S2710
RTT - Patient preparation, immobilisation, and verification protocols
ESTRO 2026
structured rollout and a look back on lessons learned. Material/Methods: A dedicated multidisciplinary task force (comprising simulation and treatment nurses, material coordinators, medical physicists, radiation oncologists, and quality experts) was assembled to lead the initiative. The process began with a survey capturing the needs and preferences of RTTs, followed by an ergonomic risk analysis to ensure safe and comfortable working conditions.These insights shaped the procurement requirements, which included categories such as technical value, durability, patient comfort, user-friendliness, and innovation. A two-lot negotiation procedure was launched (standard and stereotactic immobilization), excluding personal items such as masks.A comparative study was launched which involved supplier demonstrations, reference site visits, and in-house testing to evaluate compatibility with existing workflows and equipment (CT, linac, MR, SGRT systems). Supplier dossiers and quotes were assessed based on quality, service and cost, leading to a well-informed selection. A risk matrix was developed using feedback gathered throughout the process. Initial quality checks on the material were performed before implementation.Subsequently, the team identified the most suitable mask system, ensuring it met predefined criteria and was compatible with the selected materials.This paper will further exhibit on the rollout strategy and timeline agreed upon discussion with all stakeholders. A phased implementation was chosen, supported by a Gantt chart outlining preparation steps for each group. A Failure Mode and Effect Analysis (FMEA) on the incorporation of the materials in the workflow and rollout strategy was conducted to mitigate risks during deployment and patient safety. Results: As a result of thorough preparation, targeted training, and clear communication, the new materials were smoothly integrated into daily practice.Continuous improvement remains a priority at a RT department. Follow-up efforts include amongst others feedback surveys of RTTs and evaluations of positioning and matching accuracy. In addition, several optimization projects were launched including development of additional materials and refining workflows. Conclusion: Replacing immobilization materials in a radiotherapy department demands meticulous planning—from product selection to rollout execution. Success hinges on a skilled and committed multidisciplinary team, capable of navigating complexity and driving quality forward. Keywords: Selection criteria,total replacement,risk analysis
treatment site, between 20-36% of the translational shifts had difference ≥ 2mm when comparing the registrations obtained with the 2 imaging modalities using the R1 method, with a trend to have larger differences in Tz direction (Table 1).Variance analysis demonstrated significant effects of cohort, patient, session, and registration method on translational vectors. Adjusted means of absolute residual positioning were significantly lower (p<0.0001) with R1 (1.98mm) compared to R2 (3.38mm) or R3 (3.07mm).
Conclusion: 2D-kV imaging alone is insufficient to assess the repositioning of HN cancer patients treated by radiotherapy. The position of the CTVHR differs from the bony anatomy, highlighting the need for soft tissue registration. However, this approach requires a dosimetric evaluation to assess the impact of registration on dose distribution. References: 1 Den RB, et al. IJROBP 2010;76:1353–92 Korreman S, et al. Radiother Oncol 2010;94:129–44.3 Grégoire V, et al. Cancer Radiother. 2022 Feb-Apr;26(1-2):147-155 4 Goldsworthy S, et al. J Med Imaging Radiat Sci. 2017 Dec;48(4):377-384. Keywords: Head and neck cancer, IGRT, registration Precision starts with stability: a multidisciplinary journey in the replacement of all immobilisation material in Belgium’s largest RT network Lisanne Van Puyvelde, Lynn Verlinden, Inge Peeters, Maarten Holvoet, Dirk Aelbrecht, Casper Pype, Ann Vermylen Iridium Netwerk, ZAS, Wilrijk, Belgium Purpose/Objective: In high-precision radiotherapy, the smallest detail can make the biggest difference—especially when it comes to immobilization. With over 5800 treatments annually, immobilization materials are used intensively within the Iridium Netwerk. This abstract outlines the comprehensive journey of replacing all immobilization material in Belgium’s largest radiotherapy network. A journey from defining needs and expectations, through rigorous testing and risk management, to a Digital Poster 1563
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