A hybrid IGRT workflow using SGRT and CBCT for prostate SBRT: Feasibility, efficiency, and safety.
Uloženo v:
| Název: | A hybrid IGRT workflow using SGRT and CBCT for prostate SBRT: Feasibility, efficiency, and safety. |
|---|---|
| Autoři: | Meyer J; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Tran A; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Ma TM; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Chiang BH; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Egan T; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Chen JJ; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Tao Y; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Cao N; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Kim KH; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Liao JJ; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Koufigar S; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Vuong W; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA., Weg ES; Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA. |
| Zdroj: | Journal of applied clinical medical physics [J Appl Clin Med Phys] 2025 Nov; Vol. 26 (11), pp. e70339. |
| Způsob vydávání: | Journal Article |
| Jazyk: | English |
| Informace o časopise: | Publisher: Wiley on behalf of American Association of Physicists in Medicine Country of Publication: United States NLM ID: 101089176 Publication Model: Print Cited Medium: Internet ISSN: 1526-9914 (Electronic) Linking ISSN: 15269914 NLM ISO Abbreviation: J Appl Clin Med Phys Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2017- : Malden, MA : Wiley on behalf of American Association of Physicists in Medicine Original Publication: Reston, VA : American College of Medical Physics, c2000- |
| Výrazy ze slovníku MeSH: | Prostatic Neoplasms*/surgery , Prostatic Neoplasms*/diagnostic imaging , Prostatic Neoplasms*/radiotherapy , Cone-Beam Computed Tomography*/methods , Radiosurgery*/methods , Radiotherapy Planning, Computer-Assisted*/methods , Workflow* , Radiotherapy, Intensity-Modulated*/methods , Radiotherapy, Image-Guided*/methods, Humans ; Male ; Radiotherapy Dosage ; Feasibility Studies ; Prospective Studies ; Organs at Risk/radiation effects ; Aged ; Image Processing, Computer-Assisted/methods |
| Abstrakt: | Background and Purpose: Safe delivery of prostate stereotactic body radiotherapy (SBRT) relies on precise target localization. Without access to real-time intrafraction motion management, careful optimization of IGRT protocols is necessary to safeguard treatment accuracy and patient outcomes. Methods: An IGRT workflow is proposed that incorporates surface-monitoring (SGRT) to complement cone-beam CT (CBCT) imaging. The study evaluates 23 consecutive SBRT prostate patients who were treated on a prospective registry study. Each patient received pre- and mid-treatment and a subset received post-treatment CBCTs. The frequency and magnitude of SGRT triggered beam interruptions as well as treatment times were recorded. Results: The median number of CBCTs acquired per fraction was four and the median treatment time was 23 min (IQR 19-27). SGRT detected intra-fraction surface-based motion beyond a combined 4 mm vector isocenter tolerance in 62% of all fractions treated, with a maximum motion of 15 mm. On average < 2 beam interruptions were triggered by SGRT per treatment fraction. There was no statistically significant correlation between overall treatment time and SGRT-triggered beam interruptions (r = 0.048, p = 0.645). There was a weak but statistically relevant correlation of overall treatment time with the maximum detected motion (r = 0.23, p = 0.026). SGRT detected five fractions where the patients had persistently moved outside the SGRT tolerance, and for three of these (60%), a CBCT verified that the target was out of tolerance. Conclusion: SGRT is a valuable tool that complements CBCT-based IGRT. An SGRT motion vector tolerance of 4 mm provides a pragmatic compromise between detecting patient motion and treatment efficiency. Overall, persistent patient motion during treatment was infrequent in this cohort, however, SGRT was able to detect several cases where the internal target was outside of the tolerance highlighting that patient monitoring with SGRT can contribute to improved quality and safety for prostate SBRT. (© 2025 The Author(s). Journal of Applied Clinical Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.) |
| References: | Lancet. 2019 Aug 3;394(10196):385-395. (PMID: 31227373) Int J Radiat Oncol Biol Phys. 2013 Jul 15;86(4):755-61. (PMID: 23582854) Lancet Oncol. 2022 Oct;23(10):1308-1320. (PMID: 36113498) Radiother Oncol. 2023 Feb;179:109441. (PMID: 36549340) Pract Radiat Oncol. 2020 Sep - Oct;10(5):e388-e396. (PMID: 32454176) Prostate Cancer Prostatic Dis. 2020 Jun;23(2):349-355. (PMID: 31780782) J Natl Compr Canc Netw. 2023 Oct;21(10):1067-1096. (PMID: 37856213) Int J Radiat Oncol Biol Phys. 2024 Apr 1;118(5):1181-1191. (PMID: 38160916) Radiother Oncol. 2020 Dec;153:34-42. (PMID: 32987044) Int J Radiat Oncol Biol Phys. 2005 Jul 15;62(4):965-73. (PMID: 15989996) Int J Radiat Oncol Biol Phys. 2019 May 1;104(1):42-49. (PMID: 30611838) Br J Radiol. 2021 Jan 01;94(1117):20200696. (PMID: 33095670) Med Phys. 2020 Feb;47(2):352-362. (PMID: 31724177) Radiat Oncol. 2021 Sep 26;16(1):189. (PMID: 34565439) Radiat Oncol. 2020 Oct 16;15(1):239. (PMID: 33066781) Int J Radiat Oncol Biol Phys. 2008 Feb 1;70(2):609-18. (PMID: 17996389) Int J Radiat Oncol Biol Phys. 2018 Dec 1;102(5):1420-1429. (PMID: 30071296) BMC Cancer. 2021 May 11;21(1):538. (PMID: 33975579) Tech Innov Patient Support Radiat Oncol. 2024 May 06;30:100253. (PMID: 38746647) Tech Innov Patient Support Radiat Oncol. 2021 Sep 04;19:41-45. (PMID: 34527818) Pract Radiat Oncol. 2024 Mar-Apr;14(2):146-153. (PMID: 37875222) J Appl Clin Med Phys. 2017 Nov;18(6):58-61. (PMID: 28901684) BMC Urol. 2010 Feb 01;10:1. (PMID: 20122161) Pract Radiat Oncol. 2024 Mar-Apr;14(2):e150-e158. (PMID: 37935308) Int J Radiat Oncol Biol Phys. 2006 Jun 1;65(2):528-34. (PMID: 16690435) Int J Radiat Oncol Biol Phys. 2012 Feb 1;82(2):877-82. (PMID: 21300474) Phys Eng Sci Med. 2022 Jun;45(2):457-473. (PMID: 35235188) J Appl Clin Med Phys. 2014 Nov 08;15(6):4957. (PMID: 25493520) Radiat Oncol. 2021 Sep 17;16(1):180. (PMID: 34535168) J Radiat Res. 2021 Jul 10;62(4):726-734. (PMID: 34036361) Int J Radiat Oncol Biol Phys. 2012 Sep 1;84(1):125-9. (PMID: 22330997) Transl Androl Urol. 2018 Jun;7(3):308-320. (PMID: 30050792) Radiat Oncol. 2025 Apr 17;20(1):57. (PMID: 40247390) Semin Radiat Oncol. 2018 Jun;28(3):185-193. (PMID: 29933878) Radiat Oncol. 2015 Mar 19;10:68. (PMID: 25881018) PLoS One. 2015 Apr 20;10(4):e0123359. (PMID: 25894841) J Appl Clin Med Phys. 2023 Dec;24(12):e14133. (PMID: 37643456) Radiat Oncol. 2019 Jun 13;14(1):105. (PMID: 31196120) Med Phys. 2010 Aug;37(8):4078-101. (PMID: 20879569) Front Oncol. 2020 Nov 27;10:602607. (PMID: 33330102) Radiother Oncol. 2021 Oct;163:229-236. (PMID: 34453955) Int J Radiat Oncol Biol Phys. 2007 Nov 1;69(3):936-43. (PMID: 17889275) JAMA Netw Open. 2019 Feb 1;2(2):e188006. (PMID: 30735235) Phys Eng Sci Med. 2023 Dec;46(4):1365-1374. (PMID: 37523057) Radiat Oncol. 2015 Apr 09;10:82. (PMID: 25890013) Int J Radiat Oncol Biol Phys. 2019 Jun 1;104(2):334-342. (PMID: 30721721) Phys Imaging Radiat Oncol. 2018 May 25;6:66-70. (PMID: 33458391) |
| Contributed Indexing: | Keywords: SGRT tolerances; image guided radiation therapy (IGRT) workflow optimization; patient monitoring; patient safety; prostate stereotactic body radiation therapy (SBRT); surface guided radiotherapy (SGRT) |
| Entry Date(s): | Date Created: 20251107 Date Completed: 20251107 Latest Revision: 20251110 |
| Update Code: | 20251110 |
| PubMed Central ID: | PMC12593551 |
| DOI: | 10.1002/acm2.70339 |
| PMID: | 41201189 |
| Databáze: | MEDLINE |
Full Text 
Full Text Finder 
Nájsť tento článok vo Web of Science | Abstrakt: | Background and Purpose: Safe delivery of prostate stereotactic body radiotherapy (SBRT) relies on precise target localization. Without access to real-time intrafraction motion management, careful optimization of IGRT protocols is necessary to safeguard treatment accuracy and patient outcomes.<br />Methods: An IGRT workflow is proposed that incorporates surface-monitoring (SGRT) to complement cone-beam CT (CBCT) imaging. The study evaluates 23 consecutive SBRT prostate patients who were treated on a prospective registry study. Each patient received pre- and mid-treatment and a subset received post-treatment CBCTs. The frequency and magnitude of SGRT triggered beam interruptions as well as treatment times were recorded.<br />Results: The median number of CBCTs acquired per fraction was four and the median treatment time was 23 min (IQR 19-27). SGRT detected intra-fraction surface-based motion beyond a combined 4 mm vector isocenter tolerance in 62% of all fractions treated, with a maximum motion of 15 mm. On average < 2 beam interruptions were triggered by SGRT per treatment fraction. There was no statistically significant correlation between overall treatment time and SGRT-triggered beam interruptions (r = 0.048, p = 0.645). There was a weak but statistically relevant correlation of overall treatment time with the maximum detected motion (r = 0.23, p = 0.026). SGRT detected five fractions where the patients had persistently moved outside the SGRT tolerance, and for three of these (60%), a CBCT verified that the target was out of tolerance.<br />Conclusion: SGRT is a valuable tool that complements CBCT-based IGRT. An SGRT motion vector tolerance of 4 mm provides a pragmatic compromise between detecting patient motion and treatment efficiency. Overall, persistent patient motion during treatment was infrequent in this cohort, however, SGRT was able to detect several cases where the internal target was outside of the tolerance highlighting that patient monitoring with SGRT can contribute to improved quality and safety for prostate SBRT.<br /> (© 2025 The Author(s). Journal of Applied Clinical Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.) |
|---|---|
| ISSN: | 1526-9914 |
| DOI: | 10.1002/acm2.70339 |