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Are therapeutic radiographers able to achieve clinically acceptable verification for stereotactic lung radiotherapy treatment (SBRT)?

Published online by Cambridge University Press:  07 January 2015

J. Hudson ,
C. Doolan ,
F. McDonald ,
I. Locke ,
M. Ahmed ,
G. Gunapala  and
H. McNair
J. Hudson*
Affiliation:
Departments of Radiotherapy, Lung Unit and Statistics. Royal Marsden NHS Foundation Trust and Institute of Cancer Research, UK
C. Doolan
Affiliation:
Department of Health Studies, University Campus Suffolk, Ipswich, Suffolk, UK
F. McDonald
Affiliation:
Departments of Radiotherapy, Lung Unit and Statistics. Royal Marsden NHS Foundation Trust and Institute of Cancer Research, UK
I. Locke
Affiliation:
Departments of Radiotherapy, Lung Unit and Statistics. Royal Marsden NHS Foundation Trust and Institute of Cancer Research, UK
M. Ahmed
Affiliation:
Departments of Radiotherapy, Lung Unit and Statistics. Royal Marsden NHS Foundation Trust and Institute of Cancer Research, UK
G. Gunapala
Affiliation:
Departments of Radiotherapy, Lung Unit and Statistics. Royal Marsden NHS Foundation Trust and Institute of Cancer Research, UK
H. McNair
Affiliation:
Departments of Radiotherapy, Lung Unit and Statistics. Royal Marsden NHS Foundation Trust and Institute of Cancer Research, UK
*
Correspondence to: Jacqui Hudson, Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, SM2 5PT, UK. Tel: +44 (0) 20 8915 6020. Fax: +44 (0) 20 8915 6793. E-mail: Jacqui.hudson@rmh.nhs.uk
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Abstract

Purpose

The aim of this study was to assess the feasibility of radiographer led verification of cone-beam computed tomography (CBCT) images for patients with solitary lung tumours treated with stereotactic body radiotherapy treatment (SBRT).

Material and methods

CBCT setup images of 20 patients from the first fraction of each patient were retrospectively registered by therapeutic radiographers. The displacements recorded were compared with the clinical oncologist’s original online match. The time taken by radiographers to verify the CBCT images was also recorded.

Results

Overall agreement for all radiographers when compared with the clinical oncologist match was 91%. Interobserver variations between radiographers were X plane 0·87 (0·76–0·94); Y plane 0·74 (0·51–0·88); and Z plane 0·88 (0·78–0·95) intraclass correlation coefficient and 95% confidence interval. The average time taken for verification was 128 seconds.

Conclusion

Therapeutic radiographers are able to verify CBCT images for thorax SBRT with results comparable to the ‘gold standard’ clinical oncologists’ match, however additional training will be provided for online verification. The time taken was within acceptable limits.

Keywords

CBCTnon-small cell lung cancerrole expansionstereotactic radiotherapy
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 14 , Issue 1 , March 2015 , pp. 10 - 17
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Copyright
© Cambridge University Press 2015 

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References

1.National Institute for Health and Clinical Excellence (NICE). The diagnosis and treatment of lung cancer (update). Full Guideline, April 2011, National Collaborating Centre for Cancer, Manchester.Google Scholar
2.Verstegen, N E, Lagerwaard, F J, Haasbeek, C J A, Slotman, B J, Senan, S. Outcomes of stereotactic ablative radiotherapy following a clinical diagnosis of stage I NSCLC: comparison with a contemporaneous cohort with pathologically proven disease. Radiother Oncol 2011; 101: 250–254.Google Scholar
3.Chi, A, Liao, Z, Nguyen, N P, Xu, J, Stea, B, Komaki, R. Systemic review of the patterns of failure following stereotactic body radiation therapy in early-stage non-small-cell lung cancer: clinical implications. Radiother Oncol 2010; 94: 1–11.Google Scholar
4.Fakiris, A J, McGarry, R C, Yiannoutsos, C Tet al. Stereotactic body radiation therapy for early-stage non-small-cell lung carcinoma: four-year results of a prospective phase II study. Int J Radiat Oncol Biol Phys 2009; 75: 677–682.CrossRefGoogle ScholarPubMed
5.Needham, A, Hutton, D, Baker, A. The introduction of lung stereotactic body radiotherapy in the UK… it’s now a reality!. J Radiother Pract 2012; 11: 7–15.Google Scholar
6.Siva, S, MacManus, M, Ball, D. Stereotactic radiotherapy for pulmonary oligometastases: a systematic review. J Thorac Oncol 2010; 5: 1091–1099.Google Scholar
7.National Radiotherapy Implementation Group (NRIG). National Radiotherapy Implementation Group Report; Stereotactic Body Radiotherapy Guidelines for Commissioners, Providers and Clinicians in England 2011. National Cancer Action Team, London, 2011.Google Scholar
8.Hoyer, M. Improved accuracy and outcome in radiotherapy of lung cancer. Radiother Oncol 2008; 87: 1–2.CrossRefGoogle ScholarPubMed
9.Senan, S, Lagerwaard, F. Stereotactic radiotherapy for stage I lung cancer: current results and new developments. Cancer/Radiothérapie 2010; 14: 115–118.Google Scholar
10.van Elmpt, W, Petit, S, De Ruysscher, D, Lambin, P, Dekker, A. 3D dose delivery verification using repeated cone-beam imaging and EPID dosimetry for stereotactic body radiotherapy of non-small cell lung cancer. Radiother Oncol 2010; 94: 188–194.Google Scholar
11.Guckenberger, M, Krieger, T, Richter, Aet al. Potential of image-guidance, gating and real-time tracking to improve accuracy in pulmonary stereotactic body radiotherapy. Radiother Oncol 2009; 91: 288–295.Google Scholar
12.Purdie, T G, Bissonnette, J P, Franks, Ket al. Cone-beam computed tomography for on-line image guidance of lung stereotactic radiotherapy: localization, verification, and intrafraction tumor position. Int J Radiat Oncol Biol Phys 2007; 68: 243–252.Google Scholar
13.James, S, Beardmore, C, Dumbleton, C. A survey on the progress with implementation of the radiography profession’s career progression framework in UK radiotherapy centres. Radiography 2012; 18: 153–159.CrossRefGoogle Scholar
14.Hutton, D, Leadbetter, J, Jain, P, Baker, A. Does one size fit all? Adaptive radiotherapy for bladder cancer: a feasibility study. Radiography 2013; 19: 17–22.Google Scholar
15.White, E, Kane, G. Radiation medicine practice in the image-guided radiation therapy era: new roles and new opportunities. Sem Radiat Oncol 2007; 17: 298–305.CrossRefGoogle ScholarPubMed
16.Elekta. XVI R4.5 Instructions for Use. Crawley: Elekta, 2009.Google Scholar
17.Higgins, J, Bezjak, A, Franks, Ket al. Comparison of spine, carina and tumour as registration landmarks for volumetric image-guide lung radiotherapy. Int J Radiat Oncol Biol Phys 2008; 73: 1404–1413.CrossRefGoogle Scholar
18.Givens, M L, Ayotte, K, Manifold, C. Needle thoracostomy: implications of computed tomography chest wall thickness. Acad Emerg Med 2004; 11: 211–213.Google Scholar
19.McLean, A R, Richards, M E, Crandall, C S, Marinaro, J L. Ultrasound determination of chest wall thickness: implications for needle thoracostomy. Am J Emerg Med 2011; 29: 1173–1177.Google Scholar
20.Wang, X, Zhong, R, Bai, Set al. Lung tumor reproducibility with active breath control (ABC) in image-guided radiotherapy based on cone-beam computed tomography with two registration methods. Radiother Oncol 2011; 99: 148–154.Google Scholar
21.Shrout, P E, Fleiss, J L. Intraclass correlations: uses in assessing rater reliability. Psychol Bull 1979; 86: 420–428.Google Scholar
22.Bissonnette, J-P, Purdie, T G, Higgins, J A, Li, W, Bezjak, A. Cone-beam computed tomographic image guidance for lung cancer radiation therapy. Int J Radiat Oncol Biol Phys 2009; 73: 927–934.Google Scholar
23.Grills, I S, Hugo, G, Kestin, L Let al. Image-guided radiotherapy via daily online cone-beam ct substantially reduces margin requirements for stereotactic lung radiotherapy. Int J Radiat Oncol Biol Phys 2008; 70: 1045–1056.Google Scholar
24.Plathow, C, Ley, S, Fink, Cet al. Analysis of intrathoracic tumor mobility during whole breathing cycle by dynamic MRI. Int J Radiat Oncol Biol Phys 2004; 59: 952–959.CrossRefGoogle ScholarPubMed
25.Giraud, P, De Rycke, Y, Dubray, Bet al. Conformal radiotherapy (CRT) planning for lung cancer: Analysis of intrathoracic organ motion during extreme phases of breathing. Int J Radiat Oncol Biol Phys 2001; 51: 1081–1092.Google Scholar