Clinical implementation of the first Cherenkov imaging system in a community-based hospital
Purpose: To document experiences with one year of clinical implementation of the first Cherenkov imaging system and share the methods that we developed to utilize Cherenkov imaging to improve treatment delivery accuracy in real-time. Methods: A Cherenkov imaging system was installed commissioned and...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Technical Innovations & Patient Support in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405632422000312 |
| _version_ | 1811196691853869056 |
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| author | Erli Chen Brian W. Pogue Petr Bruza Daniel A. Alexander Nancy L. Andino Savannah M. Decker Danielle M. Gaudet David J. Gladstone Melinda J. Lake Steven R. Levene Jennifer L. Michelson Hila L. Robinson Debra N. Stallings John E. Starkey Lesley A. Jarvis |
| author_facet | Erli Chen Brian W. Pogue Petr Bruza Daniel A. Alexander Nancy L. Andino Savannah M. Decker Danielle M. Gaudet David J. Gladstone Melinda J. Lake Steven R. Levene Jennifer L. Michelson Hila L. Robinson Debra N. Stallings John E. Starkey Lesley A. Jarvis |
| author_sort | Erli Chen |
| collection | DOAJ |
| description | Purpose: To document experiences with one year of clinical implementation of the first Cherenkov imaging system and share the methods that we developed to utilize Cherenkov imaging to improve treatment delivery accuracy in real-time. Methods: A Cherenkov imaging system was installed commissioned and calibrated for clinical use. The optimal room lighting conditions and imaging setup protocols were developed to optimize both image quality and patient experience. The Cherenkov images were analyzed for treatment setup and beam delivery verification. Results: We have successfully implemented a clinical Cherenkov imaging system in a community-based hospital. Several radiation therapy patient setup anomalies were found in 1) exit dose to the contralateral breast, 2) dose to the chin due to head rotation for a supraclavicular field, 3) intrafractional patient motion during beam delivery, and 4) large variability (0.5 cm to 5 cm) in arm position between fractions. The system was used to deliver deep inspiration breath hold (DIBH) treatment delivery of an electron treatment beam. Clinical process and procedures were improved to mitigate the identified issues to ensure treatment delivery safety and to improve treatment accuracy. Conclusion: The Cherenkov imaging system has proven to be a valuable clinical tool for the improvement of treatment delivery safety and accuracy at our hospital. With only minimal training the therapists were able to adjust or correct treatment positions during treatment delivery as needed. With future Cherenkov software developments Cherenkov imaging systems could provide daily surface guided radiotherapy (SGRT) and real time treatment delivery quality control for all 3D and clinical setup patients without adding additional radiation image dose as in standard kV, MV and CBCT image verifications. Cherenkov imaging can greatly improve clinical efficiency and accuracy, making real time dose delivery consistency verification and SGRT a reality. |
| first_indexed | 2024-04-12T01:03:15Z |
| format | Article |
| id | doaj.art-3810d185101c42eea0ef1843c44439f9 |
| institution | Directory Open Access Journal |
| issn | 2405-6324 |
| language | English |
| last_indexed | 2024-04-12T01:03:15Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Technical Innovations & Patient Support in Radiation Oncology |
| spelling | doaj.art-3810d185101c42eea0ef1843c44439f92022-12-22T03:54:21ZengElsevierTechnical Innovations & Patient Support in Radiation Oncology2405-63242022-12-012415Clinical implementation of the first Cherenkov imaging system in a community-based hospitalErli Chen0Brian W. Pogue1Petr Bruza2Daniel A. Alexander3Nancy L. Andino4Savannah M. Decker5Danielle M. Gaudet6David J. Gladstone7Melinda J. Lake8Steven R. Levene9Jennifer L. Michelson10Hila L. Robinson11Debra N. Stallings12John E. Starkey13Lesley A. Jarvis14Cheshire Medical Center – Dartmouth Health; Corresponding author.Thayer School of Engineering at DartmouthThayer School of Engineering at DartmouthThayer School of Engineering at DartmouthCheshire Medical Center – Dartmouth HealthThayer School of Engineering at DartmouthCheshire Medical Center – Dartmouth HealthThayer School of Engineering at Dartmouth; Dartmouth Geisel School of MedicineCheshire Medical Center – Dartmouth HealthCheshire Medical Center – Dartmouth HealthCheshire Medical Center – Dartmouth HealthCheshire Medical Center – Dartmouth HealthCheshire Medical Center – Dartmouth HealthCheshire Medical Center – Dartmouth HealthDartmouth Geisel School of Medicine; Dartmouth Cancer Center - Dartmouth HealthPurpose: To document experiences with one year of clinical implementation of the first Cherenkov imaging system and share the methods that we developed to utilize Cherenkov imaging to improve treatment delivery accuracy in real-time. Methods: A Cherenkov imaging system was installed commissioned and calibrated for clinical use. The optimal room lighting conditions and imaging setup protocols were developed to optimize both image quality and patient experience. The Cherenkov images were analyzed for treatment setup and beam delivery verification. Results: We have successfully implemented a clinical Cherenkov imaging system in a community-based hospital. Several radiation therapy patient setup anomalies were found in 1) exit dose to the contralateral breast, 2) dose to the chin due to head rotation for a supraclavicular field, 3) intrafractional patient motion during beam delivery, and 4) large variability (0.5 cm to 5 cm) in arm position between fractions. The system was used to deliver deep inspiration breath hold (DIBH) treatment delivery of an electron treatment beam. Clinical process and procedures were improved to mitigate the identified issues to ensure treatment delivery safety and to improve treatment accuracy. Conclusion: The Cherenkov imaging system has proven to be a valuable clinical tool for the improvement of treatment delivery safety and accuracy at our hospital. With only minimal training the therapists were able to adjust or correct treatment positions during treatment delivery as needed. With future Cherenkov software developments Cherenkov imaging systems could provide daily surface guided radiotherapy (SGRT) and real time treatment delivery quality control for all 3D and clinical setup patients without adding additional radiation image dose as in standard kV, MV and CBCT image verifications. Cherenkov imaging can greatly improve clinical efficiency and accuracy, making real time dose delivery consistency verification and SGRT a reality.http://www.sciencedirect.com/science/article/pii/S2405632422000312 |
| spellingShingle | Erli Chen Brian W. Pogue Petr Bruza Daniel A. Alexander Nancy L. Andino Savannah M. Decker Danielle M. Gaudet David J. Gladstone Melinda J. Lake Steven R. Levene Jennifer L. Michelson Hila L. Robinson Debra N. Stallings John E. Starkey Lesley A. Jarvis Clinical implementation of the first Cherenkov imaging system in a community-based hospital Technical Innovations & Patient Support in Radiation Oncology |
| title | Clinical implementation of the first Cherenkov imaging system in a community-based hospital |
| title_full | Clinical implementation of the first Cherenkov imaging system in a community-based hospital |
| title_fullStr | Clinical implementation of the first Cherenkov imaging system in a community-based hospital |
| title_full_unstemmed | Clinical implementation of the first Cherenkov imaging system in a community-based hospital |
| title_short | Clinical implementation of the first Cherenkov imaging system in a community-based hospital |
| title_sort | clinical implementation of the first cherenkov imaging system in a community based hospital |
| url | http://www.sciencedirect.com/science/article/pii/S2405632422000312 |
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