Intensity modulated radiation therapy (IMRT) is a true revolution in the field of radiation oncology. IMRT provides the unprecedented means of conforming does to the shape of the target tissues in 3-dimensions reducing the risk of complications thereby improving the quality of life of irradiated patients. Moreover, IMRT provides the means to deliver higher than conventional doses thus improving the chance of cure in these patients. Despite its established benefits, several barriers exist to the widespread clinical implementation of IMRT. In the past, great concerns existed regarding the large capital outlay needed for both software and hardware. This barrier is less relevant today given the increased reimbursements possible with IMRT. Today, the most significant barrier is education. IMRT is a fundamentally new approach to both treatment planning and delivery. Adoption of the IMRT approach entails new ways of thinking in regard to patient selection, treatment planning and quality assurance measures. Unfortunately, apart from a few University-based short courses, limited resources are available for the physician and physicist interested in learning IMRT. Moreover, the available courses primarily focus on the physics of IMRT, not on clinical aspects of IMRT planning and delivery.
Author(s): Arno J. Mundt, John C. Roeske
Edition: 1
Publisher: Pmph usa
Year: 2011
Language: English
Pages: 662
Tags: Медицинские дисциплины;Клинические методы диагностики, лабораторная диагностика;Лучевая диагностика и терапия;
Contributors......Page 6
Preface......Page 22
Contents......Page 24
1: Overview
......Page 32
2: Computed Tomography......Page 44
3: Positron Emission Tomography
......Page 53
4: Magnetic Resonance Imaging
......Page 60
5: Ultrasound Systems
......Page 76
6: Video Systems
......Page 89
7: Electronic Portal Imaging Devices
......Page 105
8: Integrated Computed Tomography/Linac Systems
......Page 130
9: Kilovoltage Imaging Systems
......Page 141
10: Megavoltage Imaging Systems
......Page 154
11: Respiratory Management Technologies
......Page 161
12: Electromagnetic Tracking
......Page 173
13: Emerging In-Room Imaging Technologies
......Page 187
14: Quality Assurance in the Image-Guided Era
......Page 196
15: Central Nervous System Tumors: Overview
......Page 206
15A: GA-DOTATOC-PET-Guided Target Delineation in a Patient with an Intracranial Meningioma
......Page 218
15B: MR Spectroscopy-Guided Target Delineation in a Patient with a Recurrent Glioblastoma Multiforme
......Page 222
15C: Functional MR-Guided Target Delineation in a Patient with a Cerebral AVM Undergoing SRS
......Page 225
15D: Image-Guided SRS in a Patient with Trigeminal Neuralgia using the CyberKnife System
......Page 229
15E: Planar Image-Guided Frameless IMRT in a Patient with Recurrent Nasopharyngeal Carcinoma on a Novalis Linear Accelerator
......Page 232
16: Head and Neck Tumors: Overview
......Page 235
16A: F-FDG PET-Guided Target Delineation in a Patient with Hypopharyngeal Carcinoma
......Page 255
16B: MR-Guided Target Delineation in a Patient with Nasopharyngeal Carcinoma
......Page 261
16C: F-Fluoromisonidazole PET-Guided Target Delineation in a Patient with Base of Tongue Carcinoma
......Page 265
16D: F-FDG PET-Guided Target Delineation in a Patient with Recurrent Nasopharyngeal Carcinoma
......Page 270
16E: Electronic Portal Image-Guided Setup in a Patient with Head & Neck Cancer on a Varian Linear Accelerator
......Page 273
16F: MVCT-Guided IMRT Using the Helical Tomotherapy System in a Patient with Tonsillar Carcinoma
......Page 276
16G: KV CBCT-Guided IMRT Using the Elekta Synergy System in a Patient with Tonsillar Carcinoma
......Page 279
16H: Real-Time Reverse Subtraction Video-Guided Setup and Intrafraction Monitoring in a Patient with Head & Neck Cancer
......Page 283
17: Lung Cancer: Overview
......Page 287
17A: F-FDG PET-Guided Target Delineation in a Patient with Lung Cancer
......Page 298
17B: Four-Dimensional SBRT Using the CyberKnife Synchrony System in a Patient with Early Stage Lung Cancer
......Page 302
17C: Hypofractionated IGRT Using the Helical Tomotherapy System in a Patient with Inoperable Lung Cancer
......Page 306
17D: Deep Inspiration Breath-Hold KV CBCT-Guided SBRT Using the Varian Trilogy System in a Patient with Stage I Lung Cancer
......Page 309
17E: Respiratory Gated KV CBCT-Guided SBRT Using the Varian Trilogy System in a Patient with Stage I Lung Cancer
......Page 313
18: Breast Cancer: Overview
......Page 316
18A: Three-Dimensional Ultrasound-Guided Target Delineation and Treatment Delivery Using the Clarity Ultrasound System in a Patient with Breast Cancer
......Page 327
18B: MVCT-Guided Patient Setup Using the Helical Tomotherapy System in a Patient with Early Stage Breast Cancer
......Page 332
18C: KV CBCT-Guided Treatment Delivery Using the Elekta Synergy System in a Patient with Breast Cancer
......Page 336
18D: Video-Guided Patient Positioning and Localization Using the AlignRT System in a Patient with Breast Cancer
......Page 339
18E: KV CT-Guided Radiotherapy Using the Siemens CT-on-Rails System in a Patient with Early Stage Breast Cancer
......Page 343
19: Gastrointestinal Tumors: Overview
......Page 347
19A: F-FDG PET-Guided Target Delineation in a Patient with Esophageal Cancer
......Page 359
19B: MR-Guided Target Delineation in a Patient with Hepatocellular Carcinoma
......Page 364
19C: KV Planar Image-Guided Tumor Localization in a Pancreatic Cancer Patient...
......Page 368
19D: Image-Guided Hypofractionated Radiotherapy Using the RTRT System in a Patient with Hepatocellular Carcinoma
......Page 372
19E: KV Planar Image-Guided SBRT Using the CyberKnife System in a Patient with Recurrent Pancreatic Cancer
......Page 376
20: Genitourinary Tumors: Overview
......Page 380
20A: MR-Guided Target Delineation in a Patient with Prostate Cancer
......Page 396
20B: ProstaScint-Guided Target Delineation in a Patient with Prostate Cancer...
......Page 398
20C: Ultrasound-Guided Target Localization Using the Clarity System in a Patient with Prostate Cancer
......Page 403
20D: Electronic Portal Image-Guided Setup in a Prostate Cancer Patient...
......Page 408
20E: KV Planar Imaging-Guided IMRT Using the Novalis Shaped-Beam System in a Patient with Intermediate Risk Prostate Cancer
......Page 412
20F: KV Planar Imaging-Guided SBRT Using the CyberKnife System in a Patient with Localized Prostate Cancer
......Page 417
20G: MV CBCT-Guided IMRT on a Siemens Oncor Linear Accelerator in a Patient with Prostate Cancer
......Page 421
20H: Image-Guided SBRT Using the Varian Trilogy and Calypso 4D-Localization System in a Patient with Early Stage Prostate Cancer
......Page 426
20I: MVCT-Guided Hypofractionated IMRT Using Helical Tomotherapy in a Patient with Prostate Cancer.........Page 429
20J: KV CBCT-Guided IMRT Using a Varian Linear Accelerator in a Patient with Localized Bladder Cancer
......Page 433
20K: Real-Time Target Localization and Tracking Using the Calypso System in a Patient with Prostate Cancer Undergoing IMRT
......Page 438
21: Gynecologic Tumors: Overview
......Page 442
21A: MR-Guided Target Delineation in a Patient with Locally Advanced Cervical Cancer.........Page 461
21B: F-FDG PET-Guided Target Delineation for External Beam Radiotherapy and Intracavitary Brachytherapy...
......Page 467
21C: F-FDG Pet and MR-Guided Target Delineation in a Patient with Stage IIIB Cervical Cancer
......Page 471
21D: Fat Fraction MR and F-FDG PET-Guided Active Bone Marrow Delineation in a Patient with Cervical Cancer.........Page 474
21E: Real-Time Ultrasound-Guided Brachytherapy in a Patient with Cervical Cancer.........Page 478
21F: Fractionated Image-Guided Stereotactic Radiotherapy Boost in a Patient with Stage IIB Endometrial Cancer.........Page 481
21G: Ultrasound-Guided Applicator Placement and Treatment Planning in a Patient with Cervical Cancer.........Page 485
21H: On-Line Planar and Volumetric-Based Patient Setup and Tumor Localization in a Patient with Stage IIB Cervical Cancer...
......Page 488
21I: KV Planar Image-Guided 3DCRT Using a Varian Linear Accelerator in a Patient with Endometrial Adenosarcoma
......Page 493
22: Lymphoma/Leukemia: Overview
......Page 496
22A: PET/CT-Guided Target Delineation in a Patient with Early Stage Hodgkin's Lymphoma
......Page 509
22B: F-FDG PET-Guided Target Delineation in a Patient with Non-Hodgkin's Lymphoma
......Page 512
22C: MR-Guided Active Bone Marrow Delineation in a Patient with Acute Pre-T Cell ALL Treated with Intensity Modulated Total Marrow Irradiation
......Page 515
22D: MVCT-Guided Total Marrow Irradiation Using Helical Tomotherapy in a Patient with ALL
......Page 520
22E: KV CBCT-Guided IMRT Using the Varian Trilogy System in a Patient with Non-Hodgkin's Lymphoma
......Page 525
23: Pediatric Tumors: Overview
......Page 529
23A: Optically Guided Frameless SRS Using the Varian Trilogy in a Patient with a Juvenile Pilocytic Astrocytoma
......Page 538
23B: KV Planar Image-Guided Setup Using the Varian Trilogy System in a Patient with an Intracranial Ependymoma
......Page 542
24: Metastatic Disease: Overview
......Page 545
24A: KV CBCT-Guided Frameless SRS in a Patient with a Solitary Brain Metastasis Treated on a Varian Linear Accelerator
......Page 557
24B: Optically Guided Frameless SRS Using a Single Isocenter Technique in a Breast Cancer Patient..........Page 563
24C: Image-Guided Single-Fraction IMRT Using a Varian Linear Accelerator in a Patient with a Paraspinal Metastasis
......Page 567
24D: KV Planar Image-Guided Frameless SRS in a Patient with a Cervical Spine Metastasis Treated Using the CyberKnife System......Page 571
24E: KV CT-Guided SBRT Using the Varian CT-on-Rails System in a Patient with a Solitary Spine Metastasis
......Page 575
24F: MVCT-Guided Simultaneous Multitarget Hypo-fractionated Radiotherapy Using Helical Tomotherapy...
......Page 579
24G: KV Planar Image-Guided SBRT Using the CyberKnife System in a Renal Cell Carcinoma Patient...
......Page 583
24H: KV Planar Image-Guided SBRT Using the Novalis System in an Ovarian Cancer Patient.........Page 587
24I: Electronic Portal Cine Imaging During Single-Fraction SBRT Using a Varian Linear Accelerator in a Breast Cancer Patient.........Page 590
24J: KV CBCT-Guided SBRT Using the Elekta Synergy System in a Breast Cancer Patient...
......Page 593
24K: DV CT-Guided SBRT in a Hepatocellular Carcinoma Patient with a Solitary Lung Metastasis.........Page 597
25: Adaptive IGRT: A Physician's Perspective
......Page 601
26: Adaptive IGRT: A Physicist's Perspective
......Page 626
27: Economic Analysis of IGRT
......Page 637
28: IGRT: A Cautionary Note
......Page 642
Index
......Page 648
