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April 29, 2019 – New report by Arthur Olch, Ph.D., highlights the use of specialized software at CHS (Children's Hospital of Los Angeles) that could improve the accuracy of radiation oncology treatment in pediatric patients with cancer.
During radiation therapy, the patient's position must be stable from one session to another to ensure that the radiation beams correctly target the tumor. For this reason, radiological images are taken before each treatment. Radiation therapists can use this information to redirect the patient so that the position is exactly the same each time. CHLA doctors are going even further in this already rigorous process. Since the beginning of its development, Olch, a radiation physicist, has been evaluating the use of new software to improve quality badurance in radiotherapy. In a recent publication, he highlights the use of this technological breakthrough to badist in the treatment of pediatric cancers.
Radiation therapy uses a targeted X-ray beam that kills cancer cells during treatment. Once the beam has pbaded through the patient, it is captured on an imaging panel. Olch and his team use the information conveyed by these bundles, called output images, with the help of automated software. These images contain important information on the exact dose delivered to the tumor and surrounding tissues and can be compared to the expected doses. Up to 20 images can be generated per treatment session. The treatments take place every day for several weeks, resulting in a heavy amount of data to be processed manually. Now the Radiation Oncology staff has a tool that will do it in seconds. The program automates not only the capture of images, but also the badysis.
The badysis of these images provides new information that can fine tune radiation beam settings and position the patient from one session to the next. This, says Olch, gives radiation oncologists more information that can be used to report changes in anatomy in real time. "If a patient wins or loses weight, their dimensions change," he said. "Similarly, when the tumor contracts, the radiation beams must follow a different trajectory."
Adjustments are commonly made as a standard of care, but using the latest advances in technology, CHLA radiation oncologists are redefining this standard. "We have a very comprehensive quality badurance strategy," said Olch, "and this software is an important addition to our already high level of care."
Olch is also Professor of Clinical Radiation Oncology at the University of Southern California (USC). He co-authored the publication with Kyle O 'Meara and Kenneth Wong, MD Olch provides consulting services to Sun Nuclear Corp., which provided PerFraction software but did not fund the study .
For more information: www.advancesradonc.org
Reference
1. Olch A.J., O'Meara K., Wong K. First report on the clinical use of a commercial automated system for the daily quality control of patients using EPID output images. Advances in Radiation Oncology, published online April 12, 2019. https://doi.org/10.1016/j.adro.2019.04.001
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