Liverpool and Macarthur Cancer Therapy Centres Liverpool

New South Wales, Australia

Liverpool and Macarthur Cancer Therapy Centres Liverpool

New South Wales, Australia
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Rai R.,University of New South Wales | Kumar S.,University of New South Wales | Batumalai V.,University of New South Wales | Elwadia D.,Liverpool and Macarthur Cancer Therapy Centres Liverpool | And 7 more authors.
Journal of Medical Radiation Sciences | Year: 2017

The increased utilisation of magnetic resonance imaging (MRI) in radiation therapy (RT) has led to the implementation of MRI simulators for RT treatment planning and influenced the development of MRI-guided treatment systems. There is extensive literature on the advantages of MRI for tumour volume and organ-at-risk delineation compared to computed tomography. MRI provides both anatomical and functional information for RT treatment planning (RTP) as well as quantitative information to assess tumour response for adaptive treatment. Despite many advantages of MRI in RT, introducing an MRI simulator into a RT department is a challenge. Collaboration between radiographers and radiation therapists is paramount in making the best use of this technology. The cross-disciplinary training of radiographers and radiation therapists alike is an area rarely discussed; however, it is becoming an important requirement due to detailed imaging needs for advanced RT treatment techniques and with the emergence of hybrid treatment systems. This article will discuss the initial experiences of a radiation oncology department in implementing a dedicated MRI simulator for RTP, with a focus on the training required for both radiographer and RT staff. It will also address the future of MRI in RT and the implementation of MRI-guided treatment systems, such as MRI-Linacs, and the role of both radiation therapists and radiographers in this technology. © 2017 Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.


PubMed | University of New South Wales and Liverpool and Macarthur Cancer Therapy Centres Liverpool
Type: Journal Article | Journal: Journal of medical radiation sciences | Year: 2015

There are a number of different dwell positions and time optimisation options available in the Oncentra Brachy (Elekta Brachytherapy Solutions, Veenendaal, The Netherlands) brachytherapy treatment planning system. The purpose of this case study was to compare graphical (GRO) and inverse planning by simulated annealing (IPSA) optimisation techniques for interstitial head and neck (HN) and prostate plans considering dosimetry, modelled radiobiology outcome and planning time. Four retrospective brachytherapy patients were chosen for this study, two recurrent HN and two prostatic boosts. Manual GRO and IPSA plans were generated for each patient. Plans were compared using dose-volume histograms (DVH) and dose coverage metrics including; conformity index (CI), homogeneity index (HI) and conformity number (CN). Logit and relative seriality models were used to calculate tumour control probability (TCP) and normal tissue complication probability (NTCP). Approximate planning time was also recorded. There was no significant difference between GRO and IPSA in terms of dose metrics with mean CI of 1.30 and 1.57 (P>0.05) respectively. IPSA achieved an average HN TCP of 0.32 versus 0.12 for GRO while for prostate there was no significant difference. Mean GRO planning times were greater than 75min while average IPSA planning times were less than 10min. Planning times for IPSA were greatly reduced compared to GRO and plans were dosimetrically similar. For this reason, IPSA makes for a useful planning tool in HN and prostate brachytherapy.

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