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. 2024 Jun 7:31:100597.
doi: 10.1016/j.phro.2024.100597. eCollection 2024 Jul.

Bringing online adaptive radiotherapy to a standard C-arm linac

Maureen L Groot Koerkamp  1 , Gijsbert H Bol  1 , Petra S Kroon  1 , Lean L Krikke  1 , Tessa Harderwijk  1 , Annelies J Zoetelief  1 , Annick Scheeren  1 , Stefan van der Vegt  1 , Annika Plat  1 , Jochem Hes  1 , Ineke B A van Gasteren  1 , Esmee R T Renders  1 , Reijer H A Rutgers  1 , Saskia W Kok  1 , Joost van Kaam  1 , Geja J Schimmel-de Kogel  1 , Gonda G Sikkes  1 , Dennis Winkel  1 , Michael J van Rijssel  1 , André J M Wopereis  1 , Kübra Ishakoglu  1 , Juus L Noteboom  1 , Jochem R N van der Voort van Zyp  1 , Naomi Beck  1 , Timo F W Soeterik  1 , Sandrine M G van de Pol  1 , Wietse S C Eppinga  1 , Corine A van Es  1 , Bas W Raaymakers  1
Affiliations

Bringing online adaptive radiotherapy to a standard C-arm linac

Maureen L Groot Koerkamp et al. Phys Imaging Radiat Oncol. .

Abstract

Current online adaptive radiotherapy (oART) workflows require dedicated equipment. Our aim was to develop and implement an oART workflow for a C-arm linac which can be performed using standard clinically available tools. A workflow was successfully developed and implemented. Three patients receiving palliative radiotherapy for bladder cancer were treated, with 33 of 35 total fractions being delivered with the cone-beam computed tomography (CBCT)-guided oART workflow. Average oART fraction duration was 24 min from start of CBCT acquisition to end of beam on. This work shows how oART could be performed without dedicated equipment, broadening oART availability for application at existing treatment machines.

Keywords: Bladder cancer; Cone-beam computed tomography; Image-guided radiotherapy; Linear accelerator; Online adaptive radiotherapy (oART).

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Our department has a research agreement with Elekta AB on the development of adaptive strategies for the CBCT-linac. The first author is working on a grant for this purpose, which is partly financed by Elekta AB. Elekta AB had no role in the preparation, review, or approval of the manuscript and the decision to submit the manuscript.

Figures

Fig. 1
Fig. 1
The online adaptive CBCT-guided radiotherapy workflow design. The overview shows the different steps and tools used in the online adaptive radiotherapy (oART) workflow for a palliative radiotherapy treatment of a patient with bladder cancer. The contours show the bladder CTV (red), oART PTV (green), bowel bag (purple), rectum (cyan), bony structures (yellow), and body (beige). The orange isodose line represents 95% of the prescribed dose.
See this image and copyright information in PMC

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