Surface guided electron FLASH radiotherapy for canine cancer patients

Research output: Contribution to journalJournal articleResearchpeer-review

Standard

Surface guided electron FLASH radiotherapy for canine cancer patients. / Mannerberg, Annika; Konradsson, Elise; Kügele, Malin; Edvardsson, Anneli; Kadhim, Mustafa; Ceberg, Crister; Peterson, Kristoffer; Thomasson, Hanna-Maria; Arendt, Maja L; Børresen, Betina; Jensen, Kristine Bastholm; Ceberg, Sofie.

In: Medical Physics, Vol. 50, No. 7, 2023, p. 4047-4054.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Mannerberg, A, Konradsson, E, Kügele, M, Edvardsson, A, Kadhim, M, Ceberg, C, Peterson, K, Thomasson, H-M, Arendt, ML, Børresen, B, Jensen, KB & Ceberg, S 2023, 'Surface guided electron FLASH radiotherapy for canine cancer patients', Medical Physics, vol. 50, no. 7, pp. 4047-4054. https://doi.org/10.1002/mp.16453

APA

Mannerberg, A., Konradsson, E., Kügele, M., Edvardsson, A., Kadhim, M., Ceberg, C., Peterson, K., Thomasson, H-M., Arendt, M. L., Børresen, B., Jensen, K. B., & Ceberg, S. (2023). Surface guided electron FLASH radiotherapy for canine cancer patients. Medical Physics, 50(7), 4047-4054. https://doi.org/10.1002/mp.16453

Vancouver

Mannerberg A, Konradsson E, Kügele M, Edvardsson A, Kadhim M, Ceberg C et al. Surface guided electron FLASH radiotherapy for canine cancer patients. Medical Physics. 2023;50(7):4047-4054. https://doi.org/10.1002/mp.16453

Author

Mannerberg, Annika ; Konradsson, Elise ; Kügele, Malin ; Edvardsson, Anneli ; Kadhim, Mustafa ; Ceberg, Crister ; Peterson, Kristoffer ; Thomasson, Hanna-Maria ; Arendt, Maja L ; Børresen, Betina ; Jensen, Kristine Bastholm ; Ceberg, Sofie. / Surface guided electron FLASH radiotherapy for canine cancer patients. In: Medical Physics. 2023 ; Vol. 50, No. 7. pp. 4047-4054.

Bibtex

@article{14820face2e34061ae0b45d08de3dcb1,
title = "Surface guided electron FLASH radiotherapy for canine cancer patients",
abstract = "BACKGROUND: During recent years FLASH radiotherapy (FLASH-RT) has shown promising results in radiation oncology, with the potential to spare normal tissue while maintaining the antitumor effects. The high speed of the FLASH-RT delivery increases the need for fast and precise motion monitoring to avoid underdosing the target. Surface guided radiotherapy (SGRT) uses surface imaging (SI) to render a 3D surface of the patient. SI provides real-time motion monitoring and has a large scanning field of view, covering off-isocentric positions. However, SI has so far only been used for human patients with conventional setup and treatment.PURPOSE: The aim of this study was to investigate the performance of SI as a motion management tool during electron FLASH-RT of canine cancer patients.METHODS: To evaluate the SI system's ability to render surfaces of fur, three fur-like blankets in white, grey, and black were used to imitate the surface of canine patients and the camera settings were optimized for each blanket. Phantom measurements using the fur blankets were carried out, simulating respiratory motion and sudden shift. Respiratory motion was simulated using the QUASAR Respiratory Motion Phantom with the fur blankets placed on the phantom platform, which moved 10 mm vertically with a simulated respiratory period of 4 s. Sudden motion was simulated with an in-house developed phantom, consisting of a platform which was moved vertically in a stepwise motion at a chosen frequency. For sudden measurements, 1, 2, 3, 4, 5, 6, 7, and 10 Hz were measured. All measurements were both carried out at the conventional source-to-surface distance (SSD) of 100 cm, and in the locally used FLASH-RT setup at SSD = 70 cm. The capability of the SI system to reproduce the simulated motion and the sampling time were evaluated. As an initial step towards clinical implementation, the feasibility of SI for surface guided FLASH-RT was evaluated for 11 canine cancer patients.RESULTS: The SI camera was capable of rendering surfaces for all blankets. The deviation between simulated and measured mean peak-to-peak breathing amplitude was within 0.6 mm for all blankets. The sampling time was generally higher for the black fur than for the white and grey fur, for the measurement of both respiratory and sudden motion. The SI system could measure sudden motion within 62.5 ms and detect motion with a frequency of 10 Hz. The feasibility study of the canine patients showed that the SI system could be an important tool to ensure patient safety. By using this system we could ensure and document that 10 out of 11 canine patients had a total vector offset from the reference setup position <2 mm immediately before and after irradiation.CONCLUSIONS: We have shown that SI can be used for surface guided FLASH-RT of canine patients. The SI system is currently not fast enough to interrupt a FLASH-RT beam while irradiating but with the short sampling time sudden motion can be detected. The beam can therefore be held just prior to irradiation, preventing treatment errors such as underdosing the target.",
author = "Annika Mannerberg and Elise Konradsson and Malin K{\"u}gele and Anneli Edvardsson and Mustafa Kadhim and Crister Ceberg and Kristoffer Peterson and Hanna-Maria Thomasson and Arendt, {Maja L} and Betina B{\o}rresen and Jensen, {Kristine Bastholm} and Sofie Ceberg",
note = "{\textcopyright} 2023 The Authors. Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.",
year = "2023",
doi = "10.1002/mp.16453",
language = "English",
volume = "50",
pages = "4047--4054",
journal = "Medical Physics",
issn = "0094-2405",
publisher = "John Wiley and Sons, Inc.",
number = "7",

}

RIS

TY - JOUR

T1 - Surface guided electron FLASH radiotherapy for canine cancer patients

AU - Mannerberg, Annika

AU - Konradsson, Elise

AU - Kügele, Malin

AU - Edvardsson, Anneli

AU - Kadhim, Mustafa

AU - Ceberg, Crister

AU - Peterson, Kristoffer

AU - Thomasson, Hanna-Maria

AU - Arendt, Maja L

AU - Børresen, Betina

AU - Jensen, Kristine Bastholm

AU - Ceberg, Sofie

N1 - © 2023 The Authors. Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.

PY - 2023

Y1 - 2023

N2 - BACKGROUND: During recent years FLASH radiotherapy (FLASH-RT) has shown promising results in radiation oncology, with the potential to spare normal tissue while maintaining the antitumor effects. The high speed of the FLASH-RT delivery increases the need for fast and precise motion monitoring to avoid underdosing the target. Surface guided radiotherapy (SGRT) uses surface imaging (SI) to render a 3D surface of the patient. SI provides real-time motion monitoring and has a large scanning field of view, covering off-isocentric positions. However, SI has so far only been used for human patients with conventional setup and treatment.PURPOSE: The aim of this study was to investigate the performance of SI as a motion management tool during electron FLASH-RT of canine cancer patients.METHODS: To evaluate the SI system's ability to render surfaces of fur, three fur-like blankets in white, grey, and black were used to imitate the surface of canine patients and the camera settings were optimized for each blanket. Phantom measurements using the fur blankets were carried out, simulating respiratory motion and sudden shift. Respiratory motion was simulated using the QUASAR Respiratory Motion Phantom with the fur blankets placed on the phantom platform, which moved 10 mm vertically with a simulated respiratory period of 4 s. Sudden motion was simulated with an in-house developed phantom, consisting of a platform which was moved vertically in a stepwise motion at a chosen frequency. For sudden measurements, 1, 2, 3, 4, 5, 6, 7, and 10 Hz were measured. All measurements were both carried out at the conventional source-to-surface distance (SSD) of 100 cm, and in the locally used FLASH-RT setup at SSD = 70 cm. The capability of the SI system to reproduce the simulated motion and the sampling time were evaluated. As an initial step towards clinical implementation, the feasibility of SI for surface guided FLASH-RT was evaluated for 11 canine cancer patients.RESULTS: The SI camera was capable of rendering surfaces for all blankets. The deviation between simulated and measured mean peak-to-peak breathing amplitude was within 0.6 mm for all blankets. The sampling time was generally higher for the black fur than for the white and grey fur, for the measurement of both respiratory and sudden motion. The SI system could measure sudden motion within 62.5 ms and detect motion with a frequency of 10 Hz. The feasibility study of the canine patients showed that the SI system could be an important tool to ensure patient safety. By using this system we could ensure and document that 10 out of 11 canine patients had a total vector offset from the reference setup position <2 mm immediately before and after irradiation.CONCLUSIONS: We have shown that SI can be used for surface guided FLASH-RT of canine patients. The SI system is currently not fast enough to interrupt a FLASH-RT beam while irradiating but with the short sampling time sudden motion can be detected. The beam can therefore be held just prior to irradiation, preventing treatment errors such as underdosing the target.

AB - BACKGROUND: During recent years FLASH radiotherapy (FLASH-RT) has shown promising results in radiation oncology, with the potential to spare normal tissue while maintaining the antitumor effects. The high speed of the FLASH-RT delivery increases the need for fast and precise motion monitoring to avoid underdosing the target. Surface guided radiotherapy (SGRT) uses surface imaging (SI) to render a 3D surface of the patient. SI provides real-time motion monitoring and has a large scanning field of view, covering off-isocentric positions. However, SI has so far only been used for human patients with conventional setup and treatment.PURPOSE: The aim of this study was to investigate the performance of SI as a motion management tool during electron FLASH-RT of canine cancer patients.METHODS: To evaluate the SI system's ability to render surfaces of fur, three fur-like blankets in white, grey, and black were used to imitate the surface of canine patients and the camera settings were optimized for each blanket. Phantom measurements using the fur blankets were carried out, simulating respiratory motion and sudden shift. Respiratory motion was simulated using the QUASAR Respiratory Motion Phantom with the fur blankets placed on the phantom platform, which moved 10 mm vertically with a simulated respiratory period of 4 s. Sudden motion was simulated with an in-house developed phantom, consisting of a platform which was moved vertically in a stepwise motion at a chosen frequency. For sudden measurements, 1, 2, 3, 4, 5, 6, 7, and 10 Hz were measured. All measurements were both carried out at the conventional source-to-surface distance (SSD) of 100 cm, and in the locally used FLASH-RT setup at SSD = 70 cm. The capability of the SI system to reproduce the simulated motion and the sampling time were evaluated. As an initial step towards clinical implementation, the feasibility of SI for surface guided FLASH-RT was evaluated for 11 canine cancer patients.RESULTS: The SI camera was capable of rendering surfaces for all blankets. The deviation between simulated and measured mean peak-to-peak breathing amplitude was within 0.6 mm for all blankets. The sampling time was generally higher for the black fur than for the white and grey fur, for the measurement of both respiratory and sudden motion. The SI system could measure sudden motion within 62.5 ms and detect motion with a frequency of 10 Hz. The feasibility study of the canine patients showed that the SI system could be an important tool to ensure patient safety. By using this system we could ensure and document that 10 out of 11 canine patients had a total vector offset from the reference setup position <2 mm immediately before and after irradiation.CONCLUSIONS: We have shown that SI can be used for surface guided FLASH-RT of canine patients. The SI system is currently not fast enough to interrupt a FLASH-RT beam while irradiating but with the short sampling time sudden motion can be detected. The beam can therefore be held just prior to irradiation, preventing treatment errors such as underdosing the target.

U2 - 10.1002/mp.16453

DO - 10.1002/mp.16453

M3 - Journal article

C2 - 37190907

VL - 50

SP - 4047

EP - 4054

JO - Medical Physics

JF - Medical Physics

SN - 0094-2405

IS - 7

ER -

ID: 347106710