Technical Note: Validation and implementation of a wireless transponder tracking system for gated stereotactic ablative radiotherapy of the liver

James, J; Cetnar, Ashley; Huffaker, Corinna; Nguyen, Vi; Potts, M.; Wang, Brian

doi:10.1118/1.4948669

Cited by 20 publications

(20 citation statements)

References 27 publications

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“…The HexaMotion has been used as a tool to perform end-to-end test to verify the dosimetric accuracy of gated liver SABR treatment [27]. It has also been used in our center to facilitate the development of QA for novel motion management technologies such as kilovoltage intrafraction monitoring (KIM) [28,29] and electromagnetic transponder-guided MLC tracking [11].…”

Section: Discussionmentioning

confidence: 99%

Performance assessment of a programmable five degrees-of-freedom motion platform for quality assurance of motion management techniques in radiotherapy

Huang

Keall

Rice

et al. 2017

Australas Phys Eng Sci Med

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Inter-fraction and intra-fraction motion management methods are increasingly applied clinically and require the development of advanced motion platforms to facilitate testing and quality assurance program development. The aim of this study was to assess the performance of a 5 degrees-of-freedom (DoF) programmable motion platform HexaMotion (ScandiDos, Uppsala, Sweden) towards clinically observed tumor motion range, velocity, acceleration and the accuracy requirements of SABR prescribed in AAPM Task Group 142. Performance specifications for the motion platform were derived from literature regarding the motion characteristics of prostate and lung tumor targets required for real time motion management. The performance of the programmable motion platform was evaluated against (1) maximum range, velocity and acceleration (5 DoF), (2) static position accuracy (5 DoF) and (3) dynamic position accuracy using patient-derived prostate and lung tumor motion traces (3 DoF). Translational motion accuracy was compared against electromagnetic transponder measurements. Rotation was benchmarked with a digital inclinometer. The static accuracy and reproducibility for translation and rotation was <0.1 mm or <0.1°, respectively. The accuracy of reproducing dynamic patient motion was <0.3 mm. The motion platform's range met the need to reproduce clinically relevant translation and rotation ranges and its accuracy met the TG 142 requirements for SABR. The range, velocity and acceleration of the motion platform are sufficient to reproduce lung and prostate tumor motion for motion management. Programmable motion platforms are valuable tools in the investigation, quality assurance and commissioning of motion management systems in radiation oncology.

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Section: Discussionmentioning

confidence: 99%

Performance assessment of a programmable five degrees-of-freedom motion platform for quality assurance of motion management techniques in radiotherapy

Huang

Keall

Rice

et al. 2017

Australas Phys Eng Sci Med

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“…Few studies have mentioned the use of robot-assisted imaging modalities in many interventional procedures including use of robotics for the ultrasound-guided venipuncture, robot-assisted MRIguided liver ablation, and ultrasound-assisted robotic prostate brachytherapy [86][87][88]. Similarly, wireless imaging has been utilized in few settings such as the use of wireless x-ray output analyzer system, wireless transponder tracking system for ablative radiotherapy of the liver, and use of wireless intraoral coils for dental MRI [17,89,90]. However, it is very crucial to investigate in detail the need to update the departmental protocols based on literature findings in the areas of these modern technologies related to the RD.…”

Section: Modern Radiology Technologiesmentioning

confidence: 99%

Health Care–Associated Infections and the Radiology Department

Ilyas

Burbridge

Babyn

2019

Journal of Medical Imaging and Radiation Sciences

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Health care-associated infections (HCAIs) are a significant concern for both health care workers (HCWs) and patients. They are a major contributing factor of disease in industrialized countries, and are responsible for significant morbidity, mortality, and a direct annual financial loss of $6-7 billion in North America alone. They are an increasingly challenging health issue due to multidrug-resistant pathogens such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci among others, along with an increasing number of susceptible patients. Over the last three decades, the risk of HCAIs has increased in the radiology department (RD) in part because of an increased number of patients visiting the department and an increase in the utilization of imaging modalities. In this review, we will discuss how patients and staff can be exposed to HCAIs in the RD, including contaminated inanimate surfaces, radiology equipment, and associated medical devices. As the role of medical imaging has extended from primarily diagnosis to include more interventions, the implementation and development of standardized infection minimization protocols and infection control procedures are vital in the RD, particularly in interventional radiology. With globalisation and the rapid movement of people regionally, nationally, and globally, there is greater risk of exposure to contagious diseases such as Ebola, especially if infected patients are undiagnosed when they travel. For effective infection control, advanced training and education of HCWs in the RD is essential.The purpose of this article is to provide an overview of HCAIs as related to activities of the RD. We will discuss the following major topics including the variety of HCAIs commonly encountered, the role of the RD in HCAIs, transmission of infections to patients and HCWs in the RD, standard infection prevention measures, and the management of susceptible/infected patients in the RD. We shall also examine the role of, and the preparedness of, HCWs, including RD technologists and interventional radiologists, who may be exposed to undiagnosed, yet infected patients. We shall conclude with a brief discussion of the role of further research related to HCAIs. Learning ObjectivesAfter the completion of this review article, the readers will Understand the exposure and role of radiology department in health care-associated infections, Know the causes/modes/transmission of infections in radiology department, Be conscious of standard disinfection protocols, Be aware of current and future strategies required for the effective control of health care-associated infection in the radiology department. This is a CME article and provides the equivalent of 2 hours of continuing education that may be applied to your professional development credit system. A 10-question multiple-choice quiz follows this reading. Please note that no formalized credit (category A) is available from CAMRT.

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“…The EMT tracking system used in this study has proved to be an accurate tool to monitor in real-time the prostate gland during RT [17,18] and its accuracy has been thoroughly investigated [19][20][21]. Various studies have investigated its potential for motion monitoring and EMT-based gating of liver or pancreas tumors [22][23][24][25][26]. The first use of this EMT tracking system in human lungs was described by Shah et al in an observational study evaluating the implantation, migration and feasibility of tumor tracking using smooth EMTs (i.e.…”

Section: Discussionmentioning

confidence: 99%

Clinical experience with lung-specific electromagnetic transponders for real-time tumor tracking in lung stereotactic body radiotherapy

Jaccard

Champion

Dubouloz

et al. 2019

Physics and Imaging in Radiation Oncology

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Background and purposes: Motion management is crucial for optimal stereotactic body radiotherapy (SBRT) of moving targets. We aimed to describe our clinical experience with real-time tracking of lung-specific electromagnetic transponders (EMTs) for SBRT of early stage non-small cell lung cancer in free-breathing (FB) or deep inspiration breath-hold (DIBH). Material and methods: Seven patients were implanted with EMTs. Simulation for SBRT was performed in FB and in DIBH. We prescribed 60 Gy in 3, 5 or 8 fractions to the tumor and delivered SBRT with volumetric modulated arcs and a 6 MV flattening filter free photon beam. Patients' setup at the linac was performed using EMT positions and cone-beam CT (CBCT) verification. Four patients were treated in DIBH because of a dosimetric benefit. We analysed patient alignment and treatment delivery parameters using DIBH or FB and EMT real-time tracking. Results: There were no complications from the EMT implantation. Visual inspection of CBCT before and/or after SBRT revealed good alignment of structures and EMTs. The median setup time was 9.8 min (range: 4.6-34.1 min) and the median session time was 14.7 min (range: 7.3-36.5 min). EMT positions in lungs remained stable during overall treatment and allowed real-time tracking both in FB and in DIBH SBRT. The treatment beam was gated when EMT centroid position exceeded tolerance thresholds ensuring correct delivery of radiation to the tumor. Conclusion: Using EMTs for real-time tracking of tumor motion during lung SBRT proved to be safe, accurate and easy to integrate clinically for treatments in FB or DIBH.

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Technical Note: Validation and implementation of a wireless transponder tracking system for gated stereotactic ablative radiotherapy of the liver

Cited by 20 publications

References 27 publications

Performance assessment of a programmable five degrees-of-freedom motion platform for quality assurance of motion management techniques in radiotherapy

Performance assessment of a programmable five degrees-of-freedom motion platform for quality assurance of motion management techniques in radiotherapy

Health Care–Associated Infections and the Radiology Department

Clinical experience with lung-specific electromagnetic transponders for real-time tumor tracking in lung stereotactic body radiotherapy

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