AAPM task group report 302: Surface-guided radiotherapy

Area of Science:

• Medical Physics
• Radiation Oncology
• Image-Guided Therapy

Background:

• Clinical adoption of surface imaging for radiation therapy has rapidly expanded.
• Surface imaging offers benefits in patient positioning, real-time motion tracking, and beam gating across various anatomical sites.
• Existing clinical applications demonstrate the utility of surface-guided radiation therapy (SGRT).

Purpose of the Study:

• To review current and emerging clinical applications of surface imaging in radiation therapy.
• To provide technical guidelines for the clinical use of SGRT for general patient positioning, breast deep-inspiration breath-hold treatment, and frameless stereotactic radiosurgery.
• To outline commissioning and quality assurance (QA) requirements for SGRT systems.

Main Methods:

• A comprehensive review of clinical surface imaging applications was conducted by Task Group 302.
• Technical guidelines were developed for specific SGRT indications and QA protocols.
• Workflow considerations and emerging applications like SBRT and proton therapy were discussed.

Main Results:

• The report details technical guidelines for SGRT in positioning, breast treatments, and frameless stereotactic radiosurgery.
• Essential commissioning and ongoing quality assurance (QA) requirements for SGRT are provided.
• Workflow considerations for diverse anatomical sites and CT simulation, including motion management, are addressed.

Conclusions:

• The guidelines and recommendations are applicable to all video-based SGRT systems.
• This report serves as a comprehensive resource for implementing and ensuring quality in SGRT.
• Emerging clinical applications of SGRT, including SBRT and proton therapy, are presented for future development.