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Advances in radiation therapy dosimetry.

Paliwal B, Tewatia D - J Med Phys (2009)

Bottom Line: Advanced techniques are less tolerant to poor implementation than are standard techniques.Mis-administrations are more difficult to detect and can possibly lead to poor outcomes for some patients.Some of the major challenges in the above areas are discussed.

View Article: PubMed Central - PubMed

Affiliation: University of Wisconsin Radiation Oncology Physics 600 Highland Ave., K4/B100 - 0600 Madison, USA.

ABSTRACT
During the last decade, there has been an explosion of new radiation therapy planning and delivery tools. We went through a rapid transition from conventional three-dimensional (3D) conformal radiation therapy to intensity-modulated radiation therapy (IMRT) treatments, and additional new techniques for motion-adaptive radiation therapy are being introduced. These advances push the frontiers in our effort to provide better patient care; and with the addition of IMRT, temporal dimensions are major challenges for the radiotherapy patient dosimetry and delivery verification. Advanced techniques are less tolerant to poor implementation than are standard techniques. Mis-administrations are more difficult to detect and can possibly lead to poor outcomes for some patients. Instead of presenting a manual on quality assurance for radiation therapy, this manuscript provides an overview of dosimetry verification tools and a focused discussion on breath holding, respiratory gating and the applications of four-dimensional computed tomography in motion management. Some of the major challenges in the above areas are discussed.

No MeSH data available.


Related in: MedlinePlus

Experimental validation setup for real-time motion-adaptive optimization-guided tomotherapy delivery, breathing trace and tumor trajectory, motion-corrected and motion-uncorrected fluence profiles
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Figure 0019: Experimental validation setup for real-time motion-adaptive optimization-guided tomotherapy delivery, breathing trace and tumor trajectory, motion-corrected and motion-uncorrected fluence profiles

Mentions: We are also considering a noninvasive approach for motion management during tomotherapy. It uses a real-time fiducial external infrared marker for tracking patient breathing and updates a pre-optimized sinogram for motion compensation. A case study is described to illustrate this approach. A lung cancer patient previously treated with tomotherapy was selected for this study. Experimental set up used for treatment delivery and the PTV in all planes is shown in Figure 17. Treatment plan parameters were FW = 1.05 cm, pitch = 0.143, mod factor = 2.0, gantry period = 18; a prescribed dose of 60 Gy (2 Gy × 30 fractions) was delivered. A 4DCT was performed prior to the treatment using spirometer trace for inferior/superior motion. Lateral motion and A/P motion were assumed to be sinusoidal, and 3D target trajectory was generated for use with motion phantom. Motion-corrected and motion-uncorrected dose distributions and profiles are also shown in Figure 17.


Advances in radiation therapy dosimetry.

Paliwal B, Tewatia D - J Med Phys (2009)

Experimental validation setup for real-time motion-adaptive optimization-guided tomotherapy delivery, breathing trace and tumor trajectory, motion-corrected and motion-uncorrected fluence profiles
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2807673&req=5

Figure 0019: Experimental validation setup for real-time motion-adaptive optimization-guided tomotherapy delivery, breathing trace and tumor trajectory, motion-corrected and motion-uncorrected fluence profiles
Mentions: We are also considering a noninvasive approach for motion management during tomotherapy. It uses a real-time fiducial external infrared marker for tracking patient breathing and updates a pre-optimized sinogram for motion compensation. A case study is described to illustrate this approach. A lung cancer patient previously treated with tomotherapy was selected for this study. Experimental set up used for treatment delivery and the PTV in all planes is shown in Figure 17. Treatment plan parameters were FW = 1.05 cm, pitch = 0.143, mod factor = 2.0, gantry period = 18; a prescribed dose of 60 Gy (2 Gy × 30 fractions) was delivered. A 4DCT was performed prior to the treatment using spirometer trace for inferior/superior motion. Lateral motion and A/P motion were assumed to be sinusoidal, and 3D target trajectory was generated for use with motion phantom. Motion-corrected and motion-uncorrected dose distributions and profiles are also shown in Figure 17.

Bottom Line: Advanced techniques are less tolerant to poor implementation than are standard techniques.Mis-administrations are more difficult to detect and can possibly lead to poor outcomes for some patients.Some of the major challenges in the above areas are discussed.

View Article: PubMed Central - PubMed

Affiliation: University of Wisconsin Radiation Oncology Physics 600 Highland Ave., K4/B100 - 0600 Madison, USA.

ABSTRACT
During the last decade, there has been an explosion of new radiation therapy planning and delivery tools. We went through a rapid transition from conventional three-dimensional (3D) conformal radiation therapy to intensity-modulated radiation therapy (IMRT) treatments, and additional new techniques for motion-adaptive radiation therapy are being introduced. These advances push the frontiers in our effort to provide better patient care; and with the addition of IMRT, temporal dimensions are major challenges for the radiotherapy patient dosimetry and delivery verification. Advanced techniques are less tolerant to poor implementation than are standard techniques. Mis-administrations are more difficult to detect and can possibly lead to poor outcomes for some patients. Instead of presenting a manual on quality assurance for radiation therapy, this manuscript provides an overview of dosimetry verification tools and a focused discussion on breath holding, respiratory gating and the applications of four-dimensional computed tomography in motion management. Some of the major challenges in the above areas are discussed.

No MeSH data available.


Related in: MedlinePlus