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Modern medical imaging and radiation therapy technologies are so complex and computer driven that it is difficult for physicians and technologists to know exactly what is happening at the point-of-care. Medical physicists responsible for filling this gap in knowledge must stay abreast of the latest advances at the intersection of medical imaging an
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.
External-beam radiotherapy has long been challenged by the simple fact that patients can (and do) move during the delivery of radiation. Recent advances in imaging and beam delivery technologies have made the solution-adapting delivery to natural movement-a practical reality. Adaptive Motion Compensation in Radiotherapy provides the first detailed
External-beam radiotherapy has long been challenged by the simple fact that patients can (and do) move during the delivery of radiation. Recent advances in imaging and beam delivery technologies have made the solution—adapting delivery to natural movement—a practical reality. Adaptive Motion Compensation in Radiotherapy provides the first detailed treatment of online interventional techniques for motion compensation radiotherapy. This authoritative book discusses: Each of the contributing elements of a motion-adaptive system, including target detection and tracking, beam adaptation, and patient realignment Treatment planning issues that arise when the patient and internal target are mobile Integrated motion-adaptive systems in clinical use or at advanced stages of development System control functions essential to any therapy device operating in a near-autonomous manner with limited human interaction Necessary motion-detection methodology, repositioning techniques, and approaches to interpreting and responding to target movement data in real time Medical therapy with external beams of radiation began as a two-dimensional technology in a three-dimensional world. However, in all but a limited number of scenarios, movement introduces the fourth dimension of time to the treatment problem. Motion-adaptive radiation therapy represents a truly four-dimensional solution to an inherently four-dimensional problem. From these chapters, readers will gain not only an understanding of the technical aspects and capabilities of motion adaptation but also practical clinical insights into planning and carrying out various types of motion-adaptive radiotherapy treatment.
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
Successful clinical use of intensity-modulated radiation therapy (IMRT) represents a significant advance in radiation oncology. Because IMRT can deliver high-dose radiation to a target with a reduced dose to the surrounding organs, it can improve the local control rate and reduce toxicities associated with radiation therapy. Since IMRT began being used in the mid-1990s, a large volume of clinical evidence of the advantages of IMRT has been collected. However, treatment planning and quality assurance (QA) of IMRT are complicated and difficult for the clinician and the medical physicist. This book, by authors renowned for their expertise in their fields, provides cumulative clinical evidence and appropriate techniques for IMRT for the clinician and the physicist. Part I deals with the foundations and techniques, history, principles, QA, treatment planning, radiobiology and related aspects of IMRT. Part II covers clinical applications with several case studies, describing contouring and dose distribution with clinical results along with descriptions of indications and a review of clinical evidence for each tumor site. The information presented in this book serves as a valuable resource for the practicing clinician and physicist.
Adaptive radiation therapy (ART) is an emerging area of interest within radiation oncology that aims to estimate the doses actually delivered to patients and adapt their treatment plans to mitigate any changes from the planned dose. Recently introduced technologies, including dose recalculation on repeated volumetric patient imaging and deformable image registration (DIR), are required to perform state-of-the-art ART. The inherent uncertainties of these new technologies are not well known, however, undermining the confidence in clinical decisions made using these tools. This work presents a methodology to quantify the uncertainties of ART for the purpose of providing clinicians with a better foundation for making such decisions. To accomplish this goal, this dissertation is divided into four distinct aims: quantify the dosimetric uncertainty of dose recalculations performed on inter-fraction volumetric patient images, determine the uncertainty introduced by using a plan dose overlay instead of performing dose recalculation, quantify the uncertainty of DIR, and translate the quantified uncertainties into clinically useful tools.
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.
​This book provides a complete overview of the role of machine learning in radiation oncology and medical physics, covering basic theory, methods, and a variety of applications in medical physics and radiotherapy. An introductory section explains machine learning, reviews supervised and unsupervised learning methods, discusses performance evaluation, and summarizes potential applications in radiation oncology. Detailed individual sections are then devoted to the use of machine learning in quality assurance; computer-aided detection, including treatment planning and contouring; image-guided radiotherapy; respiratory motion management; and treatment response modeling and outcome prediction. The book will be invaluable for students and residents in medical physics and radiation oncology and will also appeal to more experienced practitioners and researchers and members of applied machine learning communities.