Initial Institutional Experience and Workflow of Biology-Guided Radiotherapy (BgRT) for a Patient With Non-small Cell Lung Cancer

We describe a case of a 69-year-old gentleman with a biopsy-proven non-small cell lung cancer (NSCLC) who was treated with the SCINTIX biology-guided radiotherapy (BgRT). In this report, we focus on the development of our institutional clinical workflow for BgRT to ensure a safe and seamless process. This entails the initial import of diagnostic PET/CT with fluorodeoxyglucose-avid lesion(s), 4D CT simulation, contouring including the biology tracking zone, a patient modeling session for planning PET, and radiation treatment (RT). BgRT is a promising technology that has the potential to allow functional adaptation of RT. In our patient with NSCLC who was treated with 5-fraction BgRT, we were able to achieve the threshold for activity concentration and a sufficiently normalized tumor signal. Furthermore, the time analyses of treatment steps demonstrated an efficient workflow.