| Luo Chunli,Zhang Jie,Yu Lihua,Liu Xiaoming,Zhou Bing,Xu Haoran,Sun Xiansong,Yu Lang.Workflow and time efficiency analysis of different image guided brachytherapy for cervical cancer[J].Chinese Journal of Radiological Medicine and Protection,2023,43(10):774-778 |
| Workflow and time efficiency analysis of different image guided brachytherapy for cervical cancer |
| Received:March 13, 2023 |
| DOI：10.3760/cma.j.cn112271-20230313-00072 |
| KeyWords:Cervical cancer Image-guided brachytherapy Total reference air kerma Time efficiency analysis |
| FundProject:中央高水平医院临床科研业务费(2022-PUMCH-A-101,2022-PUMCH-B-052) |
| Author Name | Affiliation | E-mail | | Luo Chunli | Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China | | | Zhang Jie | Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China | | | Yu Lihua | Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China | | | Liu Xiaoming | Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China | | | Zhou Bing | Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China | | | Xu Haoran | Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China | | | Sun Xiansong | Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China | | | Yu Lang | Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China | Lay227215@163.com |
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| Abstract:: |
| Objective To explore the radiation dose of brachytherapy plan for cervical cancer patients under different image-guided method and the time efficiency characteristics of each part of the clinical workflow, so as to provide reference for the overall arrangement of clinical brachytherapy. Methods The workflow of 223 patients with brachytherapy was retrospectively analyzed. The whole workflow was divided into 5 parts: applicator placement, image acquisition, delineation of target and organs at risk, plan design and review, and treatment implementation. The image-guided brachytherapy was divided into X-ray guided 2D treatment groups, and computed tomography(CT) and magnetic resonance imaging (MRI) guided 3D treatment groups. The radiation dose and the time spent in each part of the three image-guided brachytherapy workflow were calculated. The radiation dose was evaluated using total reference air kerma (TRAK). The results were analyzed using the nonparametric test of SPSS 20 software. Results TRAK 4.2(4.4,3.9) cGy was significantly higher in X-ray guided 2D treatment group than in the CT guided 3D treatment group [3.5(3.9,2.7) cGy,H=90.73,P < 0.01] and the MRI guided 3D treatment group[2.7(2.9,2.4) cGy, H=90.73,P < 0.01]. The total workflow time of the X-Ray film guidance group was the shortest [55.0(67.0,50.0) min], followed by the CT guidance group [80.0(91.0,72.0) min], and the total workflow time of the MRI image guidance group was the longest [119.0(143.0,105.5) min,H=106.39, P <0.01]. The image acquisition time of the MRI-guided group was significantly higher than that of the X-ray film guidance group and the CT-guided group (H=44.80, P<0.01). The time of target delineation in the MRI-guided group was significantly longer than that in the CT-guided group (Z=-5.10, P<0.01). The MRI-guided group took the longest time for planning, followed by the CT-guided group, and the X-ray guided group took the shortest time (H=57.93, P<0.01). Conclusions The 2D brachytherapy mode guided by X-ray film had the shortest process time but higher TRAK, while the 3D brachytherapy mode guided by MR had the longest process time, and the planned TRAK result were comparable to those guided by CT. When multiple patients are treated with brachytherapy at the same time, the work efficiency can be improved by interspersing different phases and the waiting time can be avoided. |
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