Treatment efficiency and quality improvement via double imaging modality (DIM) versus single imaging modality (SIM) image-guided radiotherapy for prostate cancer
Purpose: Daily image-guided radiotherapy (IGRT) for prostate cancer reduces treatment-related toxicity. However, positional and anatomical variations can result in patient re-setup, increased treatment time, and additional imaging dose. A simple technique of two distinct imaging modalities was inves...
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Elsevier
2025-03-01
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| Series: | Technical Innovations & Patient Support in Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405632425000083 |
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| author | Milad Mirzaei Suki Gill Mahsheed Sabet Martin A. Ebert Pejman Rowshanfarzad Jake Kendrick Angela Jacques Clare Herbert Jeremy Croker Sean Bydder Joshua Dass Edward Bailey Rohen White Catherine Moffat Colin Tang Adriano Polpo Nicholas Bucknell |
| author_facet | Milad Mirzaei Suki Gill Mahsheed Sabet Martin A. Ebert Pejman Rowshanfarzad Jake Kendrick Angela Jacques Clare Herbert Jeremy Croker Sean Bydder Joshua Dass Edward Bailey Rohen White Catherine Moffat Colin Tang Adriano Polpo Nicholas Bucknell |
| author_sort | Milad Mirzaei |
| collection | DOAJ |
| description | Purpose: Daily image-guided radiotherapy (IGRT) for prostate cancer reduces treatment-related toxicity. However, positional and anatomical variations can result in patient re-setup, increased treatment time, and additional imaging dose. A simple technique of two distinct imaging modalities was investigated: initially, an anteroposterior kilovoltage (AP-kV) planar image was acquired, followed by cone beam computed tomography (CBCT). To determine whether this dual imaging modality (DIM) can reduce repeat CBCTs with an AP-kV screening image compared to CBCT alone, i.e. a single imaging modality (SIM). Methods: Patients were enrolled sequentially before and after the new departmental protocol for IGRT. Initially, all patients had a CBCT prior to treatment (SIM group) as usual. For the DIM group, AP-kV imaging was added to the first three fractions, and subsequent AP-kV imaging (on demand) for patients unable to maintain adequate bladder and bowel compliance. Sixty intact prostate or post-prostatectomy patients were included: 30 before the change in protocol (SIM group) and 30 after (DIM group). Bladder volume, rectal filling, and positioning errors were evaluated. Results: In the SIM group, 30 patients underwent a total of 1116 CBCTs. In the DIM group, 30 patients had 156 AP-kV images and 1077 CBCTs. In the SIM group, 166 were repeat CBCTs with a median of 4 repeat CBCTs per patient. In DIM group, 132 were repeat CBCTs with a median of 3 repeat CBCTs per patient. We found a significant difference in incidence of repeat CBCTs due to suboptimal bladder filling (p = 0.028) and rectal gas (p = 0.045), indicating the number of repeat CBCTs was significantly lower in patients imaged with DIM. Conclusion: The DIM technique was found to be superior to the SIM technique, as it allowed the desired bladder volume, rectal condition, and patient positioning to be achieved prior to CBCT, reducing the need for repeat CBCTs. |
| format | Article |
| id | doaj-art-5e132980b7c84eb5b6140bd824fc0ca4 |
| institution | DOAJ |
| issn | 2405-6324 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Technical Innovations & Patient Support in Radiation Oncology |
| spelling | doaj-art-5e132980b7c84eb5b6140bd824fc0ca42025-08-20T02:50:45ZengElsevierTechnical Innovations & Patient Support in Radiation Oncology2405-63242025-03-013310030710.1016/j.tipsro.2025.100307Treatment efficiency and quality improvement via double imaging modality (DIM) versus single imaging modality (SIM) image-guided radiotherapy for prostate cancerMilad Mirzaei0Suki Gill1Mahsheed Sabet2Martin A. Ebert3Pejman Rowshanfarzad4Jake Kendrick5Angela Jacques6Clare Herbert7Jeremy Croker8Sean Bydder9Joshua Dass10Edward Bailey11Rohen White12Catherine Moffat13Colin Tang14Adriano Polpo15Nicholas Bucknell16Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; School of Physics, Mathematics and Computing, University of Western Australia, Crawley, WA, Australia; Centre for Advanced Technologies in Cancer Research, Perth, WA, Australia; Corresponding author at: Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; School of Physics, Mathematics and Computing, University of Western Australia, Crawley, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; School of Physics, Mathematics and Computing, University of Western Australia, Crawley, WA, Australia; Centre for Advanced Technologies in Cancer Research, Perth, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; School of Physics, Mathematics and Computing, University of Western Australia, Crawley, WA, Australia; Centre for Advanced Technologies in Cancer Research, Perth, WA, AustraliaSchool of Physics, Mathematics and Computing, University of Western Australia, Crawley, WA, Australia; Centre for Advanced Technologies in Cancer Research, Perth, WA, AustraliaSchool of Physics, Mathematics and Computing, University of Western Australia, Crawley, WA, Australia; Centre for Advanced Technologies in Cancer Research, Perth, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; Institute for Health Research, University of Notre Dame, Fremantle, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; Edith Cowan University, Joondalup, WA, AustraliaSchool of Physics, Mathematics and Computing, University of Western Australia, Crawley, WA, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, AustraliaPurpose: Daily image-guided radiotherapy (IGRT) for prostate cancer reduces treatment-related toxicity. However, positional and anatomical variations can result in patient re-setup, increased treatment time, and additional imaging dose. A simple technique of two distinct imaging modalities was investigated: initially, an anteroposterior kilovoltage (AP-kV) planar image was acquired, followed by cone beam computed tomography (CBCT). To determine whether this dual imaging modality (DIM) can reduce repeat CBCTs with an AP-kV screening image compared to CBCT alone, i.e. a single imaging modality (SIM). Methods: Patients were enrolled sequentially before and after the new departmental protocol for IGRT. Initially, all patients had a CBCT prior to treatment (SIM group) as usual. For the DIM group, AP-kV imaging was added to the first three fractions, and subsequent AP-kV imaging (on demand) for patients unable to maintain adequate bladder and bowel compliance. Sixty intact prostate or post-prostatectomy patients were included: 30 before the change in protocol (SIM group) and 30 after (DIM group). Bladder volume, rectal filling, and positioning errors were evaluated. Results: In the SIM group, 30 patients underwent a total of 1116 CBCTs. In the DIM group, 30 patients had 156 AP-kV images and 1077 CBCTs. In the SIM group, 166 were repeat CBCTs with a median of 4 repeat CBCTs per patient. In DIM group, 132 were repeat CBCTs with a median of 3 repeat CBCTs per patient. We found a significant difference in incidence of repeat CBCTs due to suboptimal bladder filling (p = 0.028) and rectal gas (p = 0.045), indicating the number of repeat CBCTs was significantly lower in patients imaged with DIM. Conclusion: The DIM technique was found to be superior to the SIM technique, as it allowed the desired bladder volume, rectal condition, and patient positioning to be achieved prior to CBCT, reducing the need for repeat CBCTs.http://www.sciencedirect.com/science/article/pii/S2405632425000083IGRTProstateAnteroposterior kilovoltage imaging (AP-kV)CBCTBladderRectal gas |
| spellingShingle | Milad Mirzaei Suki Gill Mahsheed Sabet Martin A. Ebert Pejman Rowshanfarzad Jake Kendrick Angela Jacques Clare Herbert Jeremy Croker Sean Bydder Joshua Dass Edward Bailey Rohen White Catherine Moffat Colin Tang Adriano Polpo Nicholas Bucknell Treatment efficiency and quality improvement via double imaging modality (DIM) versus single imaging modality (SIM) image-guided radiotherapy for prostate cancer Technical Innovations & Patient Support in Radiation Oncology IGRT Prostate Anteroposterior kilovoltage imaging (AP-kV) CBCT Bladder Rectal gas |
| title | Treatment efficiency and quality improvement via double imaging modality (DIM) versus single imaging modality (SIM) image-guided radiotherapy for prostate cancer |
| title_full | Treatment efficiency and quality improvement via double imaging modality (DIM) versus single imaging modality (SIM) image-guided radiotherapy for prostate cancer |
| title_fullStr | Treatment efficiency and quality improvement via double imaging modality (DIM) versus single imaging modality (SIM) image-guided radiotherapy for prostate cancer |
| title_full_unstemmed | Treatment efficiency and quality improvement via double imaging modality (DIM) versus single imaging modality (SIM) image-guided radiotherapy for prostate cancer |
| title_short | Treatment efficiency and quality improvement via double imaging modality (DIM) versus single imaging modality (SIM) image-guided radiotherapy for prostate cancer |
| title_sort | treatment efficiency and quality improvement via double imaging modality dim versus single imaging modality sim image guided radiotherapy for prostate cancer |
| topic | IGRT Prostate Anteroposterior kilovoltage imaging (AP-kV) CBCT Bladder Rectal gas |
| url | http://www.sciencedirect.com/science/article/pii/S2405632425000083 |
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