Volumetric modulated craniospinal irradiation workflow optimization through quantitative analytics: a...

Area of Science:

• Radiation Oncology
• Medical Physics
• Pediatric Oncology

Background:

• Volumetric Modulated Arc Therapy (VMAT) is a sophisticated radiation technique.
• Craniospinal Irradiation (CSI) is a complex treatment regimen often used in pediatric oncology.
• Assessing clinical workflow efficiency is crucial for optimizing patient care and resource allocation in radiation therapy.

Purpose of the Study:

• To evaluate the efficiency of clinical workflow for radiation therapy delivery in pediatric and adult patients.
• To analyze treatment times for VMAT CSI using quantitative analytics.
• To identify predictors of total radiation time (TRT) and potential causes for prolonged treatment sessions.

Main Methods:

• Retrospective collection of clinical and treatment data for VMAT CSI sessions from June 2013 to November 2018.
• Inclusion of 41 pediatric and 6 adult patients across two hospitals.
• Descriptive statistics and multiple linear regression modeling to predict TRT; outlier detection for quality assurance.

Main Results:

• Median pediatric TRT was 21.07 min, significantly shorter than adult TRT of 37.23 min.
• Pediatric patient height, fraction number, and isocenter count predicted TRT (p < 0.01).
• Factors like anxiety, setup challenges, and IGRT review contributed to prolonged TRT, particularly in pediatric cases.

Conclusions:

• Descriptive statistics and regression modeling effectively assess workflow efficiency and estimate radiation treatment times.
• Modeling VMAT CSI delivery times helps set expectations for image-guided radiation therapy (IGRT) and beam delivery.
• Workflow analytics can pinpoint inefficiencies and guide care coordination improvements.