Micropos Medical Ab · NGM:MPOS
Micropos Medical Ab — Technical Presentation (May 2024)
20 slides from Micropos Medical Ab's technical presentation, May 2024
Slide 1: DE BARI Berardino, MD PD, Radiation Oncology Dpt
DE BARI Berardino, MD PD Radiation Oncology Dpt, Réseau Hospitalier Neuchâtelois La Chaux-de-Fonds (Switzerland) Curr. Oncol. 2024, 31, 962–974.
Slide 2: NCCN Guidelines: Principles of Radiation Therapy, Prostate Cancer
Réseau National ensive NCCN Guidelines Version 1.2023 (eee Cancer Nowchatatoie Newark Prostate Cancer PRINCIPLES OF RADIATION THERAPY Table 1: Below are examples of regimens that have shown acceptable efficacy and toxicity. The optimal regimen for an individual patient warrants evaluation of comorbi
Slide 3: Background: SBRT in PCa
BACKGROUND: SBRT IN PCa Stereotactic Body Radiotherapy (SBRT) is as a standard treatment for prostate cancer (PCa). Tight margins and high dose gradients are needed, and the precise localization of the target is mandatory. Our retrospective study reports our experience regarding the evaluation of in
Slide 4: RayPilot transmitter installation in patient
RAYPILOT® transmitter in center of prostate Balloon inbladdee —— ee Standard urine out lumen = Valve for ballon filling Figure 1. A picture showing the final installation in a patient.
Slide 5: Clinical features of the patients enrolled
Electromagnetic Transmitter-Based Prostate Gating for Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motion Table 1. Clinical features of the patients enrolled in this study (data on 31 patients for 155 sessions). Number of Cases % Number of patients 3
Slide 6: PTV1 and PTV2 treatment volumes and doses
PTV1: Whole prostate +/−distal 1.5 cm of SV (only in ISUP 3–5) +2 mm; PTV2: GTV(s) defined through MRI of +2 mm. The PTV1 received 36.25 Gy over 5 consecutive fractions of 7.25 Gy/fraction, while the PTV(s) received 40 Gy over 5 consecutive fractions of 8 Gy/fraction, delivered with a Simultaneous I
Slide 7: PTV1 and PTV2 treatment volumes and doses
PTV1: Whole prostate +/−distal 1.5 cm of SV (only in ISUP 3–5) +2 mm; PTV2: GTV(s) defined through MRI of +2 mm. The PTV1 received 36.25 Gy over 5 consecutive fractions of 7.25 Gy/fraction, while the PTV(s) received 40 Gy over 5 consecutive fractions of 8 Gy/fraction, delivered with a Simultaneous I
Slide 8: Number of XVI CBCT images per session
Electromagnetic Transmitter-Based Prostate Gating for Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motion Table 2. Total, median, minimum, and maximum number of XVI CBCT images evaluated per treatment session (31 patients). Total n. of XVI CBCT Media
Slide 9: Distribution of XVI procedures per fraction
Electromagnetic Transmitter-Based Prostate Gating for Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motion Number of fractions ~ co 886 88 ~ o 10 11 12 o = n wo = a o _ © © Number of XVI Figure 2. Distribution of the number of XVI procedures performed
Slide 10: Patient distribution by mean total treatment duration
Electromagnetic Transmitter-Based Prostate Gating for Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motion a > Patient distribution N e = 00:06 00:08 00:10 00:12 00:14 00:16 00:18 00:20 00:22 00:24 00:26 00:28 Mean duration for total treatment (5 frac
Slide 11: Durations for each fraction
Electromagnetic Transmitter-Based Prostate Gating for Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motion Table 5. Mean, median, minimum, and maximum durations for each fraction (n = 31 patients). Mean Median Min Max Fraction #1 14 min 33s 8 min 48s
Slide 12: Setup control groups A, B and C
Dose-Escalated Linac-Based Stereotactic Body Radiation Electromagnetic Transmitter-Based Prostate Gating for ee | Therapy: An Evaluation of Intrafraction Motion e Group A (3 patients, 15 sessions)—only one setup control was performed and needed before the beginning of the treatment, without any othe
Slide 13: XVI CBCT procedures in Group B
Electromagnetic Transmitter-Based Prostate Gating for Es Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motion oa i] Ps o Number of Fraction 8s 68 = o Number of XVI Figure 5. Distribution of the number of XVI CBCT procedures in Group B ( = 15).
Slide 14: XVI CBCT procedures in Group C
Electromagnetic Transmitter-Based Prostate Gating for Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motion 50 50 w ) 2 40 2 40 & 8 id 8 = 30 uw 30 a) x) s er 2 20 : 20 2 2 10 10 0 —— 0 1 2 3 4 5 6 0 1 2 3 4 5 Number of XVI Number of XVI Figure 6. Dist
Slide 15: Distribution of fraction duration for 155 sessions
Electromagnetic Transmitter-Based Prostate Gating for Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motion 22b + 20} | ¢ & z 15/ 4 r a a] § 10}- 4 Hy ira 5} zl 3F a 2b | at os Ha _ a J 00:05 00:10 00:15 00:20 00:25 00:30 00:45 01:00 Figure 7. Distribu
Slide 16: Prostate displacement by direction
Electromagnetic Transmitter-Based Prostate Gating for Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motion Direction Mean (mm) SD (mm) Mean Absolute (mm) Lateral —0.38 2.76 1.0969 Longitudinal —0.28 2.42 1.208 Vertical —0.38 1.92 1.0957
Slide 17: Distribution of real prostate motion
Dose-Escalated Linac-Based Stereotactic Body Radiation Electromagnetic Transmitter-Based Prostate Gating for ee | Therapy: An Evaluation of Intrafraction Motion a 3 T T 2- al Bi} Ho i 1 ! L i \ n a 10 2 6 = 2 ° 2 4 6 8 10 # Displacement [mm] 10* 8 3 T T T T B2r =] & Sit 4 z, | _ HY 10 2 6 4 2 o 2 4
Slide 18: Time outside the CTV-to-PTV margin
Electromagnetic Transmitter-Based Prostate Gating for Es Réseau Hospitalier Nouchételois Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motion Table 4. Time spent in % of time outside the CTV-to-PTV margin for the whole population and for Groups A, B,
Slide 19: Conclusions: EM-based real-time tracking in PCa SBRT
We successfully implemented an EM-based real-time tracking strategy during dose escalated PCa SBRT. Most of the patients presented shifts that were <2 mm in any direction. Continuous motion monitoring allowed the identification and correction of the small number of fractions presenting larger shifts
Slide 20: Thank you very much for your kind attention
DE BARI Berardino, MD PD Radiation Oncology Dpt, Réseau Hospitalier Neuchâtelois La Chaux-de-Fonds (Switzerland) THANK YOU VERY MUCH FOR YOUR KIND ATTENTION!!!! Curr. Oncol. 2024, 31, 962–974.