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1.
  • Batista, Vania, et al. (author)
  • Surface guided radiation therapy: : An international survey on current clinical practice
  • 2022
  • In: Technical Innovations and Patient Support in Radiation Oncology. - : Elsevier BV. - 2405-6324. ; 22, s. 1-8
  • Journal article (peer-reviewed)abstract
    • Introduction: Surface Guided Radiation Therapy (SGRT) is being increasingly implemented into clinical practiceacross a number of techniques and irradiation-sites. This technology, which is provided by different vendors, canbe used with most simulation- and delivery-systems. However, limited guidelines and the complexity of clinicalsettings have led to diverse patterns of operation. With the aim to understand current clinical practice a surveywas designed focusing on specifics of the clinical implementation and usage.Materials and methods: A 32-question survey covered: type and number of systems, quality assurance (QA),clinical workflows, and identification of strengths/limitations. Respondents from different professional groupsand countries were invited to participate. The survey was distributed internationally via ESTRO-membership,social media and vendors.Results: Of the 278 institutions responding, 172 had at least one SGRT-system and 136 use SGRT clinically.Implementation and QA were primarily based on the vendors’ recommendations and phantoms. SGRT wasmainly implemented in breast RT (116/136), with strong but diverse representation of other sites. Many (58/135) reported at least partial elimination of skin-marks and a third (43/126) used open-masks. The most commonimaging protocol reported included the combination of radiographic imaging with SGRT. Patient positioning(115/136), motion management (104/136) and DIBH (99/136) were the main applications.Main barriers to broader application were cost, system integration issues and lack of demonstrated clinical value.A lack of guidelines in terms of QA of the system was highlighted.Conclusions: This overview of the SGRT status has the potential to support users, vendors and organisations in thedevelopment of practices, products and guidelines.
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2.
  • Freislederer, P., et al. (author)
  • Recent advanced in Surface Guided Radiation Therapy
  • 2020
  • In: Radiation oncology (London, England). - : Springer Science and Business Media LLC. - 1748-717X. ; 15:1
  • Research review (peer-reviewed)abstract
    • The growing acceptance and recognition of Surface Guided Radiation Therapy (SGRT) as a promising imaging technique has supported its recent spread in a large number of radiation oncology facilities. Although this technology is not new, many aspects of it have only recently been exploited. This review focuses on the latest SGRT developments, both in the field of general clinical applications and special techniques.SGRT has a wide range of applications, including patient positioning with real-time feedback, patient monitoring throughout the treatment fraction, and motion management (as beam-gating in free-breathing or deep-inspiration breath-hold). Special radiotherapy modalities such as accelerated partial breast irradiation, particle radiotherapy, and pediatrics are the most recent SGRT developments.The fact that SGRT is nowadays used at various body sites has resulted in the need to adapt SGRT workflows to each body site. Current SGRT applications range from traditional breast irradiation, to thoracic, abdominal, or pelvic tumor sites, and include intracranial localizations.Following the latest SGRT applications and their specifications/requirements, a stricter quality assurance program needs to be ensured. Recent publications highlight the need to adapt quality assurance to the radiotherapy equipment type, SGRT technology, anatomic treatment sites, and clinical workflows, which results in a complex and extensive set of tests.Moreover, this review gives an outlook on the leading research trends. In particular, the potential to use deformable surfaces as motion surrogates, to use SGRT to detect anatomical variations along the treatment course, and to help in the establishment of personalized patient treatment (optimized margins and motion management strategies) are increasingly important research topics. SGRT is also emerging in the field of patient safety and integrates measures to reduce common radiotherapeutic risk events (e.g. facial and treatment accessories recognition).This review covers the latest clinical practices of SGRT and provides an outlook on potential applications of this imaging technique. It is intended to provide guidance for new users during the implementation, while triggering experienced users to further explore SGRT applications.
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