ESTRO 2025 - Abstract Book

S199

Brachytherapy - General

ESTRO 2025

HDR vault had the lowest associated emissions (59 kgCO 2 e per patient). This is expected as vault patients spend little, if any, time in the operating room and on wards, and have fewer associated medications. LDR and HDR prostate had similar carbon emissions per patient (131 kg CO 2 e and 127 kg CO 2 e respectively), and HDR cervix had the largest (183 kg CO 2 e per patient). The contribution of medications was difficult to assess because of poorly available carbon intensity data, and is not included above. However, our data suggest that approximately 250 kg CO 2 e (range 100 - 500) could arise from medication given during brachytherapy, for procedures involving the operating room. Emissions during manufacture, disposal and transport of sources are not included; estimates suggest that around 20 – 40 kg CO 2 e per patient could arise from this. Staff travel was also not included because many staff work both for brachytherapy and other services. There are significant differences between centres that arise from the catchment area of the centre, the choice of anaesthetics and whether or not patients are kept as day or overnight cases. Conclusion: The major contributors to carbon footprint are patient travel and time spent on wards and in the operating room. Medication, mostly arising from the operating room procedures, is likely to be extremely significant. This study will be useful as a pilot to the larger ESTRO brachytherapy footprinting study.

Keywords: Sustainability, radiotherapy

References: 1 WHO: https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health 2 UN: https://news.un.org/en/story/2022/04/1115452; 3 https://www.gov.uk/government/publications/greenhouse-gas-reporting-conversion-factors-2023 4 NHS SDU 2016: https://networks.sustainableheathcare.org.uk/networks/carbon-footprinting healthcare/sustainable-development-unit-sdu-carbon-footprints-various-units-healthcare-activity

2668

Digital Poster Analysis of workflow changes with Imaging Ring Installation in Interventional Radiation Therapy Federica Gherardi 1 , Eva Iannacone 1 , Mario Petrazzuoli 2 , Valentina d'Alesio 1 , Francesca Buonanno 1 , Marcello Serra 1 ,

Marco Gagliardi 1 , Mariano Davide 1 , Mariateresa Coppola 1 , Laura Coli 1 , Paolo Muto 1 1 Radiotherapy, IRCCS Pascale, Naples, Italy. 2 Radiotherapy, AOU Federico II, Naples, Italy

Purpose/Objective: Image-guided brachytherapy (IGBT) is a cornerstone of interventional radiotherapy (IRT). However, patient mobilization during IGBT procedures can be time-consuming, resource-intensive, and increase the risk of applicator displacement. This study investigates the impact of the ImagingRing system on workflow efficiency in IGBT for cervical cancer. Material/Methods: Our radiotherapy unit implemented the ImagingRingMobile system in November 2023. This mobile unit utilizes the latest generation of ConeBeam CT (CBCT) technology for 3D image acquisition. We retrospectively compared the total procedure time for cervical cancer patients treated between November 2022 and October 2023 (pre ImagingRing) and November 2023 to October 2024 (post-ImagingRing). Results: Pre-ImagingRing Workflow:Prior to the ImagingRing, IGBT workflow heavily relied on departmental scheduling. We lacked a dedicated MRI space or a dedicated CT slot for IGBT procedures, scheduling had to be coordinated around