S2941
RTT- RTT operational practice and workflow innovations
ESTRO 2026
dMRI could increase the number of patients eligible for SF-RT up to 67%, with further work required in this area. Methods to safely treat more complex areas such as the brain and head and neck with SF-RT also need to be explored. References: 1 Schuler, T, Roderick, S, Wong, S, et al. (2025) Real- World Implementation of Simulation-Free Radiation Therapy (SFRT-1000): A Propensity Score-Matched Analysis of 1000 Consecutive Palliative Courses Delivered in Routine Care. IJROBP, 121(3), 585-595.2 Guerrero, F, Koivula, E, Seravalli, G, et al (2019) Feasibility of MRI-only photon and proton dose calculations for pediatric patients with abdominal tumors. Phys Med Biol, 64(5), 0550103 O’Connor, LM, Choi, JH, Dowling, A et al. (2022) Comparison of synthetic computed tomography generation methods, incorporating male and female anatomical differences, for magnetic resonance imaging-only definitive radiotherapy. Front Oncol, 12, 822687. Keywords: Simulation-free, paediatric, palliative Optimising the image positioning control of benign pathologies such as plantar fascitiis with Surface Guided Radiation Therapy (SGRT). Ainoa Vizuete Pérez 1 , Jéssica Jimenez Sánchez 2 , Miriam Mancera Soto 1 , Sonia Bermejo Martínez 2 , Erica Vilanova Rodríguez 2 , Josep Isern Verdum 2 1 Radiation Physics and Radiation Protection, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 2 Radiation Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain Purpose/Objective: This study aimed to evaluate and optimize the positioning control imaging protocol initially designed for standard extremity treatments by implementing SGRT in patients with benign plantar fasciitis. Material/Methods: Digital Poster 4113 A retrospective observational study was conducted in patients diagnosed with plantar fasciitis treated during 2025. A total of 30 patients were included. Postural video, SGRT (AlignRT), and intrafraction monitoring were used for setup and treatment verification (figure 1). No thermoplastic masks were used, as patient positioning was fully guided by SGRT. Displacements were recorded and compared in the vertical, longitudinal, and lateral directions. Statistical analysis was conducted using Python-based tools for descriptive and correlation analysis.
Results: The variables of vertical (vert), longitudinal (long), and lateral (lat) displacement were analyzed across 159 observations (figure 2). The mean values (±SD) were:Vert: − 0.07cm ± 0.17cmLong: 0.00cm ± 0.17cmLat: 0.02cm ± 0.18cmAll distributions deviated from normality according to the Shapiro–Wilk test (p < 0.001 for all variables). Pearson’s correlation analysis showed a mild association between longitudinal and lateral displacements (r = 0.31), while correlations among other axes were minimal (r < 0.1).
Conclusion: SGRT achieved positioning accuracy with limited inter- axis correlation, indicating stable and reproducible setup performance improving intrafraction monitoring. These findings support workflows to reduce imaging frequency in benign pathologies, ensuring equivalent accuracy. Additionally, the optimized protocol reduces total radiation dose and decreases treatment costs, as the use of thermoplastic masks is not required. References: Freislederer, P., Kügele, M., Öllers, M., Swinnen, A., Sauer, T.O., Bert, C., Giantsoudi, D., Corradini, S., &
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