Survey on fan-beam computed tomography for radiotherapy: Current implementation and future perspectives of motion management and surface guidance devices

Physics and Imaging in Radiation Oncology, vol. 29, pp. 100523

Abstract

Background and purpose: This work reports on the results of a survey performed on the use of computed tomography (CT) imaging for motion management, surface guidance devices, and their quality assurance (QA). Additionally, it details the collected user insights regarding professional needs in CT for radiotherapy. The purpose of the survey is to understand current practice, professional needs and future directions in the field of fan-beam CT in radiation therapy (RT). Materials and methods: An online institutional survey was conducted between 1-Sep-2022 and 10-Oct-2022 among medical physics experts at Belgian and Dutch radiotherapy institutions, to assess the current status, challenges, and future directions of motion management and surface image-guided radiotherapy. The survey consisted of a maximum of 143 questions, with the exact number depending on participants' responses. Results: The response rate was 66 % (31/47). Respiratory management was reported as standard practice in all but one institution; surface imaging during CT-simulation was reported in ten institutions. QA procedures are applied with varying frequencies and methodologies, primarily with commercial anatomy-like phantoms. Surface guidance users report employing commercial static and dynamic phantoms. Four main subjects are considered clinically important by the respondents: surface guidance, CT protocol optimisation, implementing gated imaging (4DCT, breath-hold), and a tattoo-less workflow. Conclusions: The survey highlights the scattered pattern of QA procedures for respiratory motion management, indicating the need for well-defined, unambiguous, and practicable guidelines. Surface guidance is considered one of the most important techniques that should be implemented in the clinical radiotherapy simulation workflow.

Authors 11

1. Chrysi Papalazarou corresponding Aachen

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center, Leiden, the Netherlands

2. Sima Qamhiyeh

   Universitair Ziekenhuis Leuven

   Affiliation as printed

   Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium

3. Robert S. J. P. Kaatee

   Radiotherapeutisch Instituut Friesland

   Affiliation as printed

   Radiotherapy Institute Friesland, Leeuwarden, the Netherlands

4. Joke De Rouck

   AZ Sint-Lucas

   Affiliation as printed

   Department of Radiotherapy, AZ Sint Lucas, Ghent, Belgium

5. Esther Decabooter

   Maastricht University Medical Centre · Maastro Clinic

   Affiliation as printed

   Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands

6. Guido C. Hilgers

   Radiotherapiegroep

   Affiliation as printed

   Radiotherapiegroep, Arnhem/Deventer, the Netherlands

7. Koen Salvo
   Affiliation as printed

   Department of Radiotherapy, AZ Sint-Maarten, Mechelen, Belgium

8. Hilde Bosmans

   Universitair Ziekenhuis Leuven · KU Leuven

   Affiliation as printed

   Department of Radiology, University Hospital Gasthuisberg, Leuven, Belgium

   Medical Physics and Quality Assessment, Department of Imaging and Pathology, KULeuven, Leuven, Belgium

9. Brent van der Heyden

   Ghent University · KU Leuven

   Affiliation as printed

   Department of Oncology, Laboratory of Experimental Radiotherapy, KU Leuven, Leuven, Belgium

   IBiTech-MEDISIP, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium

10. G. Pittomvils

    Ghent University Hospital

    Affiliation as printed

    Department of Radiation-Oncology, Ghent University Hospital, Ghent, Belgium

11. Evelien Bogaert

    Ghent University Hospital

    Affiliation as printed

    Department of Radiation-Oncology, Ghent University Hospital, Ghent, Belgium