A survey of image‐guided radiation therapy use in the United States

Simpson, Daniel R.; Lawson, Joshua D.; Nath, Sameer K.; Rose, Brent S.; Mundt, Arno J.; Mell, Loren K.

doi:10.1002/cncr.25129

Cited by 91 publications

(46 citation statements)

References 72 publications

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“…In addition, image-guidance using cone beam computed tomography (CBCT) and implanted fiducial markers further increased the precision of radiation therapy. Image-guided radiation therapy is applied most commonly in genitourinary malignancies, and incremental costs related to online image-guided treatment strategies are acceptable (1,2). Planning studies have demonstrated that IMRT treatment can reduce the dose to OAR compared to 3D-CRT, without a reduction of planning target volume (PTV) coverage (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients

Wortel

Incrocci

Pos

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

109

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Section: Introductionmentioning

confidence: 99%

Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients

Wortel

Incrocci

Pos

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

109

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“…Taking IMRT as the example, the seminal early theoretical work began in the early 1980s, and the technology for convenient delivery became available in the 1990s and more widely available after around the year 2000. The time delay between early and late implementation of IMRT is at least 10 years, and this is similar for other such new technologies in the USA 14 and in Europe. 15 The safety works are clearly not responsible, but more likely resource issues, for provision of the required technology, but also for the supporting human activity required.…”

Section: Radiotherapy Requires a High Level Of Support For Safety Prmentioning

confidence: 61%

Does a too risk-averse approach to the implementation of new radiotherapy technologies delay their clinical use?

Garcia

Nyström²,

Fiorino

et al. 2015

BJR

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Radiotherapy is a generally safe treatment modality in practice; nevertheless, recent well-reported accidents also confirm its potential risks. However, this may obstruct or delay the introduction of new technologies and treatment strategies/techniques into clinical practice. Risks must be addressed and judged in a realistic context: risks must be assessed realistically. Introducing new technology may introduce new possibilities of errors. However, delaying the introduction of such new technology therefore means that patients are denied the potentially better treatment opportunities. Despite the difficulty in quantitatively assessing the risks on both sides of the possible choice of actions, including the "lost opportunity", the best estimates should be included in the overall risk-benefit and cost-benefit analysis. Radiotherapy requires a sufficiently high level of support for the safety, precision and accuracy required: radiotherapy development and implementation is exciting. However, it has been anxious with a constant awareness of the consequences of mistakes or misunderstandings. Recent history can be used to show that for introduction of advanced radiotherapy, the risk-averse medical physicist can act as an electrical fuse in a complex circuit. The lack of sufficient medical physics resource or expertise can short out this fuse and leave systems unsafe. Future technological developments will continue to present further safety and risk challenges. The important evolution of radiotherapy brings different management opinions and strategies. Advanced radiotherapy technologies can and should be safely implemented in as timely a manner as possible for the patient groups where clinical benefit is indicated.

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“…The high uptake of volumetric imaging for prostate IGRT shows a trend similar to that identified in a survey in the USA in 2009. 8 The high proportion of 66% of UK centres using CBCT verification in this survey indicates an improvement in IGRT equipment compared with the 2010 data from the ESTRO-HERO project. 6 There remain some inequities in provision of image guidance technology, with seven NHS centres using planar imaging only.…”

Section: Discussionmentioning

confidence: 77%

Image-guided radiotherapy for prostate cancer in the United Kingdom: a national survey

Ariyaratne¹,

Chesham²,

Alonzi³

2017

The British Journal of Radiology

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Objective: To survey the technology and practice of image-guided radiotherapy (IGRT) for prostate cancer in the UK. Methods: A pre-tested semi-structured online questionnaire was sent to National Health Service (NHS) and private radiotherapy providers in the UK between March and April 2014. The survey was carried out on the Opinio© online platform. Results: There was a high survey response rate of 83%. There is widespread use of intensity-modulated radiotherapy and advanced verification imaging modalities. Cone-beam CT (CBCT) is the main verification imaging modality in radical prostate radiotherapy, used in 66% of UK centres. Fiducial markers in combination with imaging were used in 30% of centres. Over half the centres used a daily imaging schedule, with a Day 1-3 frequency followed by weekly frequency used less commonly. 26% of centres used daily CBCT. Conclusion: There is widespread use of volumetric verification imaging with CBCT for prostate radiotherapy in the UK. There is no consensus on the optimal verification imaging schedule. Advances in knowledge: This survey provides an insight into contemporary UK practice of IGRT for prostate cancer, both in the NHS and private sector. It demonstrates the widespread use of CBCT imaging and highlights the need for further research to optimize the practice.

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A survey of image‐guided radiation therapy use in the United States

Abstract: BACKGROUND-Image-guided radiation therapy (IGRT) is a novel array of in-room imaging modalities that are utilized for tumor localization and patient set-up in radiation oncology. The prevalence of IGRT use among U.S. radiation oncologists is unknown.

Cited by 91 publications

References 72 publications

Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients

Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients

Does a too risk-averse approach to the implementation of new radiotherapy technologies delay their clinical use?

Image-guided radiotherapy for prostate cancer in the United Kingdom: a national survey

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