While modern dose-planning for radiotherapy can tightly align a high-dose volume to a three-dimensional tumor shape, it's impossible to be absolutely certain of the tumor's precise position and motion during treatment. To help account for this, substantial safety margins are added – but this still doesn't guarantee that the tumor won't move out of the high-dose region or that the surrounding organs won't move into it – which can result in insufficient treatment or adverse side effects.
The Inspiration Behind the Innovation
About half of all cancer patients will receive radiotherapy at some point during their treatment. The goal is to deliver a high dose of radiation that eradicates all of the cancer cells while the dose to the surrounding normal tissue is kept low enough to avoid adverse side effects (i.e. swelling, burns, wounds that won't heal, radiation-induced cancer, organ failure and death). This can be difficult to achieve because many tumors move during treatment due to respiration, digestion and other bodily functions.
The project team has worked extensively for over a decade to produce tools and methods for motion management during radiotherapy with the goal of performing a real-time calculation of the actual radiation dose delivered to the tumor.
DoseTracker is a real-time software-enabled tool that monitors the dose of radiation given to moving anatomy during cancer treatments. It calculates and compares the administered radiation dose with the planned dose and provides a complete overview of clinically relevant metrics, giving the treatment team the support and confidence necessary to make informed treatment decisions and intervene in the event of a suboptimal dose delivery.
The team’s ultimate goal is to replace the current practice of unmonitored radiotherapy with the use of real-time observations of anatomical changes and their dosimetric impact, instantly guiding adaptations to the planned treatment.
Thomas Ravkilde: Medical Physicist; Aarhus University Hospital
Per Rugaard Poulsen: Professor; Aarhus University Hospital