ESTRO 2024 - Abstract Book

S9 ESTRO 2024 efficiency and accuracy by reducing human errors, minimizing inter-observer differences in segmentation and planning, and saving time. This presentation provides a comprehensive overview of recent advancements and applications of AI technologies in various aspects of brachytherapy, highlighting challenges, opportunities, and future directions. Invited Speaker

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Applicability and usage of dose mapping/accumulation in radiotherapy

Martina Murr 1 , Kristy K. Brock 2 , Marco Fusella 3 , Nicholas Hardcastle 4 , Mohammad Hussein 5 , Michael G. Jameson 6 , Isak Wahlstedt 7 , Johnson Yuen 8 , Jamie R. McClelland 9 , Eliana Vasquez Osorio 10 1 Section for Biomedical Physics, Department of Radiation Oncology, Tübingen, Germany. 2 The University of Texas MD Anderson Cancer Center, Department of Imaging Physics, Texas, USA. 3 Terme Hospital, Department of Radiation Oncology, Abano, Italy. 4 Peter MacCallum Cancer Centre & Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. 5 Metrology for Medical Physics Centre, National Physical Laboratory, Teddington, United Kingdom. 6 GenesisCare New South Wales, Faculty of Medicine and Health, New South Wales, Australia. 7 Technical University of Denmark, Department of Health Technology, Kongens Lyngby, Denmark. 8 St George Hospital, Cancer Care Centre, New South Wales, Australia. 9 Centre for Medical Image Computing and Wellcome and EPSRC Centre for Interventional and Surgical Sciences, Dept of Medical Physics and Biomedical Engineering,, London, United Kingdom. 10 Division of Cancer Sciences, Faculty of Biology,, Medicine and Health, Manchester, United Kingdom Dose mapping/accumulation (DMA) has been a topic in radiotherapy (RT) for years but has not yet found its widespread way into clinical RT routine. During the ESTRO Physics workshop 2021 on ‘‘commissioning and quality assurance of deformable image registration (DIR) for current and future RT applications”, we built a working group on DMA from which we present the results of our discussions in this symposium based on the article [1]. This article aims to shed light on the current DMA situation in RT and highlight the issues that hinder its conscious integration into clinical RT routine. As a first outcome of our discussions, we present a scheme (cf. Figure 1) where representative RT use cases are positioned, considering expected anatomical variations and the impact of dose mapping uncertainties on patient safety, which we have named the DMA landscape (DMAL). This tool is helpful for future reference when DMA applications get closer to clinical day-to-day use. Secondly, we discussed current challenges, lightly touching on first-order effects (related to the impact of DIR uncertainties in dose mapping) and focusing in detail on second-order effects often dismissed in the current literature (such as resampling and interpolation, quality assurance considerations, and radiobiological issues). Finally, we developed recommendations and guidelines for vendors and users. Our main points include: • Striving for context-driven DIR (considering their impact on clinical decisions/judgments) rather than perfect DIR. • Being conscious of the limitations of the implemented DIR algorithm. • Consider when dose mapping (with properly quantified uncertainties) is a better alternative than no mapping. Abstract: