Image-guided radiotherapy for prostate cancer in the United Kingdom: a national survey

Ariyaratne, H.; Chesham, H.; Alonzi, R.

doi:10.1259/bjr.20160059

Cited by 20 publications

(10 citation statements)

References 11 publications

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“…So far, clinical implementations of MR-only radiotherapy for prostate cancer have used implanted fiducial markers for image guidance with the markers digitally added to the sCT [7] , [4] , [5] . However a significant number of centres do not use fiducial markers and employ CBCT soft-tissue matching for prostate radiotherapy treatments (

of UK centres) [8] . Additionally, radiotherapy treatments of many other cancers are not conventionally performed with implanted fiducial markers.…”

Section: Introductionmentioning

confidence: 99%

The accuracy of Magnetic Resonance – Cone Beam Computed Tomography soft-tissue matching for prostate radiotherapy

Wyatt

Brooks

Ainslie

et al. 2019

Physics and Imaging in Radiation Oncology

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A B S T R A C TBackground and purpose: Magnetic Resonance (MR)-Only radiotherapy requires a method for matching image with on-treatment Cone Beam Computed Tomography (CBCT). This study aimed to investigate the accuracy of MR-CBCT soft-tissue matching for prostate MR-only radiotherapy. Materials and methods: Three patient cohorts were used, with all patients receiving MR and CT scans. For the first cohort (10 patients) the first fraction CBCT was automatically rigidly registered to the CT and MR scans and the MR-CT registration predicted using the MR-CBCT and CT-CBCT registrations. This was compared to the automatic MR-CT registration. For the second and third cohorts (five patients each) the first fraction CBCT was independently matched to the CT and MR by four radiographers, the MR-CBCT and CT-CBCT matches compared and the inter-observer variability assessed. The second cohort used a CT-based structure set and the third a MRbased structure set with the MR relabelled as a 'CT'. Results: The mean difference between predicted and actual MR-CT registrations was = ± R 0.1 0.2 mm All (s.e.m.). Radiographer MR-CBCT registrations were not significantly different to CT-CBCT, with mean differences in soft-tissue match 0.2 mm and all except one difference . This was less than the MR-CBCT interobserver limits of agreement [3.5, 2.4, 0.9] mm (vertical, longitudinal, lateral), which were similar ( 0.5 mm) to CT-CBCT. Conclusions: MR-CBCT soft-tissue matching is not significantly different to CT-CBCT. Relabelling the MR as a 'CT' does not appear to change the automatic registration. This suggests that MR-CBCT soft-tissue matching is feasible and accurate.

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of UK centres) [8] . Additionally, radiotherapy treatments of many other cancers are not conventionally performed with implanted fiducial markers.…”

Section: Introductionmentioning

confidence: 99%

The accuracy of Magnetic Resonance – Cone Beam Computed Tomography soft-tissue matching for prostate radiotherapy

Wyatt

Brooks

Ainslie

et al. 2019

Physics and Imaging in Radiation Oncology

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“…Retrospective studies have demonstrated IGRT can reduce late GU and GI toxicity (26)(27)(28). However, it is likely most men received IGRT in this cohort as a snapshot UK survey showed two-thirds of centres were using IGRT in March 2014, with this number likely to have increased over time (29). Furthermore, one would not expect there to be a significant difference in the use of IGRT across the H-RT and C-RT groups in the IMRT era.…”

Section: Strengths and Limitationsmentioning

confidence: 90%

Comparison of Treatment-Related Toxicity With Hypofractionated or Conventionally Fractionated Radiation Therapy for Prostate Cancer: A National Population-Based Study

et al. 2020

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IntroductionRandomised controlled trials (RCTs) have demonstrated comparable early oncological outcomes after hypofractionated (H-RT) and conventionally fractionated radiation therapy (C-RT) in the radical treatment of prostate cancer (PCa). The effect of hypofractionation on treatment-related (gastrointestinal) GI and (genitourinary) GU toxicity remains uncertain, especially in older men and those with locally advanced PCa. Materials and MethodsPopulation-based study of all patients treated with radical C-RT (n=9,106) and H-RT (n= 3,027) in all radiotherapy centres in the English National Health Service between 2014 and 2016. We identified severe GI and GU toxicity using a validated codingframework and compared C-RT and H-RT using a competing-risks proportional hazards regression analysis. ResultsThe median age in our cohort was 72 years old and the majority of patients had locally advanced disease (65%). There was no difference in GI toxicity (C-RT: 5.0 events/100 person-years; H-RT: 5.2 events/100 person-years; adjusted sHR: 1.00,

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“…A volumetric image with high spatial resolution and sufficient soft-tissue contrast is reconstructed and registered to the reference planning CT to determine the correct target position. Translational and rotational positioning errors can be corrected online before irradiation [ 23 , 24 , 101 – 103 ].…”

Section: Technological Advancesmentioning

confidence: 99%

“…At present, the precise identification of target volumes for treatment planning is mainly based on the integration of radiological/metabolic imaging, such as magnetic resonance imaging (MRI) or positron emission tomography (PET), with computed tomography (CT) scan simulation [ 15 – 20 ]. Tumour localisation immediately before and during treatment delivery by means of image-guided techniques is becoming a part of clinical practice and is a fundamental prerequisite for high-precision RT [ 21 – 24 ]. As part of a comprehensive RT treatment process, adaptive RT (ART) techniques make it possible to modify the treatment plan during the course of RT in order to account for anatomical and biological changes [ 13 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Recent advances in radiation oncology

Garibaldi

Jereczek‐Fossa

Marvaso

et al. 2017

ecancer

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Radiotherapy (RT) is very much a technology-driven treatment modality in the management of cancer. RT techniques have changed significantly over the past few decades, thanks to improvements in engineering and computing. We aim to highlight the recent developments in radiation oncology, focusing on the technological and biological advances. We will present state-of-the-art treatment techniques, employing photon beams, such as intensity-modulated RT, volumetric-modulated arc therapy, stereotactic body RT and adaptive RT, which make possible a highly tailored dose distribution with maximum normal tissue sparing. We will analyse all the steps involved in the treatment: imaging, delineation of the tumour and organs at risk, treatment planning and finally image-guidance for accurate tumour localisation before and during treatment delivery. Particular attention will be given to the crucial role that imaging plays throughout the entire process. In the case of adaptive RT, the precise identification of target volumes as well as the monitoring of tumour response/modification during the course of treatment is mainly based on multimodality imaging that integrates morphological, functional and metabolic information. Moreover, real-time imaging of the tumour is essential in breathing adaptive techniques to compensate for tumour motion due to respiration.Brief reference will be made to the recent spread of particle beam therapy, in particular to the use of protons, but also to the yet limited experience of using heavy particles such as carbon ions.Finally, we will analyse the latest biological advances in tumour targeting. Indeed, the effectiveness of RT has been improved not only by technological developments but also through the integration of radiobiological knowledge to produce more efficient and personalised treatment strategies.

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Image-guided radiotherapy for prostate cancer in the United Kingdom: a national survey

Cited by 20 publications

References 11 publications

The accuracy of Magnetic Resonance – Cone Beam Computed Tomography soft-tissue matching for prostate radiotherapy

The accuracy of Magnetic Resonance – Cone Beam Computed Tomography soft-tissue matching for prostate radiotherapy

Comparison of Treatment-Related Toxicity With Hypofractionated or Conventionally Fractionated Radiation Therapy for Prostate Cancer: A National Population-Based Study

Recent advances in radiation oncology

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