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Optimizing the Patient Positioning Workflow of Patients with Pelvis, Limb, and Chest/Spine Tumors at an Ion-Beam Gantry based on Optical Surface Guidance

PURPOSE: Surface-guided radiation therapy (SGRT) has been investigated intensively to ensure correct patient positioning during a radiation therapy course. Although the implementation is well defined for photon-beam facilities, only a few analyses have been published for ion-beam therapy centers. To...

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Autores principales: Qubala, Abdallah, Schwahofer, Andrea, Jersemann, Stefan, Eskandarian, Saleh, Harrabi, Semi, Naumann, Patrick, Winter, Marcus, Ellerbrock, Malte, Shafee, Jehad, Abtehi, Samira, Herfarth, Klaus, Debus, Jürgen, Jäkel, Oliver
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9822948/
https://www.ncbi.nlm.nih.gov/pubmed/36624871
http://dx.doi.org/10.1016/j.adro.2022.101105
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author Qubala, Abdallah
Schwahofer, Andrea
Jersemann, Stefan
Eskandarian, Saleh
Harrabi, Semi
Naumann, Patrick
Winter, Marcus
Ellerbrock, Malte
Shafee, Jehad
Abtehi, Samira
Herfarth, Klaus
Debus, Jürgen
Jäkel, Oliver
author_facet Qubala, Abdallah
Schwahofer, Andrea
Jersemann, Stefan
Eskandarian, Saleh
Harrabi, Semi
Naumann, Patrick
Winter, Marcus
Ellerbrock, Malte
Shafee, Jehad
Abtehi, Samira
Herfarth, Klaus
Debus, Jürgen
Jäkel, Oliver
author_sort Qubala, Abdallah
collection PubMed
description PURPOSE: Surface-guided radiation therapy (SGRT) has been investigated intensively to ensure correct patient positioning during a radiation therapy course. Although the implementation is well defined for photon-beam facilities, only a few analyses have been published for ion-beam therapy centers. To investigate the accuracy, reliability, and efficiency of SGRT used in ion-beam treatments against the conventional skin marks, a retrospective study of a unique SGRT installation in an ion gantry treatment room was conducted, where the environment is quite different to conventional radiation therapy. METHODS AND MATERIALS: There were 32 patients, divided into 3 cohorts—pelvis, limb, and chest/spine tumors—and treated with ion-beams. Two patient positioning workflows based on 300 fractions were compared: workflow with skin marks and workflow with SGRT. Position verification was followed by planar kilo voltage imaging. After image matching, 6 degrees of freedom corrections were recorded to assess interfraction positioning errors. In addition, the time required for patient positioning, image matching, and the number of repeated kilo voltage imaging also were gathered. RESULTS: SGRT decreased the translational magnitude shifts significantly (P < .05) by 0.5 ± 1.4 mm for pelvis and 1.9 ± 0.5 mm for limb, whereas for chest/spine, it increased by 0.7 ± 0.3 mm. Rotational corrections were predominantly lowered with SGRT for all cohorts with significant differences in pitch for pelvis (P = .002) and chest/spine (P = .009). The patient positioning time decreased by 18%, 9%, and 15% for pelvis, limb, and chest/spine, respectively, compared with skin marks. By using SGRT, 53% of all studied patients had faster positioning time, and 87.5% had faster matching time. Repositioning and consequent reimaging decreased from about 7% to 2% with a statistically significant difference of .042. CONCLUSIONS: The quality of patient positioning before ion-beam treatments has been optimized by using SGRT without additional imaging dose. SGRT clearly reduced inefficiencies in the patient positioning workflow.
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spelling pubmed-98229482023-01-08 Optimizing the Patient Positioning Workflow of Patients with Pelvis, Limb, and Chest/Spine Tumors at an Ion-Beam Gantry based on Optical Surface Guidance Qubala, Abdallah Schwahofer, Andrea Jersemann, Stefan Eskandarian, Saleh Harrabi, Semi Naumann, Patrick Winter, Marcus Ellerbrock, Malte Shafee, Jehad Abtehi, Samira Herfarth, Klaus Debus, Jürgen Jäkel, Oliver Adv Radiat Oncol Scientific Article PURPOSE: Surface-guided radiation therapy (SGRT) has been investigated intensively to ensure correct patient positioning during a radiation therapy course. Although the implementation is well defined for photon-beam facilities, only a few analyses have been published for ion-beam therapy centers. To investigate the accuracy, reliability, and efficiency of SGRT used in ion-beam treatments against the conventional skin marks, a retrospective study of a unique SGRT installation in an ion gantry treatment room was conducted, where the environment is quite different to conventional radiation therapy. METHODS AND MATERIALS: There were 32 patients, divided into 3 cohorts—pelvis, limb, and chest/spine tumors—and treated with ion-beams. Two patient positioning workflows based on 300 fractions were compared: workflow with skin marks and workflow with SGRT. Position verification was followed by planar kilo voltage imaging. After image matching, 6 degrees of freedom corrections were recorded to assess interfraction positioning errors. In addition, the time required for patient positioning, image matching, and the number of repeated kilo voltage imaging also were gathered. RESULTS: SGRT decreased the translational magnitude shifts significantly (P < .05) by 0.5 ± 1.4 mm for pelvis and 1.9 ± 0.5 mm for limb, whereas for chest/spine, it increased by 0.7 ± 0.3 mm. Rotational corrections were predominantly lowered with SGRT for all cohorts with significant differences in pitch for pelvis (P = .002) and chest/spine (P = .009). The patient positioning time decreased by 18%, 9%, and 15% for pelvis, limb, and chest/spine, respectively, compared with skin marks. By using SGRT, 53% of all studied patients had faster positioning time, and 87.5% had faster matching time. Repositioning and consequent reimaging decreased from about 7% to 2% with a statistically significant difference of .042. CONCLUSIONS: The quality of patient positioning before ion-beam treatments has been optimized by using SGRT without additional imaging dose. SGRT clearly reduced inefficiencies in the patient positioning workflow. Elsevier 2022-12-05 /pmc/articles/PMC9822948/ /pubmed/36624871 http://dx.doi.org/10.1016/j.adro.2022.101105 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Scientific Article
Qubala, Abdallah
Schwahofer, Andrea
Jersemann, Stefan
Eskandarian, Saleh
Harrabi, Semi
Naumann, Patrick
Winter, Marcus
Ellerbrock, Malte
Shafee, Jehad
Abtehi, Samira
Herfarth, Klaus
Debus, Jürgen
Jäkel, Oliver
Optimizing the Patient Positioning Workflow of Patients with Pelvis, Limb, and Chest/Spine Tumors at an Ion-Beam Gantry based on Optical Surface Guidance
title Optimizing the Patient Positioning Workflow of Patients with Pelvis, Limb, and Chest/Spine Tumors at an Ion-Beam Gantry based on Optical Surface Guidance
title_full Optimizing the Patient Positioning Workflow of Patients with Pelvis, Limb, and Chest/Spine Tumors at an Ion-Beam Gantry based on Optical Surface Guidance
title_fullStr Optimizing the Patient Positioning Workflow of Patients with Pelvis, Limb, and Chest/Spine Tumors at an Ion-Beam Gantry based on Optical Surface Guidance
title_full_unstemmed Optimizing the Patient Positioning Workflow of Patients with Pelvis, Limb, and Chest/Spine Tumors at an Ion-Beam Gantry based on Optical Surface Guidance
title_short Optimizing the Patient Positioning Workflow of Patients with Pelvis, Limb, and Chest/Spine Tumors at an Ion-Beam Gantry based on Optical Surface Guidance
title_sort optimizing the patient positioning workflow of patients with pelvis, limb, and chest/spine tumors at an ion-beam gantry based on optical surface guidance
topic Scientific Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9822948/
https://www.ncbi.nlm.nih.gov/pubmed/36624871
http://dx.doi.org/10.1016/j.adro.2022.101105
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