ESTRO 2024 - Abstract Book

S4186

Physics - Intra-fraction motion management and real-time adaptive radiotherapy

ESTRO 2024

Results:

The status-quo pre-treatment PSQA workload for the Separate-OIS workflow was estimated to 402 clicks, distributed over four chronological sub-processes: 40% plan approval and -documentation, 11% phantom-QA preparation, 19% 1st MPE check and 30% 2nd MPE check (Fig. 2A). For the Integrated-OIS workflow, a total of 269 clicks were recorded with 18%, 5%, 34% and 43% for the same sub-processes, respectively (Fig. 2B). The Separate-OIS and Integrated-OIS workflows demand 18 vs. 10 manual entries of treatment parameters, respectively. The lower number of clicks required for the Integrated-OIS workflow are associated with the seamless integration of OIS and TPS, combined with less time spent on the manual creation and review of report documents exchanged by separate systems. Twenty-six SCs were defined, divided in 13 exact (“hard”) checks and 13 tolerance threshold-based (“soft”) checks. They are situated at two subsequent, designated workflow points: (1) After plan approval in the TPS and (2) after DICOM data transfer from the OIS to the treatment control system (TCS). SCs operate on patient data, prescription, gantry- and couch parameters as well as image-/structure sets, beam parameters and dose calculation settings (Fig. 2C/D). From the total 402 clicks recorded for PSQA operations in the Separate-OIS workflow, 47 (12%) clicks related to plan release and MPE checks would be directly covered by SCs in the envisioned OAPT workflow. For the Integrated OIS workflow, 45 clicks (17%) would be covered by SCs. Notably, this portion only reflects the direct impact of SCs on the status-quo PSQA workload. The full OAPT-PSQA workflow will lead to a substantial additional decrease of manual operations (e.g. due to phantom-less QA and automated documentation), which was out of the scope of this work.