S2677
RTT - Patient experience and quality of life
ESTRO 2026
Impact of Accelerated Gantry Rotation on Patient- Reported Anxiety During Rapid Cone-Beam CT Imaging Alex T Price 1,2 , Atefeh Rezeai 1 , Theodore Arsenault 1,2 , Runyon Woods 1 , Rojano Kashani 1,2 , Angela Jia 1,2 , Daniel E Spratt 1,2 , Clair R Kueny 3 , Lauren E Henke 1,2 1 Radiation Oncology, University Hospitals, Cleveland, USA. 2 Radiation Oncology, Case Western Reserve University, Cleveland, USA. 3 Department of Psychological Science, Missouri University of Science & Technology, Rolla, USA Purpose/Objective: Recent advances in image-guided radiotherapy (IGRT) have led to increased gantry rotation speeds, enhancing image quality, reducing motion artifacts, and improving workflow efficiency. However, higher mechanical speeds of machinery in other industries have led to higher levels of human-reported anxiety when working with the machinery (1). In the context of increased gantry rotation speeds, the psychological implications of faster mechanical motion have not been investigated. This prospective study assessed whether exposure to a C-arm linac with high-speed cone-beam computed tomography (CBCT) system affects patient-reported anxiety during setup imaging for radiotherapy. Material/Methods: As part of a prospective imaging trial (NCT05975619), forty patients receiving external beam radiotherapy were imaged using a rapid C-arm CBCT imaging solution (TrueBeam with HyperSight, Varian Medical Systems, Palo Alto, CA) featuring an increased gantry rotation speed (9.0°/s; 1.5 RPM) compared with the conventional 6.0°/s (1.0 RPM). Patients from four anatomical cohorts (head and neck, thorax, abdomen, pelvis) completed the validated 6-item State-Trait Anxiety Inventory (STAI-6) immediately before and after the first and last imaging sessions to capture patient anxiety (2). Changes in anxiety were analyzed within and across imaging sessions using Wilcoxon signed-rank tests, and anxiety associations with breath-hold imaging were evaluated via Pearson correlation. Results: Thirty-eight patients completed 127 evaluable surveys. Overall anxiety levels were low (median STAI-6 = 20.0 [IQR: 20.0–30.0]). During the first imaging session, anxiety remained stable (median change = 0.0 [IQR: – 4.2–0.0], p = 0.36). Across all sessions, 86.6% of responses indicated low anxiety, 9.5% moderate, and 3.9% high. Longitudinally, patient-reported anxiety significantly decreased from the first pre-image survey to the final post-imaging survey (median change = –3.3 [IQR: –10.0–0.0], p = 0.001), suggesting familiarity with the imaging process. Distributions of anxiety change pre- and post-imaging sessions are illustrated in Figure
1. Among 77 breath-hold sessions (median = 2 [IQR: 2– 3] breath-holds per scan), no correlation was observed between breath-hold use and anxiety (r = 0.24, p = 0.22).
Conclusion: Higher rotation-speed CBCT imaging with 1.5 RPM gantry rotation is well tolerated and does not increase patient-reported anxiety or distress. Anxiety scores decreased with repeated exposure, reflecting enhanced familiarity and comfort over time. These findings support the clinical adoption of rapid gantry rotation speed for imaging, highlighting its technical efficiency and psychological acceptability. This underscores that advancements in radiotherapy technology can enhance workflow while maintaining a positive patient experience. References: 1. Probst TM, Lindgren RJ, Dorosh RJ, et al. Effects of prior robot experience, speed, and proximity on psychosocial reactions to a soft growing robot. IISE Trans. Occup. Ergon. Hum. Factors. 2024;12:84–96.2. Marteau TM, Bekker H. The development of a six - item short - form of the state scale of the Spielberger State— Trait Anxiety Inventory (STAI). Br. J. Clin. Psychol. 1992;31:301–306.
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