Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
Conclusion: This preliminary study demonstrates the potential for MRI to
improve the visualization of thoracic primary tumours, oesophagus and
cardiac anatomy, all of which can be challenging to see on CT imaging,
particularly in patients with collapse, consolidation or mediastinal tumour
invasion.
Keywords: Radiotherapy planning, MRI, lung
POSTER SESSION 2 – P2.05: RADIOTHERAPY
RT TECHNIQUES –
TUESDAY, DECEMBER 6, 2016
P2.05-043 LUNG TUMOUR MOTION KILOVOLTAGE INTRAFRACTION
MONITORING (KIM): FIRST CLINICAL RESULTS
Chen-Yu Huang 1 , Fiona Hegi-Johnson 1 , Doan Nguyen 1 , Ricky O’Brien 1 , Kuldeep
Makhija 1 , Chun-Chien (Andy) Shieh 1 , Eric Hau 2 , Roland Yeghiaian-Alvandi 2 ,
Sean White 2 , Jeffrey Barber 2 , Jianjie Luo 2 , Shamira Cross 2 , Benjamin Ng 2 ,
Katherine Small 2 , Paul Keall 1
1 Radiation Physics Laboratory, University of Sydney, Sydney/NSW/Australia,
2 Nepean Cancer Care Centre, Sydney/NSW/Australia
Background: Lung tumour positional uncertainty has been identified as a
major issue that deteriorates the efficacy of radiotherapy. The recent
development of the Kilovoltage intrafraction monitoring (KIM) which uses
widely available gantry-mounted kilovoltage (kV) imager has been applied to
prostate motion monitoring. This study reports the first clinical result of KIM
for lung cancer radiotherapy with an Elekta machine. Methods: A locally
advanced stage IIIlung cancer patient undergoing conventionally fractionated
VMAT was enrolled in an ethics-approved study of KIM. A Gold Anchor fiducial
marker (0.4 mm diameter x 20 mm length) was implanted in the tumour near
the right hilum (Fig 1, left). kV images were acquired at 5.5 Hz during
treatment. Post-treatment, markers were segmented and reconstructed to
obtain 3D tumour trajectories. A Microsoft Kinect audio and depth sensing
device was also mounted on the couch to get the external respiratory signal.
Figure 1. kV image of the Gold Anchor marker (left) and the KIM measured lung
tumour 3D motion and the external Kinect signal (right). Results: Our method
was successfully applied for the first KIM lung patient. The fiducial marker
was visible on 62.9% of the kV images. The average lung tumour motion (mean
± SD) in superior-inferior (SI), anterior-posterior (AP) left-right (LR), directions
were 0.27±7.52, -0.09±3.37, and -0.64±4.55 mm respectively. Seven fractions of
lung tumour 3D motion and Kinect external signal were acquired, with the
representative result illustrated (Fig 1, right). Conclusion: This is the first time
that KIM has been used for intrafractional tumour motion monitoring during
lung cancer radiotherapy, and also the first implementation of KIM on an
Elekta imaging platform. This clinical translational research milestone paves
the way for the broad implementation of image guidance to facilitate the
detection and correction of geometric error for lung radiotherapy, and
resultant improved clinical outcomes.
Keywords: kilovoltage intrafraction monitoring, tumour motion, Image
guidance, Radiotherapy
POSTER SESSION 2 – P2.05: RADIOTHERAPY
RT TECHNIQUES –
TUESDAY, DECEMBER 6, 2016
P2.05-044 INFLUENCE OF TECHNOLOGICAL ADVANCES AND
INSTITUTIONAL EXPERIENCE ON OUTCOME OF STEREOTACTIC
BODY RADIOTHERAPY FOR LUNG METASTASES
Juliane Hoerner-Rieber 1 , Nasrin Abbassi-Senger 2 , Sonja Adebahr 3 , Nicolaus
Andratschke 4 , Oliver Blanck 5 , Marciana Duma 6 , Michael J. Eble 7 , Iris Ernst 8 ,
Michael Flentje 9 , Sabine Gerum 10 , Peter Hass 11 , Christoph Henkenberens 12 ,
Guido Hildebrandt 13 , Detlef Imhoff 14 , Henning Kahl 15 , Robert Krempien 16 ,
Nathalie Desirée Klass 17 , Fabian Lohaus 18 , Frank Lohr 19 , Cordula Petersen 20 ,
Elsge Schrade 21 , Jan Streblow 1 , Lorenz Uhlmann 22 , Andrea Wittig 23 , Florian
Sterzing 1 , Matthias Guckenberger 4
1 Strahlentherapie & Radioonkologie, Universitätsklinikum Heidelberg, Heidelberg/
Germany, 2 Jena University, Jena/Germany, 3 Freiburg University, Freiburg/Germany,
4 Zurich University, Zurich/Switzerland, 5 Uksh Universitätsklinikum Schleswig-
Holstein, Kiel, Kiel/Germany, 6 Technical University Munich, Munich/Germany,
7 Aachen University, Aachen/Germany, 8 Münster University, Muenster/Germany,
9 Würzburg University, Wuerzburg/Germany, 10 Munich University, Munich/
Germany, 11 University Hospital Magdeburg, Magdeburg/Germany, 12 Medical School
Hannover, Hannover/Germany, 13 Rostock University, Rostock/Germany, 14 Frankfurt
University, Frankfurt/Germany, 15 Hospital Augsburg, Augsburg/Germany, 16 Helios
Klinikum Berlin Buch, Berlin/Germany, 17 Bern University, Bern/Germany, 18 Technical
University Dresden, Dresden/Germany, 19 University Medical Center Mannheim,
University of Heidelberg, Mannheim/Germany, 20 Hamburg University, Hamburg/
Germany, 21 Hospital Heidenheim, Heidenheim/Germany, 22 Heidelberg University,
Heidelberg/Germany, 23 University Hospital Giessen and Marburg, Marburg/
Germany
Background: Many technological and methodical advances have made
stereotactic body radiotherapy (SBRT) more accurate and more efficient
during the last years. This study aims to investigate whether technological
innovations and experience in SBRT also translated into improved local
control (LC) and overall survival (OS). Methods: The working group
“Stereotactic Radiotherapy” of the German Society for Radiation Oncology
established a database of 700 patients treated with SBRT for lung metastases
in 20 German centers between 1997 and 2014. It was the aim of this study
to analyze the impact of FDG-PET staging (fluoro-deoxy-glucose positron
emission tomography), biopsy confirmation, image guidance, immobilization
and dose calculation algorithm as well as the influence of SBRT treatment
Copyright © 2016 by the International Association for the Study of Lung Cancer
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