Intensity modulated radiation therapy (IMRT) has become standard of care for most cancer sites that are managed by radiation therapy. This book documents the evolution of this technology over 35 years to the current level of volumetric arc modulated therapy (VMAT). It covers every aspect of this radiation treatment technology, including the fundamentals of IMRT/VMAT, basic principles and advanced processes for implementation. The physics of IMRT is followed by the clinical application in major disease sites such as central nervous system, head and neck, breast, lung, prostate and cervix. It also provides updated references on each component of IMRT/VMAT. This book is written by leading experts in the field with extensive clinical experience in the practice and implementation of this technology.
Key Features
- Provides comprehensive coverage of IMRT for radiation therapy students, dosimetrists, physicists, medical residents and radiation professionals
- Includes up-to-date descriptions of current instrumentation and practises
- Diagrams and images are included throughout to illustrate fundamental concepts and aid understanding
- Provides extensive references for further reading
Author(s): Indra J. Das, Nicholas J. Sanfilippo, Antonella Fogliata, Luca Cozzi
Series: IPEM–IOP Series in Physics and Engineering in Medicine and Biology
Publisher: IOP Publishing
Year: 2021
Language: English
Pages: 359
City: Bristol
PRELIMS.pdf
Preface
Author biographies
Indra J Das
Nicholas J Sanfilippo
Antonella Fogliata
Luca Cozzi
Acronyms
CH001.pdf
Chapter 1 Introduction
References
CH002.pdf
Chapter 2 Beam modulation
2.1 Forward planning
2.2 Paradigm shift
2.3 Simulated annealing
References
CH003.pdf
Chapter 3 Definitions and terminology
3.1 Pixel
3.2 Voxel
3.3 Bixel (beamlet)
3.4 Intensity level
3.5 Segment
3.6 Concept of dose painting
References
CH004.pdf
Chapter 4 IMRT devices
4.1 Intensity modulation filter/compensator
4.2 Dynamic Jaw
4.3 MLC based
4.4 Direct aperture optimization (DAO)
4.5 Systems for IMRT
4.5.1 Peacock-MIMiC
4.5.2 Tomotherapy
References
CH005.pdf
Chapter 5 IMRT, IMAT and VMAT
5.1 IMRT
5.1.1 Step and shoot IMRT
5.1.2 Dynamic delivery IMRT
5.2 IMAT
5.3 Volumetric, modulated arc therapy, VMAT
5.4 Outlook
References
CH006.pdf
Chapter 6 Intensity modulated planning process
6.1 IMRT planning process
6.2 Imaging
6.3 Target volume
6.4 DVH constraints
6.5 Inverse planning
6.6 MLC sequencing
6.7 Transfer and treatment sequencing
6.8 Phantom plan
6.9 IMRT PSQA
6.10 Treatment verification
6.11 Record and verification
References
CH007.pdf
Chapter 7 Contouring
7.1 Contouring for intensity modulation inverse planning
7.2 Margins
7.3 Motion and contouring
7.4 Auto-segmentation
7.4.1 First generation of auto-segmentation methods (model-based)
7.4.2 Second generation of auto-segmentation methods
7.4.3 Third generation of auto-segmentation methods (atlas-based)
7.4.4 Fourth generation of auto-segmentation methods (deep learning)
References
CH008.pdf
Chapter 8 Treatment planning
8.1 Beam (and arc) geometry
8.2 The collimator rotation
8.3 Non-coplanarity
8.4 Flattened and unflattened beams
8.5 Modulation degrees and delivery accuracy
8.6 The feathering: large field splitting and multi-isocentric setup
8.6.1 Overlap in the lateral direction (large volumes)
8.6.2 Overlap in the longitudinal direction (long volumes)
8.7 Artifact handling
8.8 The interplay effect
8.9 The neutron production and the whole body dose: beam quality
8.10 Conclusions on treatment planning
References
CH009.pdf
Chapter 9 Optimization
9.1 The inverse planning concept
9.2 The goals and the cost function
9.3 The optimization objectives
9.4 The optimization algorithms
9.4.1 The deterministic algorithms
9.4.2 The stochastic algorithms
9.5 The direct aperture optimization
9.6 The biological optimization
9.6.1 The radiobiological models for TCP, NTCP, EUD
9.7 Benefit and deficiencies in biological optimization
9.8 Robust optimization
References
CH010.pdf
Chapter 10 Dose calculation
10.1 Required accuracy in dose calculation
10.2 Dose calculation algorithms and classification
10.2.1 The empirical models
10.2.2 The semi-empirical, correction-based algorithms
10.2.3 The kernel-based algorithms: pencil beam, AAA, collapsed cone
10.2.4 The electron transport explicit algorithms: Monte Carlo, LBTE solvers
10.3 Type ‘a’, ‘b’, ‘c’ algorithm classification
10.4 Dose-to-medium or dose-to-water?
10.5 Dose calculation accuracy in various TPS implementations
10.6 Fluence to dose and MLC parameters: another source of uncertainty
10.7 The out-of-field dose
10.8 Dose calculation with metallic objects
10.9 Other elements influencing the dose calculation accuracy
References
CH011.pdf
Chapter 11 Plan variability
11.1 Dosimetric variation: the intra- and inter-planner and planning system sources
11.2 Knowledge-based planning
11.3 Protocol-based automation
11.4 Multi-criteria optimization
11.5 MCO, a posteriori
11.6 MCO, a priori
11.7 Plan variability conclusion
References
CH012.pdf
Chapter 12 Quality assurance and verification
12.1 Theory of comparison
12.1.1 Statistical analysis
12.1.2 Dice Similarity Coefficient (DSC)
12.1.3 Gamma index
12.2 Silico method
12.3 Measurements
12.3.1 Film dosimetry
12.3.2 Sun nuclear map check
12.3.3 IBA MatriXX
12.3.4 PTW Octavius
12.3.5 Scandidos Delta4
12.3.6 Electronic Portal Imaging Dosimetry (EPID)
12.4 Log-file approach
12.5 Artificial intelligence
12.6 Outlook
References
CH013.pdf
Chapter 13 IMRT dose prescription and recording
13.1 Planning variability
13.2 ICRU-83 guidelines
13.3 State of compliance
13.4 Essentiality in IMRT
References
CH014.pdf
Chapter 14 Tumors of the central nervous system
14.1 Epidemiology
14.2 Anatomic considerations
14.3 Clinical and diagnostic evaluation
14.4 Intensity modulated radiation therapy: biologic considerations
14.5 Intensity modulated radiation therapy: technical considerations
14.6 IMRT for CNS tumors: general considerations
14.7 Clinical experience of IMRT in brain tumors
14.8 Clinical experience of IMRT in spinal and paraspinal tumors
14.9 IMRT for craniospinal irradiation
References
CH015.pdf
Chapter 15 Head and neck cancer
15.1 Epidemiology
15.2 Anatomy
15.3 Nasopharyngeal carcinoma: general considerations
15.4 IMRT for nasopharyngeal carcinoma
15.5 Oropharyngeal carcinoma: general considerations
15.6 IMRT for oropharyngeal carcinoma
15.7 Carcinoma of the oral cavity: general considerations
15.8 IMRT for oral cavity carcinoma
15.9 Cancer of the larynx and hypopharynx: general considerations
References
CH016.pdf
Chapter 16 Lung cancer
16.1 Epidemiology
16.2 Anatomy
16.3 Lung cancer: general considerations
16.4 IMRT for lung cancer
References
CH017.pdf
Chapter 17 Breast cancer
17.1 Epidemiology
17.2 Anatomy
17.3 Breast cancer: general considerations
17.4 IMRT for breast cancer
References
CH018.pdf
Chapter 18 Prostate cancer
18.1 Epidemiology
18.2 Anatomy
18.3 Prostate cancer: general considerations
18.4 Prostate cancer IMRT
References
CH019.pdf
Chapter 19 Cervical cancer
19.1 Epidemiology
19.2 Cervical cancer: general considerations
19.3 IMRT for cervical cancer
References
CH020.pdf
Chapter 20 Summary and outlook
20.1 Plan automation, adaptive therapy and artificial intelligence: A glance into the crystal ball
20.2 Decision-making artificial intelligence (AI) guided radiotherapy
References
