ESTRO 2023 - Abstract Book

S1624

Digital Posters

ESTRO 2023

Results OAPT will be the method of choice in ten years (PC), mainly in case of variable organ filling and performed with a single in-room imaging modality (FC). There was no consensus on whether offline adaptation will still be performed once OAPT is used clinically. All steps of OAPT require automation to maintain patient throughput (FC). Artificial Intelligence is needed for safe automation, with its central role seen in auto-segmentation (FC). Standardising reporting of endpoints in clinical trials (PC) and cumulative dose reporting (PC) is necessary. It is not currently clear what the best and fastest patient QA method for OAPT will be, and further investigations are required to answer this question (FC). As efficient workflows and tools are medical products, the clinical implementation requires cooperation between industry, research and clinic (FC) with automated and fast systems, reliable deformable registration for dose accumulation, and higher quality in-room imaging identified as the top three priorities (PC). The future importance of MRI-guided PT did not reach consensus. RRMM is needed for near-real-time OAPT and to treat moving targets (FC) as it mitigates dose deteriorations for both, target and OARs (FC). It should combine multiple approaches, including breath-hold, rescanning, gating, or tracking (FC) based on individual patient selection criteria (FC) and pre-treatment motion characteristics (FC). Optimisation of rescanning parameters, motion model uncertainties and pre-treatment 4D evaluation were considered clinically important (FC). The need to report fractional 4D dose distribution in clinical trials did not reach consensus. 4D dose calculation and its uncertainty evaluation were identified as top requirements (FC). 4D log-file dose reconstruction, (surface) image-based gating/tracking, efficient image guidance and on-board MR guidance were considered of interest but without reaching consensus. Conclusion A DELPHI consensus analysis was performed to explore needed developments for OAPT and RRMM. Join efforts between industry, research and clinics are needed to translate innovations into efficient and clinically feasible workflows for broad scale implementation. Consistent reporting of well-defined endpoints should be included in clinical trials to evaluate the clinical impact of both methods.

[1] Zhang Y, Trnkova P et al, ESTRO 2021

PO-1881 Analysis of the Interplay Effect in Lung SABR Based on Breathing Motion and Plan Characteristics.

A. ALI 1,2 , J. Greenwood 1 , M. Varasteh 3 , S. Esteve 2 , P. Jeevanandam 2 , F. Göpfert 4 , D. Irvine 2 , A. Hounsell 2,3 , C. McGarry 2,3

1 Queen’s University Belfast, School of Mathematics and Physics, Belfast, United Kingdom; 2 Belfast Health and Social Care Trust, Radiotherapy Physics, Belfast, United Kingdom; 3 Queen’s University Belfast, Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom; 4 PTW, PTW, Freiburg, Germany

Purpose or Objective