Davies, Lucy Siew Chen, McHugh, Louise, Aznar, Marianne, Lindsay, Josh and Eccles, Cynthia 
ORCID: 0000-0002-5445-5428
(2021)
Streamlining the image- guided radiotherapy process for proton beam therapy.
BRITISH JOURNAL OF RADIOLOGY, 94 (1128).
20210764-.
Abstract
<h4>Objectives</h4>This work evaluated the on-treatment imaging workflow in the UK's first proton beam therapy (PBT) centre, with a view to reducing times and unnecessary imaging doses to patients.<h4>Methods</h4>Imaging dose and timing data from the first 20 patients (70% paediatrics, 30% TYA/adult) treated with PBT using the initial image-guided PBT (IGPBT) workflow of a 2-dimensional kilo-voltage (2DkV), followed by cone-beam computed-tomography (CBCT) and repeat 2DkV was included. Pearson correlations and Bland-Altman analysis were used to describe correlations between 2DkV and CBCT images to determine if any images were superfluous.<h4>Results</h4>229 treatment sessions were evaluated. Patient repositioning following the initial 2DkV (i2DkV) was required on 19 (8.3%) fractions. This three-step process resulted in an additional mean imaging dose of 3.4 mGy per patient, and 5.1 minutes on the treatment bed for the patient, over a whole course of PBT, compared to a two-step workflow (removing the i2DkV image). Correspondence between the mean displacements from i2DkV and CBCT was high, with <i>R</i> = 0.94, 0.94 and 0.80 in the anteroposterior, superiorinferior and right-left directions, respectively. Bland-Altman analysis showed very little bias and narrow limits of agreement.<h4>Conclusions</h4>Removing the i2DkV, streamlining to a two-step workflow, would reduce treatment times and imaging dose, and has been implemented as standard verification protocol. For challenging cases (<i>e.g.</i> paediatric patients under GA), further investigations are required before the three-step workflow can be modified.<h4>Advances in knowledge</h4>This is the first report assessing a preliminary imaging protocol in PBT in the UK and determining a way to reduce dose and time, which ultimately benefits the patient.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Neoplasms, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Time, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Child, Child, Preschool, Female, Male, Cone-Beam Computed Tomography, Young Adult, Workflow, Radiotherapy, Image-Guided, Proton Therapy, United Kingdom |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health Faculty of Health and Life Sciences > Institute of Population Health > School of Health Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 16 Feb 2023 14:28 |
| Last Modified: | 08 Jan 2024 12:27 |
| DOI: | 10.1259/bjr.20210764 |
| Open Access URL: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC86310... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3168450 |
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