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Image-guided radiation therapy: techniques and strategies
Southeast Radiation Oncology, Presbyterian Cancer Center, Presbyterian Hospital, Charlotte, NC
With the advances in diagnostic imaging and computerized treatment planning, radiation oncology has made tremendous strides in designing sophisticated treatment plans. These developments along with technological upgrades of the linear accelerators and novel treatment platforms have allowed for delivery of higher conformal doses while sparing critical normal structures. Such plans, which use reduced set-up margins and intensity-modulated radiation therapy, require accurate and precise delivery. These advances have led to renewed interest in verification imaging during treatment delivery. Image-guided radiation therapy (IGRT) is an active field whereby real-time images are used to make corrections in regard to set-up accuracy and also adaptive modifications based on changes in tumor size and shape. Studies demonstrate continued refinements in the technical aspect of IGRT, which are translating into improved patient outcomes. This article will review the rationale for image guidance with discussion of organ movement and target delineation. It will describe new image-guided technologies as well as discuss some of the limitations. It will then explore potential developments that hopefully will reshape and advance the current practice of radiation oncology.
| Commun Oncol 2008;5:86–92 | full text |  186 kb |