Streamlining the image-guided radiotherapy process for proton beam therapy.

Objectives: This work evaluated the on-treatment imaging workflow in the UK's first proton beam therapy (PBT) centre, with a view to reducing times and unnecessary imaging doses to patients.

Methods: Imaging dose and timing data from the first 20 patients (70% paediatrics, 30% TYA/adult) treated with PBT using the initial image-guided PBT (IGPBT) workflow of a 2-dimensional kilo-voltage (2DkV), followed by cone-beam computed-tomography (CBCT) and repeat 2DkV was included. Pearson correlations and Bland-Altman analysis were used to describe correlations between 2DkV and CBCT images to determine if any images were superfluous.