SGRT in place of ABC for SABR breath hold

SBRT
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Hi everyone,

We currently use ABC to achieve DIBH for Lung SABR patients and EBH for Abdominal SABR patients. While effective, we’ve found that this method can be intrusive for patients, time-consuming to set up, and costly due to the need for mouthpieces.

Has anyone used SGRT as an alternative for managing breath holds in SABR treatments? If so, could you share your experiences, particularly in terms of effectiveness of motion management in EBH as there seems to be less information about this out there.

I’d also be interested to hear what ROIs you have found to be effective.

I Looking forward to hearing your insights!

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Hi Helen,

Yes we use SGRT for Lung SABR with free-breathing and DIBH and we also use SGRT for liver SABR patients in EEBH. The only other centre I know of doing this is in Australia.

If anyone in your centre was at ESTRO a few weeks ago, I had 2 posters on the implementation of EEBH in liver SABR- you might be able to search them on the ESTRO app. If you look on my linkedin you will find the poster reference numbers.

Hope this helps!

Orla McKivitt- Cork University Hospital.

1 Like
3

Hi,

One of our recent physics trainees did an MSc project comparing patient monitoring using CBCT versus AlignRT for ABC liver SABR patients. They found some good correlation and this work will be carried on to look at supplementing ABC and possibly replacing it with SGRT in the future. I can put you in touch with their project supervisor to discuss the details and the results.

Regards

Colin Jennings

Rosemere Cancer Centre, Preston UK

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Thanks Colin,

That’s great! I’m also doing my MSc thesis on motion management. I will be demonstrating the preliminary results of our study on the reproducibility of EEBH using SGRT in liver SABR patients at ASTRO later this year, so will be great to see your ABC results too!

Thanks,

Orla.

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Thank you both! It’s really helpful to hear others are looking into this as an option for motion management.

I look forward to seeing how your studies compare and will get in touch for further details.

Thanks again

Helen Sheridan

Bristol Haematology and Oncology Centre

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Hi,

A very interesting topic. We at coventry hospital are also looking at the use of SGRT for DIBH lung sabr patients. Can I ask how you can be sure the patient is taking the same breath every time and what delta tolerances you use for these patients?. Also do you spent a lot of time coaching the patient prior to CT etc

As a starting point we went back to look at our DIbh breast patients and have found the diaphragm position sometimes varies between fractions.

Thanks alysha

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we have been doing SABR breath hold with SGRT for a little while. Check out these publications:

https://www.frontiersin.org/journals/on … 73279/full

https://www.thegreenjournal.com/article … 4/fulltext

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Hi,

I’m a bit late for this discussion, but I hope to receive a reply.

We are currently using SGRT for all of our patients, including both TrueBeam and Halcyon/Ethos (InBore). However, SGRT with DIBH is only being used for breast patients. For all other cases, we are using RPM from Varian. This is something we would like to change, but we are facing challenges in implementing it. Our main issue is the signal on the TrueBeam. We’ve tried various ROIs, but as soon as we run the CBCT, our cameras lose track of the patient at certain angles. We understand that the positioning of the isocenter is an important factor in this.

I would really appreciate any feedback on your workflow and how you manage this.

Looking forward to hearing from you.

Best regards,
Aurora - RTT
Haukeland University Hospital, Norway