TY - JOUR
T1 - Implementing a Novel Remote Physician Treatment Coverage Practice for Adaptive Radiation Therapy During the Coronavirus Pandemic
AU - Price, Alex
AU - Kim, Hyun
AU - Henke, Lauren E.
AU - Knutson, Nels C.
AU - Spraker, Matthew B.
AU - Michalski, Jeff
AU - Hugo, Geoffrey D.
AU - Robinson, Clifford G.
AU - Green, Olga
N1 - Publisher Copyright:
© 2020 The Author(s)
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Purpose: The 2019 coronavirus disease pandemic has placed an increased importance on physical distancing to minimize the risk of transmission in radiation oncology departments. The pandemic has also increased the use of hypofractionated treatment schedules where magnetic resonance-guided online adaptive radiation therapy (ART) can aid in dose escalation. This specialized technique requires increased staffing in close proximity, and thus the need for novel coverage practices to increase physical distancing while still providing specialty care. Methods and Materials: A remote-physician ART coverage practice was developed and described using commercially available software products. Our remote-physician coverage practice provided control to the physician to contour and review of the images and plans. The time from completion of image registration to the beginning of treatment was recorded for 20 fractions before remote-physician ART coverage and 14 fractions after implementation of remote-physician ART coverage. Visual quality was calculated using cross-correlation between the treatment delivery and remote-physician computer screens. Results: For the 14 fractions after implementation, the average time from image registration to the beginning of treatment was 24.9 ± 6.1 minutes. In comparison, the 20 fractions analyzed without remote coverage had an average time of 29.2 ± 9.8 minutes. The correlation between the console and remote-physician screens was R =.95. Conclusions: Our novel remote-physician ART coverage practice is secure, interactive, timely, and of high visual quality. When using remote physicians for ART, our department was able to increase physical distancing to lower the risk of virus transmission while providing specialty care to patients in need.
AB - Purpose: The 2019 coronavirus disease pandemic has placed an increased importance on physical distancing to minimize the risk of transmission in radiation oncology departments. The pandemic has also increased the use of hypofractionated treatment schedules where magnetic resonance-guided online adaptive radiation therapy (ART) can aid in dose escalation. This specialized technique requires increased staffing in close proximity, and thus the need for novel coverage practices to increase physical distancing while still providing specialty care. Methods and Materials: A remote-physician ART coverage practice was developed and described using commercially available software products. Our remote-physician coverage practice provided control to the physician to contour and review of the images and plans. The time from completion of image registration to the beginning of treatment was recorded for 20 fractions before remote-physician ART coverage and 14 fractions after implementation of remote-physician ART coverage. Visual quality was calculated using cross-correlation between the treatment delivery and remote-physician computer screens. Results: For the 14 fractions after implementation, the average time from image registration to the beginning of treatment was 24.9 ± 6.1 minutes. In comparison, the 20 fractions analyzed without remote coverage had an average time of 29.2 ± 9.8 minutes. The correlation between the console and remote-physician screens was R =.95. Conclusions: Our novel remote-physician ART coverage practice is secure, interactive, timely, and of high visual quality. When using remote physicians for ART, our department was able to increase physical distancing to lower the risk of virus transmission while providing specialty care to patients in need.
UR - http://www.scopus.com/inward/record.url?scp=85087672781&partnerID=8YFLogxK
U2 - 10.1016/j.adro.2020.05.007
DO - 10.1016/j.adro.2020.05.007
M3 - Article
C2 - 32775784
AN - SCOPUS:85087672781
SN - 2452-1094
VL - 5
SP - 737
EP - 742
JO - Advances in Radiation Oncology
JF - Advances in Radiation Oncology
IS - 4
ER -