On the surface.

Surface-guided radiation alignment sure is nifty, with huge fields of view and no call for further ionizing radiation, but this practical study asks what this technology really adds to radiation safety above and beyond standard image-guidance. It analyzes three incident reporting systems to determine how many of over 10,000 events could have been prevented using surface-guided software. The answer was just over 1 in 5. These were mostly due to wrong isocenter (43%...ruh roh) or accessories (34%). The authors recognize the reluctance of widespread adoption of this software as a compliment to other imaging due to the increased complexity (what if cone beam CT and surface imaging disagree..?) without complimentary reimbursement, and conclude its worth a rehaul to integrate seamlessly into existing workflows. | Al-Hallaq, Radiother Oncol 2021

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