The Clinical and Dosimetric Impact of Real-Time Target Tracking in Pancreatic SBRT

International Journal of Radiation Oncology, Biology, Physics
Yevgeniy VinogradskiyBernard L Jones

Abstract

Motion often hinders the safe delivery of ablative doses of radiation in the treatment of pancreatic tumors. Real-time tumor-tracking methods are an emerging technique to increase the accuracy of delivery. In this study, we report on a large, retrospective cohort of pancreatic patients treated with real-time, fiducial-based, kV-image guidance of stereotactic body radiation therapy (SBRT). The purpose of our study was to determine the impact of real-time tracking on treatment accuracy, tumor dose, and clinical workflow. Real-time tracking data from 68 patients treated with pancreatic SBRT were analyzed. The kV images orthogonal to the treatment beam were acquired in real time during treatment to visualize the location of implanted fiducial markers. Positional corrections were made if the fiducial markers were observed >3 mm from the expected reference position. We recorded the frequency and nature of treatment interventions resulting from real-time tracking and derived a neural network-based dosimetric model to calculate the impact of these in-treatment interventions on target dose. Treatment pauses that required patient realignment because of real-time tumor tracking occurred during 32% of all fractions. The median magnitude of...Continue Reading

Citations

Jun 22, 2019·Physics in Medicine and Biology·Jenny BertholetUwe Oelfke
Dec 31, 2019·Journal of Applied Clinical Medical Physics·Takaaki YoshimuraHiroki Shirato
Apr 6, 2019·Practical Radiation Oncology·Yijun DingBernard L Jones
May 22, 2021·Physical and Engineering Sciences in Medicine·Sankar ArumugamMark Lee
Dec 6, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Sara J ZakemKaryn A Goodman
Oct 11, 2020·Clinical Oncology : a Journal of the Royal College of Radiologists·J DhontJ Bertholet
Sep 6, 2021·Medical Physics·Sarah Han-OhDaniel Bliss
Jun 26, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Gail AnastasiMarianne C Aznar

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