S2870
RTT - RTT education, training, and advanced practice
ESTRO 2026
positioning accuracy for patients with smaller PTV volumes. However, for patients with larger PTV volumes, ROI-O achieved better alignment with CBCT and improved overall setup accuracy. These findings suggest that SG positioning, particularly with ROI-O for larger targets, can enhance setup precision and may serve as a more reliable and efficient approach in breast radiotherapy clinical practice. Keywords: Breast Cancer, SGRT, Region of Interest, Digital Poster 2650 Implementation of an integrated PET/4DCT protocol for curative radiotherapy planning in non- small-cell lung cancer patients. Sarah Fortin Jørgensen 1 , Maja Støvring Sørensen 2 , Mathias Gæde Askløf 2 , Peter Andreas Andersen 1 , Mette Pøhl 1 , Elisabeth Lagoni Juhl 1 , Annika Loft 2 , Anne Kirkebjerg Due 1,2 1 Department of Oncology, Rigshospitalet, Copenhagen, Denmark. 2 Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark Purpose/Objective: At our institution, curative radiotherapy planning for patients with non-small-cell lung cancer (NSCLC) involving the mediastinum treated with 2 Gy × 33 traditionally includes both a diagnostic PET/CT and a 4DCT, both with intravenous contrast. These are acquired on consecutive days in different departments: the PET/CT in Nuclear Medicine and the 4DCT in Radiation Therapy. To improve patient convenience and optimize departmental resources, an integrated PET/4DCT protocol was developed and implemented. This report aims to describe the protocol design and resulting resource savings. Material/Methods: In a collaborative effort between the Nuclear Medicine and Radiation Therapy departments, an integrated PET/4DCT protocol was developed. An emphasis was put on maintaining optimal contrast timing for the diagnostic CT and with this constraint achieving the best possible contrast timing for the 4DCT acquisition (fig. 1).
Workflow, staffing, and scheduling were adjusted accordingly. Data from the initial implementation phase, including rescan rates and departmental resource use, were compared with historical data. Results: Before the integrated workflow, patients attended two appointments on consecutive days requiring a CT scanner slot and two RTTs, as well as a PET/CT scanner slot including one RTT and one PET/CT scanner staff. With the integrated protocol, patients attend a single one-hour appointment, eliminating one visit and one contrast administration. The PET/4DCT scan uses the existing PET/CT slot and staff, while the Radiation Therapy Department saves a CT slot and two RTTs (fig. 2). During implementation, seven patients were scanned; four required a 4DCT rescan. The rescan rate is expected to align with the historical rate of 21% (April–September 2024).
Annually, approximately 50 NSCLC patients require both scans in our institution. With the integrated protocol, Radiation Therapy staff hours are projected to decrease from 100 to 50, and CT scanner use from 50 slots to none. Nuclear Medicine resource use remains unchanged. Conclusion:
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