Methods to combine and sum external beam and brachytherapy dose distributions
Chairs
Vania Batista (DE), Åsa Tedgren (SE)
Motivation:
A combination of Brachytherapy (BT) and external RT (extRT) is a quite common therapeutic approach. However, the contribution of both techniques for the overall treatment is commonly under-documented, resulting in a possible suboptimal plan. The challenges to assess the combined dose are due to the different patient anatomy (inter-fractional anatomical changes, tumor shrinkage and setup), different TPS and/or lack of tools, fractionation schemes (integration of biological models into dose summation), and use of different imaging modalities.
Different approaches to consider this mutual impact might be a simple dose metric, ROI-mapping into the BT-Plan, DVHs addition, or dose summation using deformable registration.
The applications of such methods might allow dose escalation, optimization of fractionation/treatment schemes, and comprehensive reporting of clinical outcomes.
This workshop will be tailored to match interests from medical physicist from the external beam radiotherapy and brachytherapy.
Proposed outcomes:
- Collect information about the different methods to consider both dose distribution
- Suggest different levels of approaches and understand their limitations (per treatment site, and Brachytherapy technique)
- List the requirements to implement it into the clinical routine
- Extend the existing review to other sites (e.g. Prostate, H&N) and update (if necessary) the Gyn existing reviews.
- Formation of a multidisciplinary working group dedicated to this topic.
Speakers:
- Joakim Jonsson- Medical Physicist at the Umeå University, Faculty of Medicine, Department of Radiation Sciences. Main research field is deformable image registration techniques applied to different IGRT-workflows in the field of EBRT.
- Bradley Pieters - Radiation oncologist at the Amsterdam University Medical Centers. His clinical and research interest is urologic and gynecologic tumors and brachytherapy in general.
- Taran Paulsen Hellebust - Head of research on Department of Medical Physics Oslo University Hospital and associate professor at University in Oslo. Main research has been in gynaecological radiotherapy (both brachytherapy and EBRT). Last years with main interests in how to combine image series to improve delineation and to calculate accumulated dose using DIR methods.
- Georgina Fröhlich - Medical physicist at the National Institute of Oncology, Budapest, Hungary, and take lectures at the Eötvös University, Budapest. Current main research topic is the dose integration of combined treatment of modern EBRT and brachytherapy techniques.
Preliminary Programme
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Day 1
(Friday, 13.October)
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(tentative) Title
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Speaker
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09:00-09:15
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Introduction of the meeting
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all
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09:15-10:00
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Opening lecture
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all
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10:00-10:30
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Coffee
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all
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10:30-10:35
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Introduction Workshop-topic
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Chairs
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10:35-10:45
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Participants pitches
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Participants
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10:45-11:15
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Dose summation in RT - Introduction and Challenges
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Taran Paulsen Hellebust
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11:15-12:00
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Physical approaches to dose summation, pitfalls and possibilities
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Joakim Jonsson
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12:00-12:30
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Clinical relevance and impact of dose accumulation across modalities
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Bradley Pieters
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12:30-13:30
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Lunch
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all
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13:30-14:00
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Discussion: OARs & Target perspective. Dose and/or volume-adaption.
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Chairs and participant
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14:30-15:30
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Discussion round & wrap-up
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Chairs and participants
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15:30 -16:00
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Coffee
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all
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16:30-17:00
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Progress report of the different topics
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all
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Day 2
(Saturday, 14 October)
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08:00-08:10
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Introduction to day 2
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Chairs
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08:10-08:45
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Examples and challenges in different brachytherapy treatment sites - Physics
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Georgina Fröhlich
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08:45-09:30
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Physician point of view
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2 min recorded speech from different physicians
(Discussion: Bradley Pieters)
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09:30-10:00
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Discussion round (Back to the basics vs advanced method)
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Chairs and participants
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10:00-10:30
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Coffee
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all
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10:30-11:15
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Clinical cases discussion (include application of different available TPS-tools and approaches)
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1 case brought by each participant and vendors
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11:15-12:00
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Outlook: Tools of the adaptive RT and other fields if applied to BT
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Chairs and vendors
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12:00-12:30
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Discussion round
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Chairs and participants
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12:30-13:30
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Lunch
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all
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13:30-14:30
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Session Wrap-up/ Next steps.
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Chairs and participants
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14:30-15:30
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Wrap up: highlights and planned next steps of the different workshops
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all
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15:30-15:45
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Close
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all
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