Journal of Medical Imaging and Radiation Sciences最新文献

{"title":"The Evolution of Healthcare Cybersecurity and The Safeguarding of Patient Data in The Modern Age of Medicine","authors":"Alyasaa Anas ,&nbsp;Dr Flavious B. Nkubi ,&nbsp;Mr Ezeokeke Uchenna Onyebuchi ,&nbsp;Aiman A.C. Igwebgbe","doi":"10.1016/j.jmir.2024.101512","DOIUrl":"10.1016/j.jmir.2024.101512","url":null,"abstract":"<div><h3>Background/Purpose</h3><div>Modern medicine is rife with the use of information technology (IT). Beginning with the introduction of hospital information systems around 1970, digital imaging modalities like computed tomography and magnetic resonance imaging in the 1970s and 1980s, Picture Archiving and Communication Systems and softcopy reading in the 1980s and 1990s, to the electronic sharing of clinical information across regions, nations, or even globally today. The hospital has become a crucial tool for speedy, effective, and affordable communication. However, the expanding use of IT and the Internet in hospitals has also generated new issues, and one area that has grown in importance for hospitals is cybersecurity. To comprehend this challenge, it is crucial to undertake a thorough examination and meticulous study of its evolutionary journey. The evolution of healthcare cybersecurity reflects the changing landscape of healthcare delivery and technology, as well as the growing threats and challenges posed by cyberattacks.</div></div><div><h3>Methods</h3><div>A review of literature on the subject was conducted across Google, Google Scholar, journal articles, radiography and radiology websites as well as the Information and Telecommunication Union website. Words like the evolution of cybersecurity, cyberattacks in hospitals, cybersecurity in radiology, vulnerability, radiography, radiology, and medical imaging were used in the search.</div></div><div><h3>Results</h3><div>The health industry suffers some of the highest volume of cyberattacks and there are whispers of a lot to come. Combine these trends with the breach damage cost surpassing all other industries and a thunderous warning of a devastating cyberattack approaching the sector.</div></div><div><h3>Conclusion</h3><div>Healthcare organizations need to adopt proactive and comprehensive strategies to safeguard their data, such as implementing robust policies, standards, and protocols, conducting regular risk assessments and audits, educating and training staff and patients, and collaborating with other stakeholders.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of Radiomics for Next-Generation Oncologic Management – Current Trend, Challenges and Future Prospects","authors":"Dr Edmond Sai Kit Lam","doi":"10.1016/j.jmir.2024.101462","DOIUrl":"10.1016/j.jmir.2024.101462","url":null,"abstract":"&lt;div&gt;&lt;div&gt;The rapid advancements of AI and computational technologies have tremendously driven the soaring demand for personalized medicine, particularly in the field of oncology. The contemporary “-Omics” era encompasses genomics, proteomics, metabolomics, etc., which have made dominant and immense impacts on personalized healthcare delivery for the past couple decades, while an aborning concept of radiomics has been introduced since a decade ago, which involves a high-throughput extraction of quantitative, standardized, and voxel-based imaging features, including but not limited to tissue morphology, first-order statistics and spatial-related heterogeneity/texture, from radiographic images. Neoplasms are intrinsically heterogenous and contain multiple sub-clusters of cancer subpopulations; therefore, imaging textures representing clusters of adjacent imaging voxels can be grouped together to derive metrics for tumor subpopulations or habitats that are more representative and objective in reflecting intra-tumoral heterogeneity.&lt;/div&gt;&lt;div&gt;Over the past decade, mounting evidence has demonstrated the superiority of radiomics over conventional qualitative radiologic, histopathologic and clinical attributes from virtual biopsy, cancer staging, cancer histological classification, cancer prognostication, disease differentiation (e.g., pseudo-progression vs cancer recurrence), radiation-induced toxicity prediction, identification of patients who may be reluctant to neo-adjuvant chemotherapy and immunotherapy, etc. Furthermore, the term “delta-radiomics” has emerged as to reflect the dynamic temporal changes in radiomic features, that may capture treatment response or cancer progression patterns that would otherwise not be measurable using current practice. The predictive power of delta-radiomics has been demonstrated to outperform radiomic features from static images. Apart from this, a growing amount of research has illustrated certain radiomic features have been highly correlated with existing genomic markers along with expression of various microRNA signature associated with tumor response to treatment perturbations, cancer metastatic spread, and prognosis; integrating both radiomics and genomics have paved the way toward the nascent area of “radio-genomics” within the community. Moreover, there are also growing number of research on sub-regional radiomics, reporting that peri-tumoral radiomics yielded a greater predictive power than tumor-core radiomics in identifying at-risk patients of post-treatment cancer metastases. There are lot more exciting and innovative radiomics research in the current body of literature. Without doubt, radiomics offers immense and tantalizing potential to serve as a supplementary technique to the existing methods, and to revolutionize cancer management toward personalized oncologic care delivery.&lt;/div&gt;&lt;div&gt;Notwithstanding, there exist several caveats of radiomics, which if addressed, will gain further confidence and trus","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowing just Enough: Correlating Ultrasound Images with Other Imaging Modalities","authors":"Dr Yonella Demars","doi":"10.1016/j.jmir.2024.101536","DOIUrl":"10.1016/j.jmir.2024.101536","url":null,"abstract":"<div><h3>Background/Purpose</h3><div>The purpose of this presentation is to inform sonographers about the importance of understanding/reading other imaging modalities to correlate or anticipate their ultrasound findings.</div></div><div><h3>Methods</h3><div>A Philips EPIC ultrasound machine was used to evaluate various ultrasound findings that were then correlated with or anticipated from another imaging modality.</div></div><div><h3>Results</h3><div>On different occasions the sonographer was able to develop an understanding of how pathological processes appear on other imaging modalities. In addition, the sonographer was able to gain knowledge on the layout of other imaging modalities which will be useful in providing the best patient care.</div></div><div><h3>Conclusions</h3><div>Sonographers should be able to identify normal anatomy, understand body orientation, and recognize abnormalities on other imaging modalities. In addition, they should be able to correlate ultrasound findings or anticipate their findings by viewing other imaging modalities prior to completing their ultrasound exam.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Study: Diagnosis of Grynfeltt-Lesshaft Hernia Via Dynamic Ultrasound Imaging Techniques","authors":"Mrs. Adrienne Pourteau ,&nbsp;Mrs. Adrienne Pourteau","doi":"10.1016/j.jmir.2024.101546","DOIUrl":"10.1016/j.jmir.2024.101546","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this case study is to inform sonographers on the diagnosis, ultrasound appearance, and implementation of dynamic ultrasound scanning techniques of Grynfeltt-Lesshaft hernias.</div></div><div><h3>Materials and Methods</h3><div>Using both static and dynamic ultrasound imaging techniques to evaluate acute presentation of an atraumatic lumbar mass with fluctuation in size in a female patient over 60 years of age, the diagnosis of Grynfeltt-Lesshaft hernia was established. When evaluating lumbar masses, the role of the sonographer must include dynamic stress maneuvers via Valsalva maneuver and manual external probe pressure in order to determine mobility of masses and assess integrity of adjacent anatomical structures. Investigation of deep anatomical structures in addition to views of a seemingly superficial mass is crucial for accurate diagnosis via ultrasound.</div></div><div><h3>Results</h3><div>Per the recommendation of the interpreting radiologist, additional CT imaging was obtained and the ultrasound findings were confirmed. After the diagnosis of Grynfeltt-Lesshaft lumbar hernia was established, the recommended course of treatment was surgical repair of the structural defect of the lumbar triangle.</div></div><div><h3>Conclusions</h3><div>Grynfeltt-Lesshaft lumbar hernia is a very rare kind of lumbar hernia with fewer than three hundred documented cases. The role of the sonographer in evaluating lumbar masses must include investigation of anatomical structures deep to the superficial lumbar mass in question in conjunction with dynamic imaging techniques. An in-depth examination of the superficial and deep anatomy throughout the ultrasound enables physicians to establish a critical diagnosis and expedite treatment for the patient to avoid potential complications such as bowel incarceration.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal SVM Classification for Early-stage Alzheimer's Disease Diagnosis Using T1-weighted MR and F-18 FDG PET Imaging","authors":"Mr. Chayanon Pamarapa ,&nbsp;Dr. Ruedeerat Keerativittayayut ,&nbsp;Dr. Tawatchai Ekjeen ,&nbsp;Dr. Watshara Shoombuatong ,&nbsp;Dr. Yudthaphon Vichianin","doi":"10.1016/j.jmir.2024.101539","DOIUrl":"10.1016/j.jmir.2024.101539","url":null,"abstract":"<div><div>Alzheimer's disease is a significant global health challenge characterized by progressive brain degeneration associated with aging. Early detection is crucial for improved prognosis and treatment outcomes. Our study aimed to develop a support vector machine (SVM) classification model using T1-weighted MR and F-18 FDG PET brain imaging to classify cognitive normal (CN) and early-stage Alzheimer's disease, including early mild cognitive impairment (EMCI) and late mild cognitive impairment (LMCI), in individuals aged 65-75. The study comprised three steps. Firstly, image preprocessing involved uniformity processing, B1 bias field correction for MR images, and FWHM optimization with spatial/intensity normalization for PET images. Secondly, MR images were registered to the MNI305 brain template for structural segmentation, and PET images were normalized using the standardized PET template. Co-registration of normalized PET images to segmented MR images provided anatomical segmented PET uptake volumes. These served as input for the classification model. Thirdly, SVM models classified CN vs. LMCI, EMCI vs. LMCI, and CN vs. EMCI using MRI, PET, and combined PET/MR. Feature sets included all features, clinical-based features, and F1-score ranked features, resulting in 27 classification models. In CN vs. EMCI, combined PET/MR with all features achieved 0.71 AUC, 65.78% accuracy, and 68.67% specificity. For CN vs. LMCI, superior performance was observed with combined PET/MR using F1-score ranked features: 0.82 AUC, 77.78% accuracy, and 77.55% specificity. In EMCI vs. LMCI, PET alone with all features achieved the highest performance: 0.72 AUC, 69.23% accuracy, and 60.32% specificity. In conclusion, PET is pivotal in MCI stage differentiation, and using all features aids in challenging tasks (CN vs. EMCI and EMCI vs. LMCI). The combined PET/MR modality notably distinguishes CN from MCI, emphasizing the potential of multimodal imaging to enhance differentiating cognitive states in individuals.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographers Role in Quality and Safety in Diagnostic Radiology and Nuclear Medicine: IAEA Vision","authors":"Dr Olivier Pellet","doi":"10.1016/j.jmir.2024.101460","DOIUrl":"10.1016/j.jmir.2024.101460","url":null,"abstract":"<div><div>This presentation investigates the pivotal role of radiographers in upholding quality and safety standards for patients undergoing diagnostic radiology and nuclear medicine procedures, from the perspective of the International Atomic Energy Agency (IAEA). It delves into the effective implementation of Quality Management Systems (QMS) and underscores the indispensable contributions of radiographers within these frameworks. Emphasizing their significance, the discussion highlights how radiographers optimize imaging techniques, mitigate radiation exposure, and elevate overall patient care standards. Furthermore, the speaker will shed light on the IAEA's proactive measures and endeavors aimed at advancing quality and safety protocols in these medical disciplines. Specifically, attention will be drawn to IAEA's clinical audit programs such as QUAADRIL (Quality Assurance Audit for Diagnostic Radiology Improvement and Learning) and QUANUM (Quality Management Audits in Nuclear Medicine Practices), designed to enhance professional practices and ensure optimal patient outcomes.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Patient Experience in CT Imaging","authors":"Mr Mike Wing Tak Lai","doi":"10.1016/j.jmir.2024.101461","DOIUrl":"10.1016/j.jmir.2024.101461","url":null,"abstract":"<div><div>Cardiac CT is the most complicated procedure for CT imaging and Paediatric cardiac CT is even more challenging due to the nature of the patients who may not able to obey the command and keep still during the whole examination procedure. Several challenges for Paediatric cardiac CT includes: The timing of blood flow may be different significantly for patients even with similar body size; wide range of pathology and congenital anomalies for paediatrics and most important of all is the size and body weight of the patient may pose a limitation on the rate and dose of contrast that can be delivered during the cardiac CT examination. In 2019, Hong Kong Children's Hospital commenced the CT services for Paediatric cardiac patients. Through the collaboration of Radiographers and Radiologists, we have developed a set of protocols to optimize the radiation dose, contrast dose and examination routines for our Paediatric patients with different body size and clinical conditions. This presentation aims at providing a holistic approach for Paediatric CT imaging with an in house developed theory to optimize the contrast injection rate and dosage as well as optimizing the use of kVp for imaging to achieve maximum contrast enhancement with reduction of radiation dosage to the patient.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Correction factor based T10 atlas help to achieve quick and improved Ktrans computation? a feasibility study","authors":"Dr Pradeep Singh Negi,&nbsp;Dr Amarnath Jena,&nbsp;Dr Shashi Bhushan Mehta","doi":"10.1016/j.jmir.2024.101495","DOIUrl":"10.1016/j.jmir.2024.101495","url":null,"abstract":"<div><h3>Introduction</h3><div>The ultrafast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) used for Pharmacokinetic (PK) analysis is an effective method to predict benign and malignant tumor. Attempts have been made to achieve an accurate K^trans by correcting T₁₀, a major factor that influence K^trans computation.</div></div><div><h3>Purpose</h3><div>The purpose of this study to develop a correction factor atlas database at every spatial-location (x,y coordinate) in both side of the mMR breast coil cuff space to improve T₁₀ homogeneity in the reference method using multiple tube phantom by SW based automation.</div></div><div><h3>Method</h3><div>Both multiple tube phantoms (61 tubes in each phantom) and patient's studies were acquired on simultaneous PET/MRI Biograph mMR system (Siemens, Erlangen, Germany) by using 4 channel mMR breast coil. Each spatial location correction factors (2916 each side, total 4392 correction factors) derived from multiple tube phantom were assign to an inhouse developed software (Radvista, version 3.2.95) that compute K^trans in few seconds. A retrospective analysis of DCE-MRI data acquired for 60 seconds of 146 patients with mean age of 50 years (24-80 years) having 178 enhancing histologically proved breast lesions forms the material of the study.</div></div><div><h3>Results</h3><div>Corrected and non-corrected ROC curve analysis revealed a mean K^trans, v_e value of 1.52 min^-1, 0.44 &amp; 1.16 min^-1, 0.34 respectively. The sensitivity, specificity and overall accuracy of K^trans for non-corrected data were 89.06%, 74.00% and 84.83% respectively and for corrected data it was 89.84%, 86.00%, and 88.76% respectively. The AUC of corrected data was improved to 0.927 (95% CI 0.878 to 0.960) from 0.893 (95% CI 0.839 to 0.935) for non-corrected data.</div></div><div><h3>Conclusion</h3><div>Spatially normalized T₁₀ values derived from correction factor based T₁₀ atlas in a reference method can provide a quick estimation of K^trans with improved diagnostic accuracy.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of Institutional Diagnostic Reference Level for Computed Tomography Coronary Angiogram","authors":"Mr Liang Chong Ri,&nbsp;Ms Tang Penny Hie Mein,&nbsp;Ms Cantiriga Subramaniam","doi":"10.1016/j.jmir.2024.101535","DOIUrl":"10.1016/j.jmir.2024.101535","url":null,"abstract":"<div><h3>Introduction</h3><div>Computed Tomography Coronary Angiogram (CTCA) can be routinely performed using prospective or high-pitch ECG gating, acting as valuable diagnostic imaging tool for cardiovascular disease. However, one of the concerns associated with CTCA is the ionizing radiation. Establishing an institutional diagnostic reference level (DRL) for CTCA in adults is a valuable initiative to optimize radiation dose and ensure patient safety. The aim of the study is to establish institutional diagnostic reference level in CTCA for adult 16 years old and above.</div></div><div><h3>Methods</h3><div>One-year CT dose data of 232 patients above 16 years old regarding CTCA from 01 Jan 2022 to 31 Dec 2022 were retrospectively collected for analysis from existing dose-tracking software. CTCA comprises two parts of scans: calcium score and angiogram. Calcium score was performed with high-pitch ECG gated protocol while angiogram was performed with either prospective sequence protocol or high-pitch protocol based on the patient's heart rate. The data extracted included information on scan protocols, patient demographics and radiation dose parameters. Excel version 2016 was used to calculate the mean, 75th percentile, and 90th percentile of CT dose index (CTDIvol) and dose length product (DLP) distribution according to calcium score, prospective ECG-gated and high-pitch scanning protocols.</div></div><div><h3>Result</h3><div>The institutional DRL for CTCA for our CT units were established as mean (50^th percentile) of CTDIvol (mGy), DLP (mGy.cm) for CT calcium score exam, prospective ECG-gated exam and high-pitch ECG-gated exam. Calcium score exam: (1.35 mGy), (25.15mGy.cm) respectively; Prospective ECG-gated exam: (18.43mGy), (251.55mGy.cm) respectively; High-pitch ECG-gated exam: (2.98mGy), (58.9 mGy.cm) respectively.</div></div><div><h3>Conclusion</h3><div>The study indicates that CTCA using High-pitch ECG-gated protocol results in much lower radiation exposure compared to the prospective ECG-gated protocol. The reported matrix offers a variety of dose information for quality improvement activities.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalised motion management for Stereotactic Ablative Radiation Therapy to the Lung","authors":"Mrs Amy Koskela,&nbsp;Dr Anna Arns","doi":"10.1016/j.jmir.2024.101525","DOIUrl":"10.1016/j.jmir.2024.101525","url":null,"abstract":"<div><h3>Background/Purpose</h3><div>SABR is a mainstay treatment option for stage 1 lung cancer. Our service has offered lung SABR treatment for 10 years. Standardly, these patients are treated in free breathing, with breathing motion accounted for in treatment planning, via Internal Target Volume concept. For targets in lower lobes though, significant breathing motion could lead to larger target volumes and increased dose to surrounding healthy tissue. An alternative motion management approach is deep inspiration breath-hold (DIBH). In 2023, the service initiated a pilot study on Lung SABR in DIBH and undertook a retrospective audit assessing the reliability of target position in repeated breath-hold.</div></div><div><h3>Method</h3><div>The audit assessed the residual inter-breath-hold target repositioning variability for the first eight patients by analysing intra-fractional imaging (IFI) CBCT taken during treatment delivery in repeated breath-hold. From this data, the patient with the most variability was analysed further. Each of the four fractions were re-created in the treatment planning system, applying the residual positioning error from the respective IFI CBCT and a sum plan of these four plans was created to compare dose statistics to the original plan.</div></div><div><h3>Results</h3><div>This patient's overall largest errors were 0.76cm in longitudinal, 0.31cm lateral and 0.26cm vertical directions, all still within the planning target volume. The patient's setup was discussed within a multidisciplinary team. A plan review was performed by applying the daily residual errors to a \"plan per fraction\" and then summed to a final \"treated plan\" - all dose statistics were comparable to the original plan.</div></div><div><h3>Conclusion</h3><div>Lessons were learned from this complex patient and hence implemented. The re-calculation of this patient's plan with target position \"as treated daily\" provided reassurance that the Lung SABR in DIBH technique is a valuable alternative to SABR in free breathing.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}