Reduction of organ motion effects in IMRT and conformal 3D radiation delivery by using gating and tracking techniques Journal Article
| Authors: | Giraud, P.; Yorke, E.; Jiang, S.; Simon, L.; Rosenzweig, K.; Mageras, G. |
| Article Title: | Reduction of organ motion effects in IMRT and conformal 3D radiation delivery by using gating and tracking techniques |
| Abstract: | Respiration-gated radiotherapy offers a significant potential for improvement in the irradiation of tumour sites affected by respiratory motion such as lung, breast and liver tumours. An increased conformality of irradiation fields leading to decreased complications rates of organs at risk (lung, heart) is expected. Four main strategies are used to reduce respiratory motion effects: integration of respiratory movements into treatment planning, breath-hold techniques, respiratory gating techniques, and tracking techniques. Measurements of respiratory movements can be performed either in a representative sample of the general population, or directly on the patient before irradiation. The measured amplitude could be applied to a geometrical margin or integrated into dosimetry. However, these strategies remain limited for very mobile tumours, in which this approach results in larger irradiated volumes. Reduction of breathing motion can be achieved by using either breath-hold techniques or respiration synchronized gating techniques. Breath-hold can be achieved with active techniques, in which a valve temporarily blocks airflow of the patient, or passive techniques, in which the patient voluntarily breath-holds. Synchronized gating techniques use external devices to predict the phase of the respiration cycle while the patient breaths freely. Another category is tumour tracking, which consists of two major aspects: real-time localization of, and real-time beam adaptation to, a constantly moving tumour. These techniques are presently being investigated in several medical centres worldwide. Although promising, the first results obtained in lung and liver cancer patients require confirmation. This paper describes the most frequently used gating and tracking techniques and the main published clinical reports. © 2006 Elsevier Masson SAS. All rights reserved. |
| Keywords: | review; intensity modulated radiation therapy; patient selection; treatment planning; cancer patient; cancer radiotherapy; radiation dose; methodology; tumor localization; tumor volume; heart disease; lung disease; radiotherapy dosage; radiotherapy; lung cancer; prediction; simulation; imaging system; cancer center; population research; instrumentation; dosimetry; geometry; three dimensional imaging; imaging, three-dimensional; breast tumor; device; experience; irradiation; measurement; interventional radiology; radiography, interventional; short survey; liver cancer; artifact; radiotherapy planning, computer-assisted; radiotherapy, conformal; risk reduction; breath holding; patient positioning; respiration; computer assisted radiotherapy; amplitude modulation; artifacts; x ray; sample; breathing mechanics; health care facility; respiration control; radiotherapy, computer-assisted; breathing; movement; movement (physiology); tomography scanners, x-ray computed; respiratory gating; respiratory movement; airflow; simulator; general apparatus, equipment and supplies |
| Journal Title: | Cancer/Radiotherapie |
| Volume: | 10 |
| Issue: | 5 |
| ISSN: | 1278-3218 |
| Publisher: | Elsevier Masson |
| Date Published: | 2006-09-01 |
| Start Page: | 269 |
| End Page: | 282 |
| Language: | English |
| DOI: | 10.1016/j.canrad.2006.05.009 |
| PUBMED: | 16875860 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 41" - "Export Date: 4 June 2012" - "CODEN: CARAF" - "Source: Scopus" |
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450Yorke
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