Artificial intelligence in radiation therapy treatment planning: A discrete choice experiment.

Introduction: The application of artificial intelligence (AI) in radiation therapy holds promise for addressing challenges, such as healthcare staff shortages, increased efficiency and treatment planning variations. Increased AI adoption has the potential to standardise treatment protocols, enhance quality, improve patient outcomes, and reduce costs. However, drawbacks include impacts on employment and algorithmic biases, making it crucial to navigate trade-offs.

Cultural safety in radiation therapy education: Identifying knowledge deficits to improve Indigenous health practice.

Reducing health disparities for Aboriginal and Torres Strait Islander peoples requires the integration of cultural safety into healthcare education. This commentary paper addresses cultural safety in the context of the radiation therapy profession and emphasises the importance of making practitioners aware of the knowledge gaps in healthcare practice. The educational strategies to improve cultural awareness amongst undergraduate students and qualified radiation therapists (RTs) are explored.

Dose to organs at risk for total body irradiation: Single-institution data using the modulated arc total body irradiation technique.

Background: Organs at risk (OAR) dose reporting for total body irradiation (TBI) patients is limited, and standardly reported only as mean doses to the lungs and kidneys. Consequently, dose received and effects on other OAR remain unexplored. To remedy this gap, this study reports dose data on an extensive list of OAR for patients treated at a single institution using the modulated arc total body irradiation (MATBI) technique.

An evaluation of ankle and foot bolus in paediatric modulated arc total body irradiation (MATBI).

Introduction: This retrospective planning study aimed to evaluate the role of bolus in achieving dose uniformity in the ankles and feet in paediatric patients undergoing Modulated Arc Total Body Irradiation (MATBI) treatment and to identify patient factors that may negate or warrant its use.

Methods: The clinically treated plans of 20 paediatric patients who received MATBI treatment utilising ankle and foot bolus (Bolus plan) were compared with two retrospectively generated plans; a plan with bolus removed and no re-optimisation (No Bolus plan), and a re-optimised plan without bolus attempting to achieve equal dosimetry to the clinical plan via monitor unit adjustment (MU plan). Descriptive statistics were used to evaluate the dose uniformity criteria of ±10% coverage of the reference dose (RD) for each subregion of the ankle and foot for the three plans.

Meaningful consumer engagement in medical radiation sciences: enhancing quality improvement and research projects.

Consumer engagement and partnership are increasingly recognised as a significant component of healthcare planning, provision, quality improvement and research. This article provides an overview of consumer engagement embedded in two different projects: a quality improvement project and a research project. The considerations and steps taken to effectively engage and partner with consumers throughout both projects will be discussed such as the prompt for consumer engagement, how the consumer/s were recruited and their specific contributions.

Automation and artificial intelligence in radiation therapy treatment planning.

Automation and artificial intelligence (AI) is already possible for many radiation therapy planning and treatment processes with the aim of improving workflows and increasing efficiency in radiation oncology departments. Currently, AI technology is advancing at an exponential rate, as are its applications in radiation oncology. This commentary highlights the way AI has begun to impact radiation therapy treatment planning and looks ahead to potential future developments in this space.

Identifying methods to best integrate indigenous knowledge and perspectives within the radiation therapy undergraduate curriculum.

The Australian healthcare system continues to work towards close the gap to improve and achieve equality in health and life expectancy for Aboriginal and Torres Strait Islander peoples. When culturally safe practice is forefront, it may be the driving force in improving Indigenous Australian healthcare outcomes. For students and practitioners to be equipped with the industry-required cultural safety skills, we believe Indigenous Australian knowledge and perspectives must be effectively integrated into undergraduate education.

Men's perceptions and preferences regarding prostate cancer radiation therapy: A systematic scoping review.

Purpose: To assess the literature on men's preferences and perceptions regarding prostate cancer radiation therapy.

Methods: A scoping review was undertaken as per JBI guidelines. Searches were conducted in PubMed, CINAHL, Scopus and Science Direct with search terms including "prostate cancer," "radiotherapy," "radiation therapy," "radiation oncology," "patient preferences," "patient perceptions" and "patient experience.

Blood T-cell profiling in metastatic melanoma patients as a marker for response to immune checkpoint inhibitors combined with radiotherapy.

Background: The addition of stereotactic ablative radiotherapy (SABR) to immune checkpoint inhibitors (ICIs) has the potential to significantly improve outcomes in the treatment of metastatic melanoma. We analysed peripheral blood immune cells of patients receiving combination SABR and ICI to detect the effect of treatment and identify potential biomarkers that predict outcome.

Methods: 24 polymetastatic melanoma patients participated in the SABR IMPACT trial, receiving standard dose immunotherapy with anti-PD-1 and/or anti-CTLA-4 and stereotactic ablative radiotherapy to one site.

Modified volumetric modulated arc therapy technique with reduced planning and treatment time for craniospinal irradiation utilising two isocentres.

Introduction: Paediatric patients (individuals below 18 years of age) requiring cranial-spinal irradiation (CSI) at our institution are commonly planned and treated using a three isocentre (3-ISO) volumetric modulated arc therapy (VMAT) technique. A modified two isocentre (2-ISO) VMAT technique was investigated with the aim to improve workflow and reduce planning and treatment time.

Methods: Five CSI paediatric patients previously treated with a 3-ISO VMAT technique were retrospectively replanned using a 2-ISO VMAT technique.

Health preference research: An overview for medical radiation sciences.

Understanding preferences of key stakeholders including patients, clinicians and policymakers can inform clinical practice, workforce and policy. It also allows health services to evaluate existing clinical practices, policies and procedures. This commentary aims to introduce medical radiation professionals to health preference research by describing commonly used preference methodologies, with a particular focus on discrete choice experiments.

Dosimetric evaluation of a patient-specific 3D-printed oral positioning stent for head-and-neck radiotherapy.

As head-and-neck radiotherapy treatments become more complex and sophisticated, and the need to control and stabilise the positioning of intra-oral anatomy becomes more important, leading the increasing use of oral positioning stents during head-and-neck radiotherapy simulation and delivery. As an alternative to the established practice of creating oral positioning stents using wax, this study investigated the use of a 3D printing technique. An Ender 5 3D printer (Creality 3D, Shenzhen, China) was used, with PLA+ "food-safe" polylactic acid filament (3D Fillies, Dandenong South, Australia), to produce a low-density 3D printed duplicate of a conventional wax stent.

Prognostic tools for survival prediction in advanced cancer patients: A systematic review.

Survival prediction for palliative cancer patients by physicians is often optimistic. Patients with a very short life expectancy (<4 weeks) may not benefit from radiation therapy (RT), as the time to maximal symptom relief after treatment can take 4-6 weeks. We aimed to identify a prognostic tool (or tools) to predict survival of less than 4 weeks and less than 3 months in patients with advanced cancer to guide the choice of radiation dose and fractionation.

An alternative to the use of lead for patient treatment shielding in superficial radiotherapy.

Lead shielding is commonly used in the delivery of superficial radiotherapy albeit that the toxicity of this substance is of concern. The feasibility of using a non-toxic alternative, AttenuFlex™, is assessed using Xstrahl and Sensus treatment units. A series of lead and AttenuFlex™ circular cut outs and applicators were used with superficial beams (1.

Stereotactic Radiation Therapy Combined With Immunotherapy Against Metastatic Melanoma: Long-Term Results of a Phase 1 Clinical Trial.

Purpose: To determine the maximum tolerated dose (MTD) of stereotactic ablative radiation therapy (SABR) in combination with immunotherapy for the treatment of patients with metastatic melanoma. The study also investigates the effects of timing and dosing of SABR on clinical efficacy.

Methods: Metastatic melanoma patients with at least 2 metastases received SABR to a single metastatic site.

The Application of the Virtual Environment for Radiotherapy Training to Strengthen IGRT Education.

The use of simulation to enhance the quality of preclinical teaching and learning in radiation therapy is increasing. This article discusses the use of the Virtual Environment for Radiotherapy Training (VERT) in supporting teaching on image-guided radiation therapy (IGRT) and image matching concepts. The authors review the capabilities of VERT and discuss how it is currently applied in undergraduate radiation therapy teaching.

Optimising patient care in medical radiation services through health economics: an introduction.

The role of health economics in optimising patient care in medical radiation clinical settings is of increasing importance in ensuring efficient and effective service delivery. This commentary introduces health economics to medical radiation professionals by outlining the main analysis types utilised, highlighted by examples in the literature. The purpose is to provide an over-arching framework and starting point for incorporating health economics into medical radiation research study protocols.

Comparison of statistical machine learning models for rectal protocol compliance in prostate external beam radiation therapy.

Purpose: Limiting the dose to the rectum can be one of the most challenging aspects of creating a dosimetric external beam radiation therapy (EBRT) plan for prostate cancer treatment. Rectal sparing devices such as hydrogel spacers offer the prospect of increased space between the prostate and rectum, causing reduced rectal dose and potentially reduced injury. This study sought to help identify patients at higher risk of developing rectal injury based on estimated rectal dosimetry compliance prior to the EBRT simulation and planning procedure.

Considerations and adaptions to the modulated arc total body irradiation technique: dosimetry description.

Total body irradiation (TBI) is a complex treatment technique, which has been slow to transition to a three-dimensional (3D) planning approach. There is limited literature available providing a detailed description on methods to plan TBI on a 3D planning system. 3D planning using the modulated arc TBI (MATBI) technique is a complex process involving a significant number of quality assurance processes and scripts, due to more than 40 treatment beams and two patient positions.

Modification of a modulated arc total body irradiation technique: Implementation and first clinical experience for paediatric patients.

Introduction: To implement the modulated arc total body irradiation (MATBI) technique within the existing infrastructure of a radiation oncology department. The technique needed to treat paediatric patients of all ages, some of whom would require general anaesthesia (GA).

Methods: The MATBI technique required minor modifications to be incorporated within existing departmental infrastructure.