National survey on image‐guided radiotherapy practice in New Zealand

Padayachee, Jerusha; Loh, Jasmin; Tiong, Albert; Lao, Louis

doi:10.1111/1754-9485.12682

Cited by 16 publications

(24 citation statements)

References 19 publications

(52 reference statements)

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“…Modern EBRT techniques and IGRT modalities were widely available and accepted, marking a trend that has been described in previous surveys (2007-2017; Table 3) (9-14). Sophisticated high-precision techniques using smaller margins require high-standard (daily online) image guidance (13,24). For example, IMRT/VMAT techniques lead to a steep dose gradient, where IGRT becomes extremely important to prevent the risk of partially missing the target.…”

Section: Discussionmentioning

confidence: 99%

“…IGRT practices among adult cancer patients have been reported in multiple studies (9)(10)(11)(12)(13), showing a tendency towards an increased IGRT use over time. A British survey in 2008 showed that routine IGRT use was low (8%), and that 25% of surveyed institutes intended to implement IGRT within a year (9).…”

Section: Introductionmentioning

confidence: 99%

“…A survey among ASTRO (American Society for Radiation Oncology) members indicated a high prevalence of IGRT practice and daily cone-beam computed tomography (CBCT) imaging, but with wide variabilities in IGRT frequency and veri cation methodologies (11). Studies from Australia and New Zealand reported IGRT as being commonly available, yet with considerable variations in clinical application (12,13).…”

Section: Introductionmentioning

confidence: 99%

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A Baseline Survey on the Treatment Workflow and Pediatric IGRT Practice Among European Members of the Project-Based Consortium and the Pediatric Radiation Oncology Society (PROS).

Windmeijer

Bel

Jong

et al. 2020

Preprint

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Background Image-guided radiotherapy (IGRT) enables high precision tumor treatment with potential for sparing healthy tissues. The value of pediatric IGRT is widely acknowledged, but there is no consensus on ‘best practice’. We aimed to assess clinical pediatric IGRT practice among European members of the Pediatric Radiation Oncology Society (PROS) and members of our project-based consortium.Methods A survey addressing radiotherapy preparation, planning and delivery in seven treatment sites was sent to European PROS members and/or our IGRT project-based consortium (70 institutes). Responses were collected from June-September 2018.Results Of the 42 responding institutes (response rate 60%), 33 indicated to treat children. 28/33 are photon-only institutes, 3/33 are dedicated proton (‘proton-only’) institutes and 2/33 use both. Immobilization includes facial masks (in 100% of brain, craniospinal axis (CSA) and head-and-neck (H&N) treatments), and vacuum cushions (all sites, except brain and H&N). Intensity-modulated radiotherapy and volumetric-modulated arc therapy are most frequently applied ranging from 71%-81% in respectively CSA (20/28), and extremities (21/26), followed by 3D conformal radiotherapy ranging from 36%-69% in respectively H&N (10/28), and extremities (18/26). Isotropic planning target volume (PTV) margins varied widely in brain and abdomen (range, 1-10mm). The use of in-room kilovolt cone-beam computed tomography ranges from 57%-86% in respectively CSA (16/28), and thorax (24/28). Daily online imaging is used by the majority of institutes, ranging from 85%-90% in respectively extremities (22/26) and pelvis (27/30). Offline imaging protocols are used by 14%-21% in respectively H&N (4/28) and thorax (6/28).Conclusions Our survey shows comparable practice in pre-treatment imaging, planning and treatment techniques, and IGRT application among the participating European institutes. However, wide ranges in PTV margin sizes exist, supporting the need to define international ‘best practice’ guidelines for pediatric IGRT, and to aim for consensus on optimal margin definitions in view of available IGRT facilities and workflows among institutes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Baseline Survey on the Treatment Workflow and Pediatric IGRT Practice Among European Members of the Project-Based Consortium and the Pediatric Radiation Oncology Society (PROS).

Windmeijer

Bel

Jong

et al. 2020

Preprint

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“…Instrument validity was measured by first acquiring a CT of the phantom–bolus assembly (Philips Brilliance Big Bore CT, Philips Healthcare, Amsterdam, Netherlands), importing the dataset to Pinnacle treatment planning system (version 9.10, Philips Medical Systems, Amsterdam, Netherlands), profiling the electron densities of the phantom, wax and bolus sheets and comparing these to established values . Soft tissue densities were 1.1 g/cm 3 , bone was 1.7 g/cm 3 and adipose tissue was 0.9 g/cm 3 .…”

Section: Methodsmentioning

confidence: 99%

“…Cone‐beam computed tomography (CBCT) is one option for image verification, with implementation undergoing a surge in Australia and New Zealand. Recent 2015–2016 surveys show that CBCT was available in 97% of Australian departments and in 86% of New Zealand departments compared with 8% of departments in this region having CBCT just a decade ago . Despite being available in almost all departments, CBCT has not replaced other image verification modalities, with kilovoltage (kV) planar imaging being the second most common imaging tool used in IGRT …”

Section: Introductionmentioning

confidence: 99%

Effect of patient size on image quality in radiotherapy kV planar verification imaging: a phantom study

Chan

Giles

Newmarch

et al. 2019

J of Medical Radiation Sci

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Introduction This study aimed to determine a maximal pelvic separation and waist circumference in pelvic patients to guide radiation therapists in acquiring kilovoltage (kV) planar images of acceptable quality for treatment verification. Methods A pelvic anthropomorphic phantom modified with different bolus thicknesses was imaged at various default kV exposure settings. Radiation therapists rated image quality and acceptance/rejection of these images for treatment verification. Results Sixteen radiation therapists participated in the study. Image quality was inversely proportional to phantom size. AP and lateral kV images were acceptable for treatment verification up to a waist circumference of 143 cm. Conclusions Exposure settings for kV image verification of large patients should be individualised to avoid unnecessary patient radiation dose through repeated imaging.

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Automated algorithm for calculation of setup corrections and planning target volume margins for offline image‐guided radiotherapy protocols

Abubakar

Zamri

Shaukat

et al. 2021

J Applied Clin Med Phys

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Purpose: Each radiotherapy center should have a site-specific planning target volume (PTV) margins and image-guided (IG) radiotherapy (IGRT) correction protocols to compensate for the geometric errors that can occur during treatment. This study developed an automated algorithm for the calculation and evaluation of these parameters from cone beam computed tomography (CBCT)-based IG-intensity modulated radiotherapy (IG-IMRT) treatment.Methods and materials: A MATLAB algorithm was developed to extract the setup errors in three translational directions (x, y, and z) from the data logged by the CBCT system during treatment delivery. The algorithm also calculates the resulted population setup error and PTV margin based on the van Herk margin recipe and subsequently estimates their respective values for no action level (NAL) and extended no action level (eNAL) offline correction protocols. The algorithm was tested on 25 head and neck cancer (HNC) patients treated using IG-IMRT. Results:The algorithms calculated that the HNC patients require a PTV margin of 3.1, 2.7, and 3.2 mm in the x-, y-, and z-direction, respectively, without IGRT. The margin can be reduced to 2.0, 2.2, and 3.0 mm in the x-, y-, and z-direction, respectively, with NAL and 1.6, 1.7, and 2.2 mm in the x-, y-, and z-direction, respectively, with eNAL protocol. The results obtained were verified to be the same with the margins calculated using an Excel spreadsheet. The algorithm calculates the weekly offline setup error correction values automatically and reduces the risk of input data error observed in the spreadsheet. Conclusions:In conclusion, the algorithm provides an automated method for optimization and reduction of PTV margin using logged setup errors from CBCT-based IGRT.

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National survey on image‐guided radiotherapy practice in New Zealand

Abstract: Image-guided radiotherapy is widely used in NZ; however, there is a wide variation in its application between centres. Detailed tumour site-specific, imaging modality-specific national guidelines will allow standardization of IGRT practices.

Cited by 16 publications

References 19 publications

A Baseline Survey on the Treatment Workflow and Pediatric IGRT Practice Among European Members of the Project-Based Consortium and the Pediatric Radiation Oncology Society (PROS).

A Baseline Survey on the Treatment Workflow and Pediatric IGRT Practice Among European Members of the Project-Based Consortium and the Pediatric Radiation Oncology Society (PROS).

Effect of patient size on image quality in radiotherapy kV planar verification imaging: a phantom study

Automated algorithm for calculation of setup corrections and planning target volume margins for offline image‐guided radiotherapy protocols

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