Image Guided Radiotherapy Of Lung Cancer

Lung cancer is the leading cause of cancer death in the United States, but IGRT (image guided radiation therapy) offers the possibility of more aggressive and enhanced treatments. The only available source on the subject that emphasizes new imaging techniques, and provides step-by-step treatment guidelines for lung cancer, this source helps clinici

This book gives a comprehensive overview on the use of image-guided radiation therapy (IGRT) in the treatment of lung cancer, covering step-by-step guidelines for clinical implementations, fundamental principles and key technical advances. It covers benefits and limitations of techniques as well as quality and safety issues related to IGRT practice. Addresses imaging simulation, treatment planning, verification, and delivery Discusses important quality assurance issues Describes current methods using specialized machines and technologies Jing Cai, PhD, is an Associate Professor of Radiation Oncology at Duke University Medical Center. Joe Y. Chang, MD, PhD, is Professor in the Department of Radiation Oncology at The University of Texas MD Anderson Cancer Center in Houston. Fang-Fang Yin, PhD, is Chief of the Division of Radiation Physics, Professor of Radiation Oncology, and Director of the Medical Physics program at Duke University.

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.

This book gives a comprehensive overview on the use of image-guided radiation therapy (IGRT) in the treatment of lung cancer, covering step-by-step guidelines for clinical implementations, fundamental principles and key technical advances. It covers benefits and limitations of techniques as well as quality and safety issues related to IGRT practice. Addresses imaging simulation, treatment planning, verification, and delivery Discusses important quality assurance issues Describes current methods using specialized machines and technologies Jing Cai, PhD, is an Associate Professor of Radiation Oncology at Duke University Medical Center. Joe Y. Chang, MD, PhD, is Professor in the Department of Radiation Oncology at The University of Texas MD Anderson Cancer Center in Houston. Fang-Fang Yin, PhD, is Chief of the Division of Radiation Physics, Professor of Radiation Oncology, and Director of the Medical Physics program at Duke University.

Image Guided Radiation Therapy (IGRT) is a true revolution in the field of radiation oncology. IGRT 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, IGRT 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 IGRT. 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 IGRT. Today, the most significant barrier is education. IGRT is a fundamentally new approach to both treatment planning and delivery. Adoption of the IGRT 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 IGRT.

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.

Image-guided radiotherapy (IGRT) is a new radiotherapy technology that combines the rapid dose fall off associated with intensity-modulated radiotherapy (IMRT) and daily tumor imaging allowing for high precision tumor dose delivery and effective sparing of surrounding normal organs. The new radiation technology requires close collaboration between radiologists, nuclear medicine specialists, and radiation oncologists to avoid marginal miss. Modern diagnostic imaging such as positron emission tomography (PET) scans, positron emission tomography with Computed Tomograpgy (PET-CT), and magnetic resonance imaging (MRI) allows the radiation oncologist to target the positive tumor with high accuracy. As the tumor is well visualized during radiation treatment, the margins required to avoid geographic miss can be safely reduced , thus sparing the normal organs from excessive radiation. When the tumor is located close to critical radiosensitive structures such as the spinal cord, IGRT can deliver a high dose of radiation to the tumor and simultaneously decreasing treatment toxicity, thus potentially improving cure rates and patient quality of life. During radiotherapy, tumor shrinkage and changes of normal tissues/volumes can be detected daily with IGRT. The volume changes in the target volumes and organs at risk often lead to increased radiation dose to the normal tissues and if left uncorrected may result in late complications. Adaptive radiotherapy with re-planning during the course of radiotherapy is therefore another advantage of IGRT over the conventional radiotherapy techniques. This new technology of radiotherapy delivery provides the radiation oncologist an effective tool to improve patient quality of life. In the future, radiation dose-escalation to the residual tumor may potentially improve survival rates. Because the treatment complexity, a great deal of work is required from the dosimetry staff and physicists to ensure quality of care. Preliminary clinical results with IGRT are encouraging but more prospective studies should be performed in the future to assess the effectiveness of IGRT in improving patient quality of life and local control. In this Frontiers Research Topic, we encourage submission of original papers and reviews dealing with imaging for radiotherapy planning, the physics and dosimetry associated with IGRT, as well as the clinical outcomes for cancer treatment with IGRT for all tumor sites.

This book equips readers with detailed knowledge on the current status of image-guided radiotherapy with photons and particles and highlights issues that need to be addressed in order to further improve treatment outcomes. The opening chapters cover clinical and technical aspects of target volume definition using anatomic (computed tomography and magnetic resonance imaging; MRI) as well as functional (MRI and positron emission tomography) imaging. Up-to-date information is then provided on the full range of image-guided high-precision radiotherapy techniques, including IMRT/VMAT, stereotactic body radiation therapy, MR-guided linear accelerators, MR-guided brachytherapy, and particle therapy. The role of ultrasonography in image-guided radiotherapy is discussed, as are the available means for target volume demarcation and stabilization and adaptive radiation therapy. Finally, outcome evaluation is explored in depth, with a particular focus on the role of multimodality imaging in predicting tumor control and normal tissue toxicity. The authors are experts in different specialties and the book will be of high value for radiation oncologists, medical physicists, radiologists, nuclear medicine physicians, and radiation technicians.