Abstract
This work describes a novel application of MR-guided online adaptive radiotherapy (MRgoART) in the management of patients whom urgent palliative care is indicated using statum-adaptive radiotherapy (STAT-ART). The implementation of STAT-ART, as performed at our institution, is presented including a discussion of the advantages and limitations compared to the standard of care for palliative radiotherapy on conventional c-arm linacs. MR-based treatment planning techniques of STAT-ART for density overrides and deformable image registration (DIR) of diagnostic CT to the treatment MR are also addressed.
Highlights
The American Cancer Society estimated that annually in 2019 there are 1.76 million new cases of cancer with 606,880 cancer deaths [1]
The implementation of STAT-adaptive radiotherapy (ART), as performed at our institution, is presented including a discussion of the advantages and limitations compared to the standard of care for palliative radiotherapy performed on conventional carm linacs
We present three strategies (Figure 1) in the STAT-ART workflow for density propagation using bulk density overrides or deformable image registration for respective homogenous or heterogenous dose calculations
Summary
The American Cancer Society estimated that annually in 2019 there are 1.76 million new cases of cancer with 606,880 cancer deaths [1]. Most cancer deaths are associated with a decreased quality of life and painful end-of-life, likely due to loco-regional or metastatic disease progression [2, 3]. Palliative radiotherapy (RT) allows for the management of patients with advanced stage cancer. As the sensitivity and accuracy of cancer detection and subsequently cancer treatments progressively improve, the life expectancy for cancer patients is steadily rising even with metastatic disease [3]. Improving the palliative RT workflow by utilizing advanced technology to offer rapid, same day treatment can reduce the pretreatment time period, allowing for near-immediate pain-relief and an improved quality of life for these patients
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