T Kim*, E Laugeman, F Reynoso, N Knutson, P Szentivanyi, M Schmidt, Washington University School of Medicine, St Louis, MO

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  T Kim

PO-GePV-M-88 (Sunday, 7/25/2021)   [Eastern Time (GMT-4)]

Purpose: X-ray guided conventional LINAC-based RT is widely available and capable for ART, but currently lacks the ability to perform on-table adaptive procedures including adaptive CT and contour generation, and adaptive planning. In this project, we proposed a procedure for on-table adaptive radiotherapy on conventional LINACs (e.g., TrueBeam).

Methods: Proposed on-table ART procedure consisted of 1) adaptive CT generation based on daily CBCT, 2) contour generation and 3) adaptive planning. We utilized offline adaptive feature of Velocity to generate adaptive CT and contours deformed from the planning CT and contours based on daily CBCT. The adaptive CT was then pushed into the treatment planning system (TPS) database where a collection of in-house scripts copied the beam’s geometric parameters from the original plan and optimized dose for the adaptive CT using commercial KBP optimization. The feasibility of the proposed procedure was evaluated in terms of procedure time after daily CBCT and quality of three plans (prediction dose and two adaptive doses).

Results: CTs and structures of head & neck cases were successfully generated based on daily CBCTs within 12 minutes. In addition to the predicted dose and two adaptive dose calculations within 5 minutes, the adaptive plan can be ready for delivery within 20 minutes.

Conclusion: We demonstrated the clinical feasibility of on-table ART with conventional LINAC using a combined commercial solution with in-house planning scripts. The proposed approach can inspire on-table ART with conventional LINACs in community clinics.

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