Author: Anthony J. Doemer, Aharon Feldman, Ian Gallagher, Yimei Huang, Brett M. Miller, Benjamin Movsas, Kundan S Thind 👨🔬
Affiliation: Henry Ford Health 🌍
Purpose: CT-guided adaptive radiation therapy (CTgART) is a technical, resource intensive, procedure that involves many different radiation oncology team members. To ensure consistent, high-quality CTgART delivery across our three geographically distinct locations, a dedicated CT Adaptive Treatment Delivery Working Group was established to develop, implement, and oversee standardized procedures, training, and credentialing for CTgART operations. This study investigates the impact of standardization efforts by analyzing adaptive treatment session times at all sites.
Methods: Following implementation of standardized protocols by the Working Group, a retrospective analysis of 126 adaptive treatment deliveries was performed from all 3 centers. Both lung (conventional and SBRT) and prostate (SBRT) cases were analyzed. For each treatment session, the amount of time between the initial CBCT (CBCTi) and the verification CBCT (CBCTv) was recorded, rounded to the nearest minute. System wide averages for each treatment site were calculated as well as averages at each site.
Results: The system wide average time for adaptive lung adaptive treatment planning was 13.9 minutes and 18.9 minutes for prostate. Site 1 averaged 12.8 minutes for prostate and site 2 averaged 19.9 minutes. Site 3 has not treated an adaptive prostate. Sites 1, 2, and 3 had average times for lung cases of 16.9 minutes, 18.3 minutes, and 12.6 minutes respectively. Demonstrating standardization effectiveness, 89.7% of prostate and 83.5% of lung deliveries fell within 1 standard deviation of the system average, with 93.1% and 97.9% within 2 standard deviations, respectively.
Conclusion: The CT Adaptive Treatment Delivery Working Group has been instrumental in achieving standardized, efficient CTgART delivery across our institution. By implementing uniform training, credentialing, and operational processes, the group has ensured consistency in treatment times, reflecting the quality of care provided to patients at all locations.