Image Based Computer Assisted Radiation Therapy

This book provides a comprehensive overview of the state-of-the-art computational intelligence research and technologies in computer-assisted radiation therapy based on image engineering. It also traces major technical advancements and research findings in the field of image-based computer-assisted radiation therapy. In high-precision radiation therapies, novel approaches in image engineering including computer graphics, image processing, pattern recognition, and computational anatomy play important roles in improving the accuracy of radiation therapy and assisting decision making by radiation oncology professionals, such as radiation oncologists, radiation technologists, and medical physicists, in each phase of radiation therapy. All the topics presented in this book broaden understanding of the modern medical technologies and systems for image-based computer-assisted radiation therapy. Therefore this volume will greatly benefit not only radiation oncologists and radiologists but also radiation technologists, professors in medical physics or engineering, and engineers involved in the development of products to utilize this advanced therapy.

Image-Guided Radiation Therapy presents key image-guided radiation treatment (IGRT) technologies for external beam radiotherapy. The book explores the decades-long technological developments that have occurred in the realm of image-guided conformal, customized radiation treatment. Expert authors, all of whom have actively participated in the development or implementation of IGRT, imaging, and enabling technologies, share their first-hand experiences on the science, clinical uses, and impact of these technologies. They describe kilovoltage and megavoltage imaging as well as radiological, ultrasound, and optical technologies for determining and validating target and patient positioning. The book examines how anatomical and biological imaging using CT and PET has contributed to the understanding of target volume boundaries and biological behavior. It also explores such innovations as 4D PET/CT and digital tomosynthesis. Advancing patient care, this book focuses on a wealth of hybrid IGRT technologies and devices for coupled imaging and treatment inside the radiation treatment room. It thoroughly covers the modalities, software tools, and imaging treatment geometries that constitute IGRT.

Image-guided therapy (IGT) uses imaging to improve the localization and targeting of diseased tissue and to monitor and control treatments. During the past decade, image-guided surgeries and image-guided minimally invasive interventions have emerged as advances that can be used in place of traditional invasive approaches. Advanced imaging technologies such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) entered into operating rooms and interventional suites to complement already-available routine imaging devices like X-ray and ultrasound. At the same time, navigational tools, computer-assisted surgery devices, and image-guided robots also became part of the revolution in interventional radiology suites and the operating room. Intraoperative Imaging and Image-Guided Therapy explores the fundamental, technical, and clinical aspects of state-of the-art image-guided therapies. It presents the basic concepts of image guidance, the technologies involved in therapy delivery, and the special requirements for the design and construction of image-guided operating rooms and interventional suites. It also covers future developments such as molecular imaging-guided surgeries and novel innovative therapies like MRI-guided focused ultrasound surgery. IGT is a multidisciplinary and multimodality field in which teams of physicians, physicists, engineers, and computer scientists collaborate in performing these interventions, an approach that is reflected in the organization of the book. Contributing authors include members of the National Center of Image-Guided Therapy program at Brigham and Women’s Hospital and international leaders in the field of IGT. The book includes coverage of these topics: - Imaging methods, guidance technologies, and the therapy delivery systems currently used or in development. - Clinical applications for IGT in various specialties such as neurosurgery, ear-nose-and-throat surgery, cardiovascular surgery, endoscopies, and orthopedic procedures. - Review and comparison of the clinical uses for IGT with conventional methods in terms of invasiveness, effectiveness, and outcome. - Requirements for the design and construction of image-guided operating rooms and interventional suites.

Intensity-modulated radiation therapy (IMRT), one of the most important developments in radiation oncology in the past 25 years, involves technology to deliver radiation to tumors in the right location, quantity and time. Unavoidable irradiation of surrounding normal tissues is distributed so as to preserve their function. The achievements and future directions in the field are grouped in the three sections of the book, each suitable for supporting a teaching course. Part 1 contains topical reviews of the basic principles of IMRT, part 2 describes advanced techniques such as image-guided and biologically based approaches, and part 3 focuses on investigation of IMRT to improve outcome at various cancer sites.

Images from CT, MRI, PET, and other medical instrumentation have become central to the radiotherapy process in the past two decades, thus requiring medical physicists, clinicians, dosimetrists, radiation therapists, and trainees to integrate and segment these images efficiently and accurately in a clinical environment. Image Processing in Radiation Therapy presents an up-to-date, detailed treatment of techniques and algorithms for the registration, segmentation, reconstruction, and evaluation of imaging data. It describes how these tools are used in radiation planning, treatment delivery, and outcomes assessment. The book spans deformable registration, segmentation, and image reconstruction and shows how to incorporate these practices in radiation therapy. The first section explores image processing in adaptive radiotherapy, online monitoring and tracking, dose accumulation, and accuracy assessment. The second section describes the mathematical approach to deformable registration. The book presents similarity metrics used for registration techniques, discussing their effectiveness and applicability in radiation therapy. It also evaluates parametric and nonparametric image registration techniques and their applications in radiation therapy processes. The third section assesses the efficiency, robustness, and breadth of application of image segmentation approaches, including atlas-based, level set, and registration-based techniques. The fourth section focuses on advanced imaging techniques for radiotherapy, such as 3D image reconstruction and image registration using a graphics processor unit. With contributions from an international group of renowned authors, this book provides a comprehensive description of image segmentation and registration, in-room imaging, and advanced reconstruction techniques. Through many practical examples, it illustrates the clinical rationale and implementation of the techniques.

This book provides detailed, state-of-the-art information and guidelines on the latest developments, innovations, and clinical procedures in image-guided and adaptive radiation therapy. The first section discusses key methodological and technological issues in image-guided and adaptive radiation therapy, including use of implanted fiducial markers, management of respiratory motion, image-guided stereotactic radiosurgery and stereotactic body radiation therapy, three-dimensional conformal brachytherapy, target definition and localization, and PET/CT and biologically conformal radiation therapy. The second section provides practical clinical information on image-guided adaptive radiation therapy for cancers at all common anatomic sites and for pediatric cancers. The third section offers practical guidelines for establishing an effective image-guided adaptive radiation therapy program.

IGRT covers nearly every aspect of radiation treatment planning and delivery in radiation therapy and explains both the "why" and the "how," the art and the science of IGRT. Image Guided Radiation Therapy: A Clinical Perspective provides an overview of the basic concepts of IGRT and includes a review of its history and present status. Additionally, Image-Guided Target Delineation Technologies presents an in-depth overview of the main imaging modalities used for target delineation, namely computed tomography (CT) including 4-dimensional (4D) CT, magnetic resonance (MR) imaging and positron emission tomography (PET). Image Guided Treatment Technologies systemically introduces the reader to the major in-room IGRT treatment technologies available today, including video, ultrasound, planar and volumetric-based imaging systems. Organized anatomically, Clinical Sites and Case Studies is a comprehensive overview of the clinical applications of IGRT. Within each section, traditional overview chapters are paired with case studies of actual treated patients, focusing on image-guided target delineation and image-guided treatment delivery.

Progess in specific computer-assisted techniques (digital imaging , computer-aided diagnosis, image-guided surgery, MEMS, etc.) combined with computer-assisted integration tools offers a valuable complement to or replacement for existing procedures in healthcare. Physicians are now employing PACS and telemedicine systems as enabling infrastructures to improve quality of and access to healthcare. Tools based on CAD and CAS facilitate completely new paths in patient care. To ensure that CARS tools benefit the patient, collaboration between various disciplines, specifically radiology, surgery, engineering, informatics, and healthcare management, is a critical factor. A multidisciplinary congress like CARS is a step in the desired direction of knowledge sharing and crossover education. It provides the necessary cooperative framework for advancing the development and application of modern computer-assisted technologies in healthcare.