In vivo dosimetry for lung radiotherapy including SBRT |
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| Affiliation: | 1. Division of Medical Physics, CancerCare Manitoba, Winnipeg R3E 0V9, Canada;2. Department of Physics and Astronomy, University of Manitoba, Winnipeg R3M 2N2, Canada;3. Department of Radiology, University of Manitoba, Winnipeg R3M 2N2, Canada;1. Royal Surrey County Hospital, Guildford, UK;2. National Physical Laboratory, Teddington, UK;3. National Radiotherapy Trials QA (RTTQA) Group, Mount Vernon Hospital, Northwood, UK;4. Catharina Ziekenhuis, Eindhoven, The Netherlands;5. European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium;6. MD Andersen Cancer Center, Houston, TX, USA;7. Imaging and Radiation Oncology Core (IROC), Houston, USA;1. Joint Department of Physics, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Fulham Road, London SW3 6JJ, UK;2. Medical Physics Department, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK;1. Medical Physics Division, Candiolo Cancer Institute - FPO, IRCCS, Strada Provinciale 142 km 3.95, 10060 Candiolo (TO), Italy;2. Radiotherapy Division, Candiolo Cancer Institute - FPO, IRCCS, Strada Provinciale 142 km 3.95, 10060 Candiolo (TO), Italy;1. Protontherapy Department, Trento Hospital, Via Al Desert 14, 38123 Trento, Italy;2. Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute of Nuclear Physics (INFN), Via Sommarive 14, 38123 Trento, Italy;3. Medical Physics, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milano, Italy;4. Medical Physics Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Firenze, Italy |
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| Abstract: | SBRT for lung cancer is being rapidly adopted as a treatment option in modern radiotherapy centres. This treatment is one of the most complex in common clinical use, requiring significant expertise and resources. It delivers a high dose per fraction (typically ∼6–30 Gy/fraction) over few fractions. The complexity and high dose delivered in only a few fractions make powerful arguments for the application of in vivo dosimetry methods for these treatments to enhance patient safety. In vivo dosimetry is a group of techniques with a common objective – to estimate the dose delivered to the patient through a direct measurement of the treatment beam(s). In particular, methods employing an electronic portal imaging device have been intensely investigated over the past two decades. Treatment verification using in vivo dosimetry approaches has been shown to identify errors that would have been missed with other common quality assurance methods. With the addition of in vivo dosimetry to verify treatments, medical physicists and clinicians have a higher degree of confidence that the dose has been delivered to the patient as intended.In this review, the technical aspects and challenges of in vivo dosimetry for lung SBRT will be presented, focusing on transit dosimetry applications using electronic portal imaging devices (EPIDs). Currently available solutions will be discussed and published clinical experiences, which are very limited to date, will be highlighted. |
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| Keywords: | Dose verification Treatment verification Lung SBRT |
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