Operating procedures, risk management and challenges during implementation of adaptive and non-adaptive MR-guided radiotherapy: 1-year single-center experience
| Autor: | Cäcilia S. Reiner, Michael Mayinger, M. Chamberlain, Nicolaus Andratschke, M. Baumgartl, N. Weitkamp, C. Linsenmeier, Panagiotis Balermpas, Matea Pavic, Matthias Guckenberger, Stephanie Tanadini-Lang, Helena Garcia Schüler, L. Wilke, J. Krayenbühl |
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| Přispěvatelé: | University of Zurich |
| Rok vydání: | 2021 |
| Předmět: |
Male
Organs at Risk Quality Assurance Health Care Risk analysis R895-920 Image-guided radiotherapy Single Center Medical physics. Medical radiology. Nuclear medicine Neoplasms Medicine RC254-282 Risk management Aged 80 and over Contouring SBRT 10042 Clinic for Diagnostic and Interventional Radiology Neoplasms. Tumors. Oncology. Including cancer and carcinogens Radiotherapy Dosage Middle Aged Prognosis 10044 Clinic for Radiation Oncology Combined Modality Therapy Oncology Female Online-adaptive radiotherapy Adult medicine.medical_specialty Process (engineering) 610 Medicine & health MR-guided radiotherapy Radiosurgery Re-Irradiation Humans Radiology Nuclear Medicine and imaging Medical physics Aged Retrospective Studies Risk Management Descriptive statistics business.industry Research Patient Selection Radiotherapy Planning Computer-Assisted Health Plan Implementation Workflow Radiotherapy Intensity-Modulated business Quality assurance Radiotherapy Image-Guided |
| Zdroj: | Radiation Oncology (London, England) Radiation Oncology, Vol 16, Iss 1, Pp 1-10 (2021) |
| ISSN: | 1748-717X |
| Popis: | Background Main purpose was to describe procedures and identify challenges in the implementation process of adaptive and non-adaptive MR-guided radiotherapy (MRgRT), especially new risks in workflow due to the new technique. We herein report the single center experience for the implementation of (MRgRT) and present an overview on our treatment practice. Methods Descriptive statistics were used to summarize clinical and technical characteristics of treatment and patient characteristics including sites treated between April 2019 and end of March 2020 after ethical approval. A risk analysis was performed to identify risks of the online adaptive workflow. Results A summary of the processes on the MR-Linac including workflows, quality assurance and possible pitfalls is presented. 111 patients with 124 courses were treated during the first year of MR-guided radiotherapy. The most commonly treated site was the abdomen (42% of all treatment courses). 73% of the courses were daily online adapted and a high number of treatment courses (75%) were treated with stereotactic body irradiation. Only 4/382 fractions could not be treated due to a failing online adaptive quality assurance. In the risk analysis for errors, the two risks with the highest risk priority number were both in the contouring category, making it the most critical step in the workflow. Conclusion Although challenging, establishment of MRgRT as a routinely used technique at our department was successful for all sites and daily o-ART was feasible from the first day on. However, ongoing research and reports will have to inform us on the optimal indications for MRgRT because careful patient selection is necessary as it continues to be a time-consuming treatment technique with restricted availability. After risk analysis, the most critical workflow category was the contouring process, which resembles the need of experienced staff and safety check paths. |
| Databáze: | OpenAIRE |
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