Surface-guided radiation therapy

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Surface-guided radiation therapy
Other namesSGRT / Surface-image guided radiation therapy
Specialty interventional radiology/oncology

Surface-guided radiation therapy (SGRT) (sometimes referred to as Surface-image Guided Radiation Therapy) is the process of using 3D imaging to position and track movement of radiation therapy patients during treatment.

Contents

Goals and clinical benefits

SGRT can help to improve the safety, effectiveness and efficiency of radiation therapy treatments, by offering guidance across every step of the radiation therapy workflow.

Developed as an advancement to image-guided radiation therapy, SGRT relies on 3D imaging as opposed to an x-ray. [1] SGRT uses cameras to feed data into a software program linked to the linear accelerator delivering the radiation. [2] Each camera uses a projector and image sensors to create a 3D surface model of a patient, by projecting a red light containing a pseudo-random speckle pattern on their skin. [3] The pattern allows the SGRT system to reference thousands of points on the skin, acting as virtual medical tattoos. [4] This imaging information is fed into the software to allow real-time tracking and sub-millimetric accuracy during radiotherapy treatments. Information on movements is fed back to the radiation therapist, who is alerted if the patient moves from the optimal position (as determined by their treatment plan). SGRT systems can be set to automatically stop the delivery of radiation if a patient moves outside of a certain tolerance level. [5]

SGRT can help to reduce errors in set-up and positioning, allow the margins around target tissue when planning to be reduced, and enable treatment to be adapted during its course, with the aim of overall improving outcomes. [6]

Clinical applications

For breast cancer treatment, SGRT increases the patient setup information compared to laser‐based setup (LBS), by using the entire patient skin surface instead of only three skin marks. [7] SGRT also enables clinicians to monitor a patient in real-time to replicate the same position during the CT scan for sarcoma patients. [8]

When used with deep inspiratory breath-hold, SGRT supports initial positioning, both in free breathing (at mid-patient reference point) and in DIBH (at treatment isocenter). [9] This process has been found to help reduce errors in set-up, positioning and improve overall outcomes for patients. It has also been used with Stereotactic Body Radiation Therapy to assist with the initial set-up and detect intrafraction patient motion throughout treatment. [3] For stereotactic surgery, SGRT allows a frameless system to be used to monitor the surface of the patient within an open-face immobilization mask. [10]

See also

Related Research Articles

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References

  1. ↑ Hombrink, Gerrit; Promberger, Claus (26 July 2021). "How and Why Surface Guided Radiation Therapy Developed". Brainlab.
  2. ↑ Freislederer, P.; Batista, V.; Ollers, M.; Nguyen, D.; Bert, C.; Lehmann, J. (30 May 2022). "ESTRO-ACROP guideline on surface guided radiation therapy". Radiotherapy & Oncology. 173: 188–196. doi: 10.1016/j.radonc.2022.05.026 . PMID   35661677. S2CID   249252289.
  3. 1 2 Lawler, Gavin (19 January 2022). "A review of surface guidance in extracranial stereotactic body radiotherapy (SBRT/SABR) for set-up and intra-fraction motion management". Technical Innovations & Patient Support in Radiation Oncology. 21: 23–26. doi:10.1016/j.tipsro.2022.01.001. PMC   8777133 . PMID   35079644.
  4. ↑ Batista, Vania; Meyer, Juergen; Kugele, Malin; Al-Hallaq, Hania (2020). "Clinical paradigms and challenges in surface guided radiation therapy: Where do we go from here?". Radiotherapy and Oncology. 153: 34–42. doi: 10.1016/j.radonc.2020.09.041 . PMID   32987044. S2CID   222168459.
  5. ↑ Sarudis, Sebastian; Karlsson, Anna; Back, Anna (2021). "Surface guided frameless positioning for lung stereotactic body radiation therapy". Journal of Applied Clinical Medical Physics. 22 (9): 215–226. doi:10.1002/acm2.13370. PMC   8425933 . PMID   34406710.
  6. ↑ Paxton, Adam Brent; Waghorn, Benjamin James; Hoisak, Jeremy David; Pawlicki, Todd (2020). Surface Guided Radiation Therapy. CRC Press. ISBN   9780429951800.
  7. ↑ Mast, Mirjam (15 April 2022). "Introduction to: Surface Guided Radiotherapy (SGRT)". Technical Innovations & Patient Support in Radiation Oncology. 22: 37–38. doi:10.1016/j.tipsro.2022.04.004. PMC   9027274 . PMID   35464887.
  8. ↑ Saito, Masahide; Ueda, Koji; Suzuki, Hidekazu; Komiyama, Takafumi; Marino, Kan; Aoki, Shinichi; Sano, Naoki; Onishi, Hiroshi (3 May 2022). "Evaluation of the detection accuracy of set-up for various treatment sites using surface-guided radiotherapy system, VOXELAN: a phantom study". Journal of Radiation Research. 63 (3): 435–442. doi:10.1093/jrr/rrac015. PMC   9124621 . PMID   35467750.
  9. ↑ Freislederer, P.; Kugele, M.; Ollers, M.; Swinnen, A.; Sauer, T-O.; Bert, C.; Giantsoudi, D.; Corradini, S.; Batista, V. (31 July 2020). "Recent advances in Surface Guided Radiation Therapy". Radiation Oncology. 187 (15): 187. doi: 10.1186/s13014-020-01629-w . PMC   7393906 . PMID   32736570.
  10. ↑ Heinzerling, John H.; Hampton, Carnell J.; Robinson, Myra; bright, Megan; Moeller, Benjamin J.; Ruiz, Justin; Prabhu, Roshan; Burri, Stuart H.; Foster, Ryan D. (20 March 2020). "Use of surface-guided radiation therapy in combination with IGRT for setup and intrafraction motion monitoring during stereotactic body radiation therapy treatments of the lung and abdomen". Journal of Applied Clinical Medical Physics. 21 (5): 48–55. doi:10.1002/acm2.12852. PMC   7286017 . PMID   32196944.
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