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Image Guided Radiation Therapy by Arno J. Mundt, John C. Roeske

By Arno J. Mundt, John C. Roeske

Depth modulated radiation remedy (IMRT) is a real revolution within the box of radiation oncology. IMRT presents the exceptional technique of conforming does to the form of the objective tissues in 3-dimensions decreasing the danger of problems thereby enhancing the standard of lifetime of irradiated sufferers. in addition, IMRT offers the capability to bring greater than traditional doses therefore enhancing the opportunity of healing in those sufferers. regardless of its demonstrated advantages, numerous boundaries exist to the common scientific implementation of IMRT. long ago, nice matters existed in regards to the huge capital outlay wanted for either software program and undefined. This barrier is much less proper at the present time given the elevated reimbursements attainable with IMRT. this present day, the main major barrier is schooling. IMRT is a essentially new method of either remedy making plans and supply. Adoption of the IMRT procedure includes new methods of considering in regard to sufferer choice, therapy making plans and caliber coverage measures. regrettably, except a couple of University-based brief classes, restricted assets can be found for the healthcare professional and physicist attracted to studying IMRT. furthermore, the to be had classes basically specialize in the physics of IMRT, no longer on scientific features of IMRT making plans and supply.

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Procedures should be written for each treatment site to identify the scan protocol, scan limits, contrast, special instructions, and, possibly, beam arrangements. Emerging Uses of CT Simulation Target Motion Management—4D CT Simulation Fully embracing IGRT demands that the radiation oncologist consider the fact that any singular “image” represents only an instantaneous representation of the patient’s anatomy. Single-slice CT scans consist of multiple planar images acquired over a period of several seconds; these images are then used to create a 3D reconstruction with interpolation applied between images.

31 As described in Chapter 2, CT simulation is now the mainstay (and often Overview / 3 FIGURE 1-1. A patient with esophageal cancer treated on a million-volt roentgen-ray machine, Memorial Hospital, New York (1943). Portals were outlined and the direction of the beams determined by using roentgenograms. 9 the sole method) of treatment planning in many clinics. 34,35 As with CT the decade before, the value of MR-guided FIGURE 1-2. Pneumoencephalogram in a patient with a brain tumor, Massachusetts General Hospital, Boston (1921).

Patient repositioning and motion detection using a video cancellation system. Int J Radiat Oncol Biol Phys 1975:1(1–2):147–153. 50. Johnson LS, Milliken BD, Hadley SW, Pelizzari CA, Haraf DJ, Chen GT. Initial clinical experience with a video-based patient positioning system. Int J Radiat Oncol Biol Phys. 1999;45(1):205–213. 51. Lattanzi J, McNeeley S, Pinover W, et al. A comparison of daily CT localization to a daily ultrasound-based system in prostate cancer. Int J Radiat Oncol Biol Phys. 1999;43(4):719–725.

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