Image-Guided Radiotherapy : A New Dimension in Radiation Oncology

Please always quote using this URN: urn:nbn:de:bvb:20-opus-140771
  • Background: The vital importance of imaging techniques in radiation oncology now extends beyond diagnostic evaluation and treatment planning. Recent technical advances have enabled the integration of various imaging modalities into the everyday practice of radiotherapy directly at the linear accelerator, improving the management of inter-and intrafractional variations. Methods: We present the topic of image-guided radiotherapy (IGRT) on the basis of a selective review of the literature. Results: IGRT can be performed with theBackground: The vital importance of imaging techniques in radiation oncology now extends beyond diagnostic evaluation and treatment planning. Recent technical advances have enabled the integration of various imaging modalities into the everyday practice of radiotherapy directly at the linear accelerator, improving the management of inter-and intrafractional variations. Methods: We present the topic of image-guided radiotherapy (IGRT) on the basis of a selective review of the literature. Results: IGRT can be performed with the aid of ultrasound, 2D X-ray devices, and computed tomography. It enables instant correction for positioning deviations and thereby improves the precision of daily radiotherapy fractions. It also enables immediate adjustment for changes in the position and filling status of the internal organs. Anatomical changes that take place over the course of radiotherapy, such as weight loss, tumor shrinkage, and the opening of atelectases, can be detected as they occur and accounted for in dosimetric calculations. There have not yet been any randomized controlled trials showing that IGRT causes fewer adverse effects or improves tumor control compared to conventional radiotherapy. Conclusion: IGRT is more precise and thus potentially safer than conventional radiotherapy. It also enables the application of special radiotherapeutic techniques with narrow safety margins in the vicinity of radiosensitive organs. Proper patient selection for IGRT must take account of the goals of treatment and the planning characteristics, as well as the available technical and human resources. IGRT should be used for steep dose gradients near organs at risk, for highly conformal dose distributions in the gastrointestinal tract where adjustment for filling variations is needed, for high-precision dose escalation to avoid geographic miss, and for patients who cannot lie perfectly still because of pain or claustrophobia.show moreshow less

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Metadaten
Author: Florian Sterzing, Rita Engenhart-Cabillic, Michael Flentje, Jürgen Debus
URN:urn:nbn:de:bvb:20-opus-140771
Document Type:Journal article
Faculties:Medizinische Fakultät / Klinik und Poliklinik für Strahlentherapie
Language:English
Parent Title (English):Deutsches Ärzteblatt International
Year of Completion:2011
Volume:108
Issue:16
Pagenumber:274-280
Source:Deutsches Ärzteblatt International 2011; 108(16): 274–80. DOI: 10.3238/arztebl.2011.0274
DOI:https://doi.org/10.3238/arztebl.2011.0274
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:cone-beam ct; guidance; head; helical tomotherapy; limitations; megavoltage computed-tomography; prostate-cancer; therapy
Release Date:2019/09/02
Licence (German):License LogoDeutsches Urheberrecht