Chapter 17 Intensity-Modulated Radiation Therapy

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Presentation transcript:

Chapter 17 Intensity-Modulated Radiation Therapy Principles and Practice of Radiation Therapy Chapter 17 Intensity-Modulated Radiation Therapy Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Introduction Goal of radiation therapy The process of three-dimensional conformal therapy (3D CRT) Intensity-modulated radiation therapy (IMRT) Comparison and results Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Advances in Three-Dimensional Imaging Computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) Reformatting of digital data Postprocessing techniques Research Comparison studies Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Treatment Delivery Practices 3D CRT and IMRT deliver beam optimization to the tumor volume Optimization Homogenous radiation beam Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Adjusting Beam Shape Multileaf collimator (MLC) Conventional radiation therapy Segment creates shape Intensity-modulated field Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Adjusting Dose Delivered Multileaf collimator intensity-modulated radiation therapy (MLC-IMRT) Accuracy of tumor volume Dynamic multileaf collimator (DMLC) Dose escalation Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Image Acquisition and Simulation The simulation process Beam’s eye view (BMV) Role of BMV in treatment planning 3D BEV tumor volume Dose optimization Role of PET in biologic imaging Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Immobilization Custom fabrications Role of immobilization in treatment delivery Image-guided radiation therapy (IGRT) Electronic portal imaging detector (EPID) Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Treatment Planning History and role Forward planning process, applications Dose-volume histograms (DVH) Inverse treatment planning processes Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

IMRT Treatment Delivery Multileaf collimators Physical modulators MLCs, static and dynamic Step and shoot, or segmental, MLC Sliding window technique Intensity-modulated arc therapy (IMAT) Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Treatment Planning Factors Beam data Small field calculations Precision of MLC positioning Dose linearity Beam symmetry Treatment and dosimetric verification Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Clinical Applications Anatomic considerations Prostate cancer Breast cancer Head and neck cancer Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Summary Recent advances PET/CT simulation Low-dose/high-resolution kilovoltage x-ray imaging 4D TomoTherapy treatment technique Summary of treatment planning Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.