Same-day consultation, simulation and lung Stereotactic Ablative Radiotherapy delivery on a Magnetic Resonance-linac
Background and Purpose: Magnetic resonance-guided radiotherapy (MRgRT) with real-time intra-fraction tumor motion monitoring allows for high precision Stereotactic Ablative Radiotherapy (SABR). This study aimed to investigate the clinical feasibility, patient satisfaction and delivery accuracy of si...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-10-01
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| Series: | Physics and Imaging in Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405631622000860 |
| _version_ | 1797980270627913728 |
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| author | Miguel A. Palacios Sonja Verheijen Famke L. Schneiders Omar Bohoudi Berend J. Slotman Frank J. Lagerwaard Suresh Senan |
| author_facet | Miguel A. Palacios Sonja Verheijen Famke L. Schneiders Omar Bohoudi Berend J. Slotman Frank J. Lagerwaard Suresh Senan |
| author_sort | Miguel A. Palacios |
| collection | DOAJ |
| description | Background and Purpose: Magnetic resonance-guided radiotherapy (MRgRT) with real-time intra-fraction tumor motion monitoring allows for high precision Stereotactic Ablative Radiotherapy (SABR). This study aimed to investigate the clinical feasibility, patient satisfaction and delivery accuracy of single-fraction MR-guided SABR in a single day (one-stop-shop, OSS). Methods and Materials: Ten patients with small lung tumors eligible for single fraction treatments were included. The OSS procedure consisted of consultation, treatment simulation, treatment planning and delivery. Following SABR delivery, patients completed a reported experience measure (PREM) questionnaire. Prescribed doses ranged 28–34 Gy. Median GTV was 2.2 cm3 (range 1.3–22.9 cm3). A gating boundary of 3 mm, and PTV margin of 5 mm around the GTV, were used with auto-beam delivery control. Accuracy of SABR delivery was studied by analyzing delivered MR-cines reconstructed from machine log files. Results: All 10 patients completed the OSS procedure in a single day, and all reported satisfaction with the process. Median time for the treatment planning step and the whole procedure were 2.8 h and 6.6 h, respectively. With optimization of the procedure, treatment could be completed in half a day. During beam-on, the 3 mm tracking boundary encompassed between 78.0 and 100 % of the GTV across all patients, with corresponding PTV values being 94.4–100 % (5th-95th percentiles). On average, system-latency for triggering a beam-off event comprised 5.3 % of the delivery time. Latency reduced GTV coverage by an average of −0.3 %. Duty-cycles during treatment delivery ranged from 26.1 to 64.7 %. Conclusions: An OSS procedure with MR-guided SABR for lung cancer led to good patient satisfaction. Gated treatment delivery was highly accurate with little impact of system-latency. |
| first_indexed | 2024-04-11T05:52:01Z |
| format | Article |
| id | doaj.art-3a7b422b59204d95b638443c1b85da54 |
| institution | Directory Open Access Journal |
| issn | 2405-6316 |
| language | English |
| last_indexed | 2024-04-11T05:52:01Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Physics and Imaging in Radiation Oncology |
| spelling | doaj.art-3a7b422b59204d95b638443c1b85da542022-12-22T04:42:01ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162022-10-01247681Same-day consultation, simulation and lung Stereotactic Ablative Radiotherapy delivery on a Magnetic Resonance-linacMiguel A. Palacios0Sonja Verheijen1Famke L. Schneiders2Omar Bohoudi3Berend J. Slotman4Frank J. Lagerwaard5Suresh Senan6Corresponding author.; Amsterdam UMC, Vrije Universiteit Medical Centre, Dept. of Radiation Oncology, de Boelelaan 1117, 1081 HV Amsterdam, the NetherlandsAmsterdam UMC, Vrije Universiteit Medical Centre, Dept. of Radiation Oncology, de Boelelaan 1117, 1081 HV Amsterdam, the NetherlandsAmsterdam UMC, Vrije Universiteit Medical Centre, Dept. of Radiation Oncology, de Boelelaan 1117, 1081 HV Amsterdam, the NetherlandsAmsterdam UMC, Vrije Universiteit Medical Centre, Dept. of Radiation Oncology, de Boelelaan 1117, 1081 HV Amsterdam, the NetherlandsAmsterdam UMC, Vrije Universiteit Medical Centre, Dept. of Radiation Oncology, de Boelelaan 1117, 1081 HV Amsterdam, the NetherlandsAmsterdam UMC, Vrije Universiteit Medical Centre, Dept. of Radiation Oncology, de Boelelaan 1117, 1081 HV Amsterdam, the NetherlandsAmsterdam UMC, Vrije Universiteit Medical Centre, Dept. of Radiation Oncology, de Boelelaan 1117, 1081 HV Amsterdam, the NetherlandsBackground and Purpose: Magnetic resonance-guided radiotherapy (MRgRT) with real-time intra-fraction tumor motion monitoring allows for high precision Stereotactic Ablative Radiotherapy (SABR). This study aimed to investigate the clinical feasibility, patient satisfaction and delivery accuracy of single-fraction MR-guided SABR in a single day (one-stop-shop, OSS). Methods and Materials: Ten patients with small lung tumors eligible for single fraction treatments were included. The OSS procedure consisted of consultation, treatment simulation, treatment planning and delivery. Following SABR delivery, patients completed a reported experience measure (PREM) questionnaire. Prescribed doses ranged 28–34 Gy. Median GTV was 2.2 cm3 (range 1.3–22.9 cm3). A gating boundary of 3 mm, and PTV margin of 5 mm around the GTV, were used with auto-beam delivery control. Accuracy of SABR delivery was studied by analyzing delivered MR-cines reconstructed from machine log files. Results: All 10 patients completed the OSS procedure in a single day, and all reported satisfaction with the process. Median time for the treatment planning step and the whole procedure were 2.8 h and 6.6 h, respectively. With optimization of the procedure, treatment could be completed in half a day. During beam-on, the 3 mm tracking boundary encompassed between 78.0 and 100 % of the GTV across all patients, with corresponding PTV values being 94.4–100 % (5th-95th percentiles). On average, system-latency for triggering a beam-off event comprised 5.3 % of the delivery time. Latency reduced GTV coverage by an average of −0.3 %. Duty-cycles during treatment delivery ranged from 26.1 to 64.7 %. Conclusions: An OSS procedure with MR-guided SABR for lung cancer led to good patient satisfaction. Gated treatment delivery was highly accurate with little impact of system-latency.http://www.sciencedirect.com/science/article/pii/S2405631622000860Lung SBRTSame-day treatmentSingle FractionMR-guidedIntra-fractionMotion Management |
| spellingShingle | Miguel A. Palacios Sonja Verheijen Famke L. Schneiders Omar Bohoudi Berend J. Slotman Frank J. Lagerwaard Suresh Senan Same-day consultation, simulation and lung Stereotactic Ablative Radiotherapy delivery on a Magnetic Resonance-linac Physics and Imaging in Radiation Oncology Lung SBRT Same-day treatment Single Fraction MR-guided Intra-fraction Motion Management |
| title | Same-day consultation, simulation and lung Stereotactic Ablative Radiotherapy delivery on a Magnetic Resonance-linac |
| title_full | Same-day consultation, simulation and lung Stereotactic Ablative Radiotherapy delivery on a Magnetic Resonance-linac |
| title_fullStr | Same-day consultation, simulation and lung Stereotactic Ablative Radiotherapy delivery on a Magnetic Resonance-linac |
| title_full_unstemmed | Same-day consultation, simulation and lung Stereotactic Ablative Radiotherapy delivery on a Magnetic Resonance-linac |
| title_short | Same-day consultation, simulation and lung Stereotactic Ablative Radiotherapy delivery on a Magnetic Resonance-linac |
| title_sort | same day consultation simulation and lung stereotactic ablative radiotherapy delivery on a magnetic resonance linac |
| topic | Lung SBRT Same-day treatment Single Fraction MR-guided Intra-fraction Motion Management |
| url | http://www.sciencedirect.com/science/article/pii/S2405631622000860 |
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