Practice-based training strategy for therapist-driven prostate MR-Linac adaptive radiotherapy

• DOI: 10.1016/j.tipsro.2023.100212
• Publication Date: 2023-05-15T11:30:38Z
• Authors: Winnie Li; Jerusha Padayachee; Inmaculada Navarro; Jeff Winter; Jennifer Dang; Srinivas Raman; Vickie Kong; Alejandro Berlin; Charles Catton; Rachel Glicksman; Victor Malkov; Andrew McPartlin; Kaushik Kataki; Patricia Lindsay; Peter Chung
• Keywords: Radiation Therapist

To develop a practice-based training strategy to transition from radiation oncologist therapist-driven prostate MR-Linac adaptive radiotherapy.In phase 1, 7 therapists independently contoured the and organs-at-risk on T2-weighted MR images 11 previously treated patients. Contours were evaluated quantitatively (i.e. Dice similarity coefficient [DSC] calculated against generated online contours) qualitatively using 5-point Likert scale; score ≥ 4 was deemed pass, 90% pass rate required proceed next phase). Phase 2 consisted of supervised workflow with no intervention 10 total cases advance. 3 involved unsupervised workflow, offline support oncologists prior fraction.In mean DSC 0.92 (range 0.85-0.97), 3.7 for prostate. Five did not attain (3-5 contour < 4), underwent follow-up one-on-one review, performed contours further set (n = 5). Each participant completed median 12 10-13) in 2; 82 cases, minor direction 5 regarding target contouring. Radiation reviewed 179 treatment fractions 3, acceptable but suggestions fraction; all other accepted without suggestions.A stepwise program developed successfully implemented enable radiotherapy.