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Markerless radiotherapy

Posted: Mon Apr 01, 2019 2:17 pm
by ben_allen
Hi all.  I am in the process of moving our department to markerless for breast radiotherapy.  How many people out there are completely mark and tattoo free? what were you biggest lessons in going through the process?



Thanks,

Re: Markerless radiotherapy

Posted: Wed Apr 03, 2019 6:45 pm
by ellen_herron_bsrtt
We are completely markless and love it! Have a game plan and think through possible problems ahead of time. We me with head of physics, dosimetry and our director to brainstorm how we would handle certain situations if they did arise (ex. system going down). We also went through a 3 month "trial run" where we agreed to keep marks as a back up. The trial was a success and we haven't looked back since :) *Tip: We make sure we index all of our patients and use tighter tolerance tables, even if we have to get creative. In addition to Vision RT we also can be confident we are in our correct position by in tolerance table parameters, checking medial light field and verifying medial SSD daily*

Re: Markerless radiotherapy

Posted: Fri May 17, 2019 8:33 am
by suzanne_coupland
We are also looking into going markerless, but have heard from other centres that they do still use measurements and pen marks, at least to get to a starting point. Our particular concern is regarding breasts, who are mostly treated on an incline, and although the breastboard is fixed, and the bumstop positioned, we still have to ask the patient to move up or down to get them at the correct point on the board. We have discussed measuring a point halfway between the ssn and xiphi to give us a starting point, but does anyone have any other solutions?

Do centres use pitch as the biggest indicator for patient positioning on the incline?

Any advice would be greatly appreciated, thanks

Re: Markerless radiotherapy

Posted: Fri May 24, 2019 8:40 am
by suzanne_coupland
On the same thread, what contingency plans do other centres have in place if Align were to fail for any extended period, with markerless treatments?


Re: Markerless radiotherapy

Posted: Fri May 24, 2019 10:32 am
by marko_laaksomaa
Hi

One fresh article to this topic:

Eliminating Daily Shifts, Tattoos, and Skin Marks: Streamlining Isocenter Localization With Treatment Plan Embedded Couch Values for External Beam Radiation Therapy, Practical Radiation Oncology, Volume 9, Issue 1, January–February 2019, Pages e110-e117, Sueyoshi et. al.

Marko

Re: Markerless radiotherapy

Posted: Thu May 30, 2019 12:11 pm
by ellen_herron_bsrtt
We sometimes do have pitch issues and have to make adjustments but they correlate with what VisionRT is telling us. So, Do you use a vacloc for the arms on top of the breastboard?

In our clinic if the system were down, we would use our table parameters along with imaging and ssd checks for patient positioning. If we thought it might be down the next day then we would place marks and use them until the system came back up.

Re: Markerless radiotherapy

Posted: Thu Jul 30, 2020 5:20 am
by chin_hwa_chan
Hi, may I ask how do you check lateral border in SGRT?

Re: Markerless radiotherapy

Posted: Tue Aug 04, 2020 10:23 am
by deirdre
Hi,

We have a rendered imaged uploaded and do a quick check of the border posistion on lateral and medial

Re: Markerless radiotherapy

Posted: Fri Aug 14, 2020 1:36 pm
by suzanne_coupland
We no longer check field borders as we have no reference mark to check with, however we have found that a combination of AlignRT and on treatment imaging confirms patient positioning. We do still check breast coverage with the light field before exiting in the room, including in breathold for our DIBH patients

Re: Markerless radiotherapy

Posted: Mon Nov 16, 2020 9:40 am
by ling_zhuang
Hi Marko, could you possibliy share the article with me? I do not have access to full article. very interested. thank you!