Beam’s Eye View Imaging in Radiation Oncology PDF
|Author||Ph.D., Ross I. Berbeco|
|File size||39.42 MB|
|Category||Free Medical Books,Oncology|
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The introduction of flat-panel detectors for clinical imaging in radiation therapy in the mid-1990s was the beginning of the age of computerized image guidance in this field. The early electronic portal imaging devices (EPIDs) provided fast, easy clinical beam’s eye view (BEV) imaging for accurate pretreatment patient positioning. With the introduction of on-board kilovoltage (kV) imaging systems in the early 2000s, megavoltage (MV) portal imaging has mostly fallen out of favor with most research and development favoring the newer low-energy systems. Recently, however, there has been a resurgence of interest in MV imaging for quality assurance, portal dosimetry, cone-beam computed tomography (CBCT), and real-time tumor tracking. The purpose of this book is to bring all of this information together in one place so that a reader may derive a clear understanding and appreciation for the current clinical applications and future opportunities afforded by beam’s eye view MV imaging. IMAGE GUIDANCE IN RADIATION THERAPY Image guidance is key to the precision and accuracy of radiation therapy. Modern radiation therapy equipment enables the delivery of very precisely calculated amounts of radiation in complicated shapes in order to maximize target conformality and minimize the damage to healthy tissues. This exquisitely delivered therapy is for naught unless the patient anatomy is located in the correct location during every treatment fraction.
In fact, poorly controlled localization can lead to harmful effects such as toxicities in organs at risk and even debilitating or lethal injury. On the flip side, highly precise and accurate localization can not only prevent harm but also enable radiation dose escalation to the target providing greater tumor control and extending survival. There are several approaches to image guidance in radiation therapy, each with advantages and disadvantages. Current clinical technologies include optical surface imaging, kV X-rays, magnetic resonance imaging, positron emission tomography, and MV X-ray imaging. Among these options, the last (MV imaging) is the most prevalent while also the most undervalued. Nearly every new clinical linear accelerator comes equipped with MV imaging as a standard feature. Given the high “penetration” in the marketplace, innovations in MV imaging can translate to a large, widespread impact. Therefore, the cost/benefit ratio for improvements in MV imaging is highly favorable.
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