Service development and innovation (radiotherapy physics)
Our scientists, technologists and dosimetrists continuously work to develop and adopt most modern and accurate treatment delivery techniques to maximise the effectiveness and minimise the side effects of radiotherapy treatments.
Our medical physics experts are central to all radiotherapy service developments ensuring scientific rigour in selection and implementation of new equipment, evaluation and adoption of best practice treatments.
Please see below for examples of some of our ongoing developments.
Regulatory compliance
Through our specialist roles (MPE, RPA) and specialist expertise in software regulation and clinical risk management we support the service in compliance with regulations including Ionising Radiation Regulations (IRR2017 and IRMER 2017) and in compliance with software and medical device management.
Admin and coordination
Our admin team coordinate the flow of work through the complex pathway to ensure that patient treatments are delivered in a timely way, ensuring compliance with waiting time targets.
Who do we work with?
Our primary customer is the radiotherapy department where we work in very close collaboration with consultant clinical oncologists and radiographers to deliver high quality radiotherapy services. We also work in a wider multi-professional team with surgeons, radiologists, nurses, sterile services department as well as working closely with equipment suppliers. We advise Trust management in designing and planning future expansion and modernisation of the radiotherapy service and facility and work with procurement in the tender process for new equipment and services.
Surface guided radiotherapy
The department is at the forefront in the UK of using this new technology for all radical treatments. The technology, known as SGRT, uses high-definition cameras combined with software to constantly monitor the 3D surface of the patient whilst their radiotherapy is delivered. It can detect patient movement with sub-millimetre accuracy, interrupting the radiation beam automatically if the patient moves more than a pre-defined tolerance, within less than 200 ms.
To measure the latency of the system, a collaborative project was carried out with another local radiotherapy centre. A moving phantom containing a high-density marker was programmed with a variety of velocities and images of the marker were acquired using the electronic portal imaging device (EPID). The moving target deviation from a static reference image was plotted against target velocity to calculate the end-to-end latency of the system.
A further project to measure latency was also carried out. This method combines the use of a solenoid to move a region of interest vertically in and out of the gating window and a magnetron current detection circuit. The difference between the timestamps from the solenoid movement and the magnetron pulse were used to calculate the latency.
Brachytherapy
EM tracking research
The brachytherapy department is currently researching the feasibility for electromagnetic tracking in the brachytherapy pathway. The aim of the research is to determine whether the commercial Aurora EM tracking solution can be used to aid reconstruction and positioning of applicators for HDR brachytherapy treatments and evaluate and establish a workflow for routine clinical use. This work is still under development and aims to improve patient treatments in brachytherapy for future patients.
Quality control and dosimetry, service development
Integral Quality Monitor MSc Project (IQM)
After the success in implementing the IQM system in patient specific dosimetry, which helped in reducing the time needed to perform the task, the quality assurance (QA) team discussed the possibility of using the IQM in the monthly Linac QA and exploring the potential of the system to reduce the QA time and streamline the process.
The IQM MSc project needs to be finished by April 2025 and the project team are currently meeting with the IQM manufacturer to discuss the study and obtain their QA tool. They will then use the tool as a comparison for the calculation module to process the data aiming to submit an interim report by end of August 2024.
The study is now accepted as a MSc project for one of our King’s College trainees and will be completed with full collaboration from the manufacturer.
Implementing ‘QATrack+’ Project
The QA team is working on the above to implement the ‘QATrack+’ for machine Database and documentation. Earlier this year the team explored the various available systems before choosing the features provided by QATrack+.
In June 2024 a virtual server was granted, and a trial version installed, and we are currently in the process of creating a ‘one Linac’ with basic database collection for testing, which should be ready for the 2nd half of 2025.
Clinical trials support
Radiotherapy physics provides scientific support to the setup and recruitment to many radiotherapy clinical trials. This work is led by Charlotte Edwards and Hannah Richardson.
Email Charlotte.Edwards@uhs.nhs.uk or Hannah.Richardson@uhs.nhs.uk or call 023 8120 6129.