A Feasibility Study on the Use of TomoTherapy Megavoltage Computed Tomography Images for Palliative Patient Treatment Planning

Characterization of an advanced cone beam CT (CBCT) reconstruction algorithm used for dose calculation on Varian Halcyon linear accelerators

In this study, the performance of a new iterative reconstruction algorithm, the pre-clinical AcurosXB iCBCT algorithm, has been characterized on Varian Halcyon linear accelerators with respect to the potential of radiotherapy dose calculations on CBCT images. The study utilized various phantom setups to verify the accuracy of the pre-clinical algorithm under different scatter conditions and compared dose calculations performed on CBCT images reconstructed with the pre-clinical algorithm to those performed on typical planning CT images. The results indicated that despite showing improvements compared to the existing iCBCT protocol, certain restrictions should be introduced when the pre-clinical AcurosXB iCBCT algorithm was used for dose calculations. Changes in the scatter condition exhibited a larger effect on CBCTs than on planning CTs. Therefore, users should be careful in offsetting the patient and positioning the patient's arms if the resultant images will be used for dose calculations. In addition, protocols with different kV settings should be approached with caution, where 100 kV protocols should only be used to scan the head and neck area, while the rest of the body should be scanned with the 125 kV and 140 kV protocols. When the patient is set up properly and the appropriate energy is selected for the anatomical area, the uncertainty of using the novel AcurosXB iCBCT algorithm for treatment planning dose calculation is within ± 2.0%.

Radiation Oncology-Where to from Here? A Global Inquiry into the Perspectives of Radiation Oncology Professionals in Light of the Growing Cancer Epidemic

INTRODUCTION

Radiation oncology is a vital tool in resisting the cancer epidemic affecting millions worldwide. This study queried the perspectives of radiation oncology professionals and sought their solutions in regard to current practice, future practice, outsourcing, and common values.

METHODS

A mass consumer survey was distributed globally that collected quantitative and qualitative data from 245 radiation oncology professionals based in 47 countries.

RESULTS

Participants scored the sector highly on the quality of current practice. The United States was identified as the perceived global leader in the practice of radiation oncology. The sector was considered moderately open to reform with suggestions of better training, greater resources, and incorporation of data informatics. A preference for paradigms involving private enterprise emerged. Appropriate outsourcing tasks and companies were identified and industry leaders evaluated. Remarkable accord was observed in values and priorities across professional groups and examined subsets.

CONCLUSIONS

There is an opportunity to realize value through the application of successful global paradigms. Our research generated a unique performance evaluation of the sector by identifying the current situation and areas open to reform. The required shift in the role of government from provider to regulator implied a mandate for a reorientation of policy settings with greater emphasis on free enterprise solutions that maximize value and ultimately advance patient care.