UCLA Journal of Radiation Oncology Fall and Winter 2022 - Flipbook - Page 29
Photography Credit: Joshua Sudock
UCLA RADIATION ONCOLOGY JOURNAL
SIM-FREE PALLIATIVE TREATMENTS
ON ETHOS
T
he majority of radiotherapy treatments in our department require planning on a
simulation image from a dedicated CT scanner. Often, patients we treat already
have recent diagnostic CT images available. These existing images, combined
with the high quality cone-beam CT (CBCT) and online adaptive planning available
on the Ethos treatment machine, allow us to craft a clinical workflow that can bypass
conventional CT simulation. We don’t intend to do away with CT simulation entirely;
it remains an important part of the radiation therapy workflow and is indispensable in
many cases. However, a sim-free workflow on Ethos would allow us to offer patients
immediate, same-day treatment starts and eliminate one trip to the department. We are
currently focusing on palliative cases where patients stand to benefit the most from these
improvements, allowing for faster relief of pain and other tumor symptoms.
Why Ethos?
Ethos, like the ViewRay MRIdian, lets us perform online adaptive: treatment planning onthe-fly to suit the patient’s anatomy and position in real-time. To accomplish this, Ethos
offers substantially higher quality CBCT imaging than our other machines. The imaging
quality and online adaptive capabilities of the Ethos machine make it a perfect platform
to implement a sim-free radiation therapy workflow.
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