A survey of practice patterns for real-time intrafractional motion-management in particle therapy
Background and purpose: Organ motion compromises accurate particle therapy delivery. This study reports on the practice patterns for real-time intrafractional motion-management in particle therapy to evaluate current clinical practice and wishes and barriers to implementation. Materials and methods:...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | Physics and Imaging in Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405631623000301 |
| _version_ | 1797809150622695424 |
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| author | Ye Zhang Petra Trnkova Toshiyuki Toshito Ben Heijmen Christian Richter Marianne Aznar Francesca Albertini Alexandra Bolsi Juliane Daartz Jenny Bertholet Antje Knopf |
| author_facet | Ye Zhang Petra Trnkova Toshiyuki Toshito Ben Heijmen Christian Richter Marianne Aznar Francesca Albertini Alexandra Bolsi Juliane Daartz Jenny Bertholet Antje Knopf |
| author_sort | Ye Zhang |
| collection | DOAJ |
| description | Background and purpose: Organ motion compromises accurate particle therapy delivery. This study reports on the practice patterns for real-time intrafractional motion-management in particle therapy to evaluate current clinical practice and wishes and barriers to implementation. Materials and methods: An institutional questionnaire was distributed to particle therapy centres worldwide (7/2020–6/2021) asking which type(s) of real-time respiratory motion management (RRMM) methods were used, for which treatment sites, and what were the wishes and barriers to implementation. This was followed by a three-round DELPHI consensus analysis (10/2022) to define recommendations on required actions and future vision. With 70 responses from 17 countries, response rate was 100% for Europe (23/23 centres), 96% for Japan (22/23) and 53% for USA (20/38). Results: Of the 68 clinically operational centres, 85% used RRMM, with 41% using both rescanning and active methods. Sixty-four percent used active-RRMM for at least one treatment site, mostly with gating guided by an external marker. Forty-eight percent of active-RRMM users wished to expand or change their RRMM technique. The main barriers were technical limitations and limited resources. From the DELPHI analysis, optimisation of rescanning parameters, improvement of motion models, and pre-treatment 4D evaluation were unanimously considered clinically important future focus. 4D dose calculation was identified as the top requirement for future commercial treatment planning software. Conclusion: A majority of particle therapy centres have implemented RRMM. Still, further development and clinical integration were desired by most centres. Joint industry, clinical and research efforts are needed to translate innovation into efficient workflows for broad-scale implementation. |
| first_indexed | 2024-03-13T06:48:15Z |
| format | Article |
| id | doaj.art-3d40c662dbcb4a2da79f287798643c2a |
| institution | Directory Open Access Journal |
| issn | 2405-6316 |
| language | English |
| last_indexed | 2024-03-13T06:48:15Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Physics and Imaging in Radiation Oncology |
| spelling | doaj.art-3d40c662dbcb4a2da79f287798643c2a2023-06-08T04:19:28ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162023-04-0126100439A survey of practice patterns for real-time intrafractional motion-management in particle therapyYe Zhang0Petra Trnkova1Toshiyuki Toshito2Ben Heijmen3Christian Richter4Marianne Aznar5Francesca Albertini6Alexandra Bolsi7Juliane Daartz8Jenny Bertholet9Antje Knopf10Center for Proton Therapy, Paul Scherrer Institute, Villigen, SwitzerlandDepartment of Radiation Oncology, Medical University of Vienna, Vienna, AustriaNagoya Proton Therapy Center, Nagoya City University West Medical Center, Nagoya, JapanDepartment of Radiotherapy, Erasmus University Medical Center (Erasmus MC), Rotterdam, the NetherlandsOncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Dresden, GermanyFaculty of Biology, Medicine and Health, Division of Cancer Sciences, University of Manchester, United KingdomCenter for Proton Therapy, Paul Scherrer Institute, Villigen, SwitzerlandCenter for Proton Therapy, Paul Scherrer Institute, Villigen, SwitzerlandF. Burr Proton Therapy, Massachusetts General Hospital and Harvard Medical School, Boston, USADivision of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, Bern, SwitzerlandCenter for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland; Institute for Medical Engineering and Medical Informatics, School of Life Science FHNW, Muttenz, SwitzerlandBackground and purpose: Organ motion compromises accurate particle therapy delivery. This study reports on the practice patterns for real-time intrafractional motion-management in particle therapy to evaluate current clinical practice and wishes and barriers to implementation. Materials and methods: An institutional questionnaire was distributed to particle therapy centres worldwide (7/2020–6/2021) asking which type(s) of real-time respiratory motion management (RRMM) methods were used, for which treatment sites, and what were the wishes and barriers to implementation. This was followed by a three-round DELPHI consensus analysis (10/2022) to define recommendations on required actions and future vision. With 70 responses from 17 countries, response rate was 100% for Europe (23/23 centres), 96% for Japan (22/23) and 53% for USA (20/38). Results: Of the 68 clinically operational centres, 85% used RRMM, with 41% using both rescanning and active methods. Sixty-four percent used active-RRMM for at least one treatment site, mostly with gating guided by an external marker. Forty-eight percent of active-RRMM users wished to expand or change their RRMM technique. The main barriers were technical limitations and limited resources. From the DELPHI analysis, optimisation of rescanning parameters, improvement of motion models, and pre-treatment 4D evaluation were unanimously considered clinically important future focus. 4D dose calculation was identified as the top requirement for future commercial treatment planning software. Conclusion: A majority of particle therapy centres have implemented RRMM. Still, further development and clinical integration were desired by most centres. Joint industry, clinical and research efforts are needed to translate innovation into efficient workflows for broad-scale implementation.http://www.sciencedirect.com/science/article/pii/S2405631623000301Particle/proton therapyIntrafraction motionReal-time respiratory motion managementImage-guided particle therapyRescanning |
| spellingShingle | Ye Zhang Petra Trnkova Toshiyuki Toshito Ben Heijmen Christian Richter Marianne Aznar Francesca Albertini Alexandra Bolsi Juliane Daartz Jenny Bertholet Antje Knopf A survey of practice patterns for real-time intrafractional motion-management in particle therapy Physics and Imaging in Radiation Oncology Particle/proton therapy Intrafraction motion Real-time respiratory motion management Image-guided particle therapy Rescanning |
| title | A survey of practice patterns for real-time intrafractional motion-management in particle therapy |
| title_full | A survey of practice patterns for real-time intrafractional motion-management in particle therapy |
| title_fullStr | A survey of practice patterns for real-time intrafractional motion-management in particle therapy |
| title_full_unstemmed | A survey of practice patterns for real-time intrafractional motion-management in particle therapy |
| title_short | A survey of practice patterns for real-time intrafractional motion-management in particle therapy |
| title_sort | survey of practice patterns for real time intrafractional motion management in particle therapy |
| topic | Particle/proton therapy Intrafraction motion Real-time respiratory motion management Image-guided particle therapy Rescanning |
| url | http://www.sciencedirect.com/science/article/pii/S2405631623000301 |
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