Introduction of Surface Guided Radiotherapy at St. Luke's Radiation Oncology Network
Surface Guided Radiotherapy (SGRT) using AlignRT technology was introduced at St. Luke's Radiation Oncology Network to enhance patient setup efficiency and monitor patient positioning during treatment. The implementation involved a multidisciplinary approach and showed significant improvements in treatment times and setup images. SGRT brings value by reducing treatment time, improving accuracy, and enabling increased throughput. Further developments include extending SGRT to pelvis and palliative radiotherapy, with plans for Stereotactic Ablative Radiotherapy (SABR) commissioning. In-house training and additional SGRT units installation are ongoing to support sustainment and future projects in the network.
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Introduction of Surface Guided Radiotherapy to Introduction of Surface Guided Radiotherapy to St Luke s Radiation Oncology Network St Luke s Radiation Oncology Network James Waldron, Susan Traynor, Aaron O Reilly, Serena O Keeffe, Aodh MacGairbhith, Niamh Kerr, Margaret Tynan, Aisling Mohan, Paul Davenport, Ruth Woods Departments of Physics, Radiation Therapy and Clinical Engineering at St Luke s Radiation Oncology Network Contact: james.waldron@slh.ie
Background and methods Background and methods Surface Guided Radiotherapy (SGRT) uses optical scanning of the patient s skin to improve patient setup efficiency and to monitor patient positioning during radiotherapy treatment. We introduced the AlignRT SGRT technology to 6 treatment units across the 3 centres in the St Luke s Network within a 2 month timeframe. A multidisciplinary approach involving collaboration between radiation therapists, engineers and medical physicists was taken. The AlignRT SGRT system from VisionRT Left: Monitoring region for Breast Radiotherapy Right: Real-time monitoring data Slide 2 of 4
Fig 1: Average Treatment Time per Fraction 31:54 Pre-SGRT Quality Improvement Analysis Quality Improvement Analysis Post-SGRT 24:34 22:48 Time (mins:secs) 22:18 21:51 Approximately 800 patients receive radiotherapy to the breast each year in the network. Treatment can consist of Breast only (2-Field) or Breast + Nodes (4-Field) and the Deep Inspiration Breath Hold (DIBH) technique may be used to reduce dose to heart when treating the left breast. We examined the change in treatment times and number of setup images for 30 Beaumont patients Pre-SGRT and Post-SGRT implementation. There was a significant reduction in treatment times for DIBH patients and a small increase for Non-DIBH patients as shown in Figure 1. The number of setup images per patient has reduced as shown in Figure 2. 17:15 2-Field DIBH 4-Field DIBH 4-Field Non-DIBH Fig 2: Average Number of MV Setup Images per Patient 9.1 8.7 Pre-SGRT 8.4 Number of MV Images 7.8 Post-SGRT 6.3 5.4 2-Field DIBH 4-Field DIBH 4-Field Non-DIBH Slide 3 of 4
Value to patients, staff and service Value to patients, staff and service SGRT reduces the patient s treatment time in most cases. Staff report a reduction in manual patient manipulation. Treatment accuracy and safety is improved. Potential to increase throughput in the service. Sustainment Sustainment In-house training delivered to all staff requiring it. 3 additional SGRT units to be installed this year. SGRT now extended to pelvis and palliative radiotherapy. Stereotactic Ablative Radiotherapy (SABR) with SGRT to be commissioned this year. The multidisciplinary approach will be taken for further projects in the network. Slide 4 of 4
