Treatment time and learning curve analysis of 1.5 T MR-Linac workflows led by radiation oncologists or therapists
Background and purpose: This study assessed the treatment time of online adaptive (i.e. Adapt-to-Shape, ATS) and virtual couch shift (i.e. Adapt-to-Position, ATP) magnetic resonance guided radiotherapy (MRgRT) on a 1.5 Tesla MR-Linac. Additionally, the transition from a radiation oncologists (RO)-le...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-03-01
|
| Series: | Clinical and Translational Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630824001782 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832582179985555456 |
|---|---|
| author | J.M. Westerhoff F.J. Raaijmakers L.A. Daamen E.N. de Groot-van Breugel L.T.C. Meijers J.R.N. van der Voort van Zyp J.J.C. Verhoeff S. Mook H.M. Verkooijen M.P.W. Intven |
| author_facet | J.M. Westerhoff F.J. Raaijmakers L.A. Daamen E.N. de Groot-van Breugel L.T.C. Meijers J.R.N. van der Voort van Zyp J.J.C. Verhoeff S. Mook H.M. Verkooijen M.P.W. Intven |
| author_sort | J.M. Westerhoff |
| collection | DOAJ |
| description | Background and purpose: This study assessed the treatment time of online adaptive (i.e. Adapt-to-Shape, ATS) and virtual couch shift (i.e. Adapt-to-Position, ATP) magnetic resonance guided radiotherapy (MRgRT) on a 1.5 Tesla MR-Linac. Additionally, the transition from a radiation oncologists (RO)-led to a radiation therapist (RTT)-led workflow, and the presence of a learning curve were assessed. Materials and methods: This study was conducted utilizing the prospective Multi-OutcoMe EvaluatioN of radiation Therapy Using the MR-Linac study (MOMENTUM, NCT04075305). Mean (±standard deviation) online adaptation time and total treatment time were collected from MR-Linac log files. Learning and proficiency phases were defined using a cumulative sum (CUSUM) analysis. Independent T-tests were performed. A p-value < 0.01 was considered statistically significant. Results: In total, 4942 fractions of 645 patients were included. Mean total treatment time was 39 (±7), 15 (±2), 34 (±8), 41 (±11), and 40 (±7) minutes for ATS-treated prostate cancer, ATP-treated prostate cancer, ATS-treated pelvic lymph node metstasis (LNM), ATS-treated abdominal LNM and ATS-treated rectal cancer, respectively. Mean online adaptation time of RO-led and RTT-led treatment was 28 (±6) and 25 (±6) minutes (p < 0.001) for ATS-treated prostate cancer. No significant differences in the remaining subgroups were found. In subgroups with a learning curve, mean online adaptation time of learning and proficiency phase were 30 (±6) and 26 (±5) minutes (p < 0.001) for ATS-treated prostate cancer, 27 (±8) and 19 (±7) minutes for pelvic LNM (p < 0.001), and 29 (±7) and 25 (±7) minutes (p < 0.001) for rectal cancer, respectively. Conclusion: The transition from RO-led to RTT-led workflows did not significantly increase total treatment time. The online adaptation time reduced after a learning curve for ATS-treated prostate cancer, pelvic LNM and rectal cancer.Keywords; MRgRT, MR-Linac, time, prostate cancer, oligolymphnode metastasis, rectal cancer. |
| format | Article |
| id | doaj-art-93f0afc0db4c4f63a3e11662324a760b |
| institution | Kabale University |
| issn | 2405-6308 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj-art-93f0afc0db4c4f63a3e11662324a760b2025-01-30T05:14:26ZengElsevierClinical and Translational Radiation Oncology2405-63082025-03-0151100901Treatment time and learning curve analysis of 1.5 T MR-Linac workflows led by radiation oncologists or therapistsJ.M. Westerhoff0F.J. Raaijmakers1L.A. Daamen2E.N. de Groot-van Breugel3L.T.C. Meijers4J.R.N. van der Voort van Zyp5J.J.C. Verhoeff6S. Mook7H.M. Verkooijen8M.P.W. Intven9University Medical Center Utrecht, Division of Imaging and Oncology, Utrecht, the Netherlands; Corresponding author.University Medical Center Utrecht, Division of Imaging and Oncology, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Division of Imaging and Oncology, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Department of Radiation Oncology, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Department of Radiation Oncology, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Department of Radiation Oncology, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Department of Radiation Oncology, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Department of Radiation Oncology, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Division of Imaging and Oncology, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Department of Radiation Oncology, Utrecht, the NetherlandsBackground and purpose: This study assessed the treatment time of online adaptive (i.e. Adapt-to-Shape, ATS) and virtual couch shift (i.e. Adapt-to-Position, ATP) magnetic resonance guided radiotherapy (MRgRT) on a 1.5 Tesla MR-Linac. Additionally, the transition from a radiation oncologists (RO)-led to a radiation therapist (RTT)-led workflow, and the presence of a learning curve were assessed. Materials and methods: This study was conducted utilizing the prospective Multi-OutcoMe EvaluatioN of radiation Therapy Using the MR-Linac study (MOMENTUM, NCT04075305). Mean (±standard deviation) online adaptation time and total treatment time were collected from MR-Linac log files. Learning and proficiency phases were defined using a cumulative sum (CUSUM) analysis. Independent T-tests were performed. A p-value < 0.01 was considered statistically significant. Results: In total, 4942 fractions of 645 patients were included. Mean total treatment time was 39 (±7), 15 (±2), 34 (±8), 41 (±11), and 40 (±7) minutes for ATS-treated prostate cancer, ATP-treated prostate cancer, ATS-treated pelvic lymph node metstasis (LNM), ATS-treated abdominal LNM and ATS-treated rectal cancer, respectively. Mean online adaptation time of RO-led and RTT-led treatment was 28 (±6) and 25 (±6) minutes (p < 0.001) for ATS-treated prostate cancer. No significant differences in the remaining subgroups were found. In subgroups with a learning curve, mean online adaptation time of learning and proficiency phase were 30 (±6) and 26 (±5) minutes (p < 0.001) for ATS-treated prostate cancer, 27 (±8) and 19 (±7) minutes for pelvic LNM (p < 0.001), and 29 (±7) and 25 (±7) minutes (p < 0.001) for rectal cancer, respectively. Conclusion: The transition from RO-led to RTT-led workflows did not significantly increase total treatment time. The online adaptation time reduced after a learning curve for ATS-treated prostate cancer, pelvic LNM and rectal cancer.Keywords; MRgRT, MR-Linac, time, prostate cancer, oligolymphnode metastasis, rectal cancer.http://www.sciencedirect.com/science/article/pii/S2405630824001782 |
| spellingShingle | J.M. Westerhoff F.J. Raaijmakers L.A. Daamen E.N. de Groot-van Breugel L.T.C. Meijers J.R.N. van der Voort van Zyp J.J.C. Verhoeff S. Mook H.M. Verkooijen M.P.W. Intven Treatment time and learning curve analysis of 1.5 T MR-Linac workflows led by radiation oncologists or therapists Clinical and Translational Radiation Oncology |
| title | Treatment time and learning curve analysis of 1.5 T MR-Linac workflows led by radiation oncologists or therapists |
| title_full | Treatment time and learning curve analysis of 1.5 T MR-Linac workflows led by radiation oncologists or therapists |
| title_fullStr | Treatment time and learning curve analysis of 1.5 T MR-Linac workflows led by radiation oncologists or therapists |
| title_full_unstemmed | Treatment time and learning curve analysis of 1.5 T MR-Linac workflows led by radiation oncologists or therapists |
| title_short | Treatment time and learning curve analysis of 1.5 T MR-Linac workflows led by radiation oncologists or therapists |
| title_sort | treatment time and learning curve analysis of 1 5 t mr linac workflows led by radiation oncologists or therapists |
| url | http://www.sciencedirect.com/science/article/pii/S2405630824001782 |
| work_keys_str_mv | AT jmwesterhoff treatmenttimeandlearningcurveanalysisof15tmrlinacworkflowsledbyradiationoncologistsortherapists AT fjraaijmakers treatmenttimeandlearningcurveanalysisof15tmrlinacworkflowsledbyradiationoncologistsortherapists AT ladaamen treatmenttimeandlearningcurveanalysisof15tmrlinacworkflowsledbyradiationoncologistsortherapists AT endegrootvanbreugel treatmenttimeandlearningcurveanalysisof15tmrlinacworkflowsledbyradiationoncologistsortherapists AT ltcmeijers treatmenttimeandlearningcurveanalysisof15tmrlinacworkflowsledbyradiationoncologistsortherapists AT jrnvandervoortvanzyp treatmenttimeandlearningcurveanalysisof15tmrlinacworkflowsledbyradiationoncologistsortherapists AT jjcverhoeff treatmenttimeandlearningcurveanalysisof15tmrlinacworkflowsledbyradiationoncologistsortherapists AT smook treatmenttimeandlearningcurveanalysisof15tmrlinacworkflowsledbyradiationoncologistsortherapists AT hmverkooijen treatmenttimeandlearningcurveanalysisof15tmrlinacworkflowsledbyradiationoncologistsortherapists AT mpwintven treatmenttimeandlearningcurveanalysisof15tmrlinacworkflowsledbyradiationoncologistsortherapists |