where the tomotherapy ring gantry is located between two sets of Helmholtz coils that can generate a sufficiently homogenous main magnetic field.It is shown that the two major challenges with the design, namely acceptable radiation dose rate (and therefore treatment duration) and moving parts in strong magnetic field, can be addressed. The high dose rate desired for helical tomotherapy delivery can be achieved using two radiation sources of 220TBq (6000Ci) each on a ring gantry with a source to axis-of-rotation distance of 75 cm. In addition to this, a dual row multi-leaf collimator (MLC) system with 15 mm leaf width at isocentre and relatively large fan beam widths between 15 and 30 mm per row shall be employed. In this configuration, the unit would be well-suited for most pelvic radiotherapy applications where the soft tissue contrast of MRI will be particularly beneficial. Non-magnetic MRI compatible materials must be used for the rotating gantry. Tungsten, which is non-magnetic, can be used for primary collimation of the fan-beam as well as for the MLC, which allows intensity modulated radiation delivery. We propose to employ a low magnetic Cobalt compound, sycoporite (CoS) for the Cobalt source material itself.Rotational delivery is less susceptible to problems related to the use of a low energy megavoltage photon source while the helical delivery reduces the negative impact of the relatively large penumbra inherent in the use of Cobalt sources for radiotherapy. On the other hand, the use of a (60)Co source ensures constant dose rate with gantry rotation and makes dose calculation in a magnetic field as easy as the range of secondary electrons is limited.The MR-integrated Cobalt tomotherapy unit, dubbed 'MiCoTo,' uses two independent physical principles for image acquisition and treatment delivery. It would offer excellent target definition and will allow following target motion during treatment using fast imaging techniques thus providing the best possible input for adaptive radiotherapy. As an additional bonus, quality assurance of the radiation delivery can be performed in situ using radiation sensitive gels imaged by MRI.
Collapse
Affiliation(s)
- Tomas Kron
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | | | | |
Collapse
|
8
|
Watanabe Y. Clinical practices of IGRT in USA. Nihon Hoshasen Gijutsu Gakkai Zasshi 2010; 66:63-70. [PMID: 20145366 DOI: 10.6009/jjrt.66.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Yoichi Watanabe
- Department of Therapeutic Radiology, University of Minnesota
| |
Collapse
|
9
|
Woodford C, Yartsev S, Van Dyk J. Image registration of a moving target phantom with helical tomotherapy: effect of the CT acquisition technique and action level proposal. Phys Med Biol 2008; 53:5093-106. [DOI: 10.1088/0031-9155/53/18/016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
10
|
Abstract
To account for geometric uncertainties during radiotherapy, safety margins are applied. In many cases, these margins overlap organs at risk, thereby limiting dose escalation. The aim of image-guided radiotherapy is to improve the accuracy by imaging tumors and critical structures on the machine just before irradiation. The availability of high-quality imaging systems and automatic image registration on the machine leads to many new clinical applications, such as high-precision hypofractionated treatments of brain metastases and solitary long tumors with online tumor position corrections. In this review, the prerequisites for image guidance in terms of planning, image acquisition, and processing are first described. Then, the various methods of correction are discussed such as table shifts and rotation and direct adaptation of machine parameters. Then, online, offline, and intrafraction correction strategies are discussed. Finally, some imaging dose issues are discussed showing that kilovoltage cone-beam computed tomography guidance has a net positive impact on the integral dose; the gain caused by margin reduction is larger than the image dose. We can conclude that image-guided radiotherapy is very much a clinical reality and that the development of optimal clinical protocols should currently be the focus of research.
Collapse
Affiliation(s)
- Marcel van Herk
- Radiotherapy Department, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
| |
Collapse
|
11
|
Takakura T, Matsubara K, Mizowaki T, Nakata M, Yano S, Okada T, Fujimoto T, Kamomae T, Tanaka R, Koshida K, Kikuchi Y. [Evaluation of a method for correcting systematic setup error in external-beam radiation therapy]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2008; 64:35-40. [PMID: 18311019 DOI: 10.6009/jjrt.64.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND AND PURPOSE We verified the propriety of our systematic error reduction strategy by means of a computer simulation based on our data of position error with a prone fixation device for prostate IMRT. MATERIALS AND METHODS Computer simulations of the off-line correction method for systematic setup errors based on the portal imaging taken on the first several days of the treatment session were performed. Using the computer simulations, an optimal number of portal images were evaluated for the SD value, from 0.5 mm to 1.5 mm at a 0.25 mm interval, and the respective required setup margins were calculated. RESULTS The value of systematic error was reduced as the frequency of data obtained increased. Moreover, the reduction rate was so remarkable that random error was large.
Collapse
Affiliation(s)
- Toru Takakura
- Clinical Radiology Service, Kyoto University Hospital, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Wu QJ, Thongphiew D, Wang Z, Mathayomchan B, Chankong V, Yoo S, Lee WR, Yin FF. On-line re-optimization of prostate IMRT plans for adaptive radiation therapy. Phys Med Biol 2008; 53:673-91. [DOI: 10.1088/0031-9155/53/3/011] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
13
|
Lam KL, Balter JM, Ten Haken RK. Effect of daily localization and correction on the setup uncertainty: dependences on the measurement uncertainty, re-positioning uncertainty and action level. Phys Med Biol 2007; 52:6575-87. [DOI: 10.1088/0031-9155/52/22/002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
14
|
|
15
|
Linthout N, Verellen D, Tournel K, Reynders T, Duchateau M, Storme G. Assessment of secondary patient motion induced by automated couch movement during on-line 6 dimensional repositioning in prostate cancer treatment. Radiother Oncol 2007; 83:168-74. [PMID: 17499870 DOI: 10.1016/j.radonc.2007.04.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2007] [Accepted: 04/22/2007] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study is to assess retrospectively secondary patient motion induced by 6D patient setup correction. MATERIALS AND METHODS For 104 patients, treated with Novalis, 6D setup correction prior to treatment was performed by ExacTrac5.0/NovalisBody in combination with the Robotic Tilt Module mounted underneath the Exact Couch top. This 6D correction might induce additional setup errors due to patient reaction against the rotations. To evaluate induced secondary motion, the 6D setup correction is verified and evaluated with respect to the tolerance limits. RESULTS The majority of measured secondary motions are found within the tolerance limits. Detected secondary motions are mostly found in longitudinal shifts and lateral rotations, and mainly found in only 1 dimension during the same verification. The verifications indicate that the patient population can be divided into a group that hardly moves and a group that moves throughout all 6D setup corrections. The patient's behavior can be predicted by the evaluation of the first five fractions as none of the patients demonstrate a learning curve during the treatment. CONCLUSIONS 6D setup correction does not induce secondary motion for the majority of the patients and can therefore be applied for all treatment indications.
Collapse
Affiliation(s)
- Nadine Linthout
- Radiotherapy Department, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Belgium.
| | | | | | | | | | | |
Collapse
|
16
|
Lefkopoulos D, Ferreira I, Isambert A, Le Péchoux C, Mornex F. Présent et avenir de la radiothérapie guidée par l'image (IGRT) et ses applications possibles dans le traitement des cancers bronchiques. Cancer Radiother 2007; 11:23-31. [PMID: 17113331 DOI: 10.1016/j.canrad.2006.10.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
These last years, the new irradiation techniques as the conformal 3D radiotherapy and the IMRT are strongly correlated with the technological developments in radiotherapy. The rigorous definition of the target volume and the organs at risk required by these irradiation techniques, imposed the development of various image guided patient positioning and target tracking techniques. The availability of these imaging systems inside the treatment room has lead to the exploration of performing real-time adaptive radiation therapy. In this paper we present the different image guided radiotherapy (IGRT) techniques and the adaptive radiotherapy (ART) approaches. IGRT developments are focused in the following areas: 1) biological imaging for better definition of tumor volume; 2) 4D imaging for modeling the intra-fraction organ motion; 3) on-board imaging system or imaging devices registered to the treatment machines for inter-fraction patient localization; and 4) treatment planning and delivery schemes incorporating the information derived from the new imaging techniques. As this paper is included in the "Cancer-Radiotherapie" special volume dedicated to the lung cancers, in the description of the different IGRT techniques we try to present the lung tumors applications when this is possible.
Collapse
Affiliation(s)
- D Lefkopoulos
- Service de physique médicale, institut Gustave-Roussy, 39, rue Camille-Desmoulins, 94805 Villejuif cedex, France.
| | | | | | | | | |
Collapse
|