An Evaluation of Treatment Time and Intrafraction Motion in Stereotactic Body Radiation Therapy

ABSTRACT Introduction Image guided‐radiation therapy (IGRT) protocols are adopted to ensure the accurate dose delivery of patient treatments. This is especially important in hypofractionated treatments, such as stereotactic body radiation therapy (SBRT), as high doses of radiation are delivered, and...

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Main Authors: Leila Rough, Julie Burbery, Catriona Hargrave, Elizabeth Brown
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Journal of Medical Radiation Sciences
Online Access:https://doi.org/10.1002/jmrs.861
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author Leila Rough
Julie Burbery
Catriona Hargrave
Elizabeth Brown
author_facet Leila Rough
Julie Burbery
Catriona Hargrave
Elizabeth Brown
author_sort Leila Rough
collection DOAJ
description ABSTRACT Introduction Image guided‐radiation therapy (IGRT) protocols are adopted to ensure the accurate dose delivery of patient treatments. This is especially important in hypofractionated treatments, such as stereotactic body radiation therapy (SBRT), as high doses of radiation are delivered, and incorrect treatment can have a significant impact on tumour control and toxicity. This study aimed to establish mean treatment times from the localisation image to the post‐treatment image in SBRT liver, lung and spine patients that utilised Elekta Intrafraction Imaging (IFI). The magnitude of intrafraction motion exhibited as time elapses during the treatment fraction was also determined. Methods IGRT data for 20 SBRT patients was retrospectively collected, including imaging times and shifts made from each pre‐, during and post‐treatment cone‐beam computed tomography (CBCT) scan. Total treatment fraction time, time between each image acquired and the 3D vector of the shifts were calculated. Descriptive statistical analysis was performed. Results The IGRT data associated with 332 CBCT images was evaluated. The average treatment time was longest in the liver (19.3 min), followed by lung (14.9 min) and spine (14.2 min). Liver patients had a mean shift 3D vector (0.1 cm), with 7.8% of shifts > 0.3 cm. Lung patients had a mean vector of 0.1 cm with 3.8% > 0.3 cm, and spine patients had a mean vector of 0 cm with 0% > 0.2 cm. Vectors > 0.3 cm occurred at multiple imaging timepoints (range: 4.9–24.4 min) for liver and lung patients. Conclusion Intrafraction imaging is required in liver and lung SBRT treatments to identify instances where clinical tolerances are exceeded.
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spelling doaj-art-b01e32bd1cb24159a9e67aaec91a57cd2025-08-20T03:46:21ZengWileyJournal of Medical Radiation Sciences2051-38952051-39092025-06-0172221722410.1002/jmrs.861An Evaluation of Treatment Time and Intrafraction Motion in Stereotactic Body Radiation TherapyLeila Rough0Julie Burbery1Catriona Hargrave2Elizabeth Brown3Radiation Oncology Princess Alexandra Hospital Ipswich Road Brisbane Brisbane Queensland AustraliaSchool of Clinical Sciences, Faculty of Health Queensland University of Technology Brisbane Queensland AustraliaSchool of Clinical Sciences, Faculty of Health Queensland University of Technology Brisbane Queensland AustraliaRadiation Oncology Princess Alexandra Hospital Ipswich Road Brisbane Brisbane Queensland AustraliaABSTRACT Introduction Image guided‐radiation therapy (IGRT) protocols are adopted to ensure the accurate dose delivery of patient treatments. This is especially important in hypofractionated treatments, such as stereotactic body radiation therapy (SBRT), as high doses of radiation are delivered, and incorrect treatment can have a significant impact on tumour control and toxicity. This study aimed to establish mean treatment times from the localisation image to the post‐treatment image in SBRT liver, lung and spine patients that utilised Elekta Intrafraction Imaging (IFI). The magnitude of intrafraction motion exhibited as time elapses during the treatment fraction was also determined. Methods IGRT data for 20 SBRT patients was retrospectively collected, including imaging times and shifts made from each pre‐, during and post‐treatment cone‐beam computed tomography (CBCT) scan. Total treatment fraction time, time between each image acquired and the 3D vector of the shifts were calculated. Descriptive statistical analysis was performed. Results The IGRT data associated with 332 CBCT images was evaluated. The average treatment time was longest in the liver (19.3 min), followed by lung (14.9 min) and spine (14.2 min). Liver patients had a mean shift 3D vector (0.1 cm), with 7.8% of shifts > 0.3 cm. Lung patients had a mean vector of 0.1 cm with 3.8% > 0.3 cm, and spine patients had a mean vector of 0 cm with 0% > 0.2 cm. Vectors > 0.3 cm occurred at multiple imaging timepoints (range: 4.9–24.4 min) for liver and lung patients. Conclusion Intrafraction imaging is required in liver and lung SBRT treatments to identify instances where clinical tolerances are exceeded.https://doi.org/10.1002/jmrs.861
spellingShingle Leila Rough
Julie Burbery
Catriona Hargrave
Elizabeth Brown
An Evaluation of Treatment Time and Intrafraction Motion in Stereotactic Body Radiation Therapy
Journal of Medical Radiation Sciences
title An Evaluation of Treatment Time and Intrafraction Motion in Stereotactic Body Radiation Therapy
title_full An Evaluation of Treatment Time and Intrafraction Motion in Stereotactic Body Radiation Therapy
title_fullStr An Evaluation of Treatment Time and Intrafraction Motion in Stereotactic Body Radiation Therapy
title_full_unstemmed An Evaluation of Treatment Time and Intrafraction Motion in Stereotactic Body Radiation Therapy
title_short An Evaluation of Treatment Time and Intrafraction Motion in Stereotactic Body Radiation Therapy
title_sort evaluation of treatment time and intrafraction motion in stereotactic body radiation therapy
url https://doi.org/10.1002/jmrs.861
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