Radiology Nuclear Medicine

Download Intensity-Modulated Radiation Therapy: Clinical Evidence and by Yasumasa Nishimura, Ritsuko Komaki PDF

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By Yasumasa Nishimura, Ritsuko Komaki

Successful medical use of intensity-modulated radiation remedy (IMRT) represents an important enhance in radiation oncology. simply because IMRT can carry high-dose radiation to a goal with a discounted dose to the encompassing organs, it could enhance the neighborhood regulate cost and decrease toxicities linked to radiation remedy. seeing that IMRT all started getting used within the mid-1990s, a wide quantity of scientific facts of some great benefits of IMRT has been gathered. despite the fact that, remedy making plans and caliber insurance (QA) of IMRT are advanced and hard for the clinician and the scientific physicist. This booklet, by means of authors popular for his or her services of their fields, presents cumulative scientific proof and acceptable thoughts for IMRT for the clinician and the physicist. half I bargains with the rules and methods, background, ideas, QA, remedy making plans, radiobiology and comparable elements of IMRT. half II covers medical functions with a number of case reviews, describing contouring and dose distribution with scientific effects in addition to descriptions of symptoms and a evaluation of scientific facts for every tumor web site. the knowledge provided during this booklet serves as a necessary source for the working towards clinician and physicist.

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The American Association for Physicists in Medicine created a series of tests for IMRT commissioning that are designed to represent common clinical treatments. These tests include the measurement of point dose and also dose planes assessed by using the gamma criterion of 3 %/3 mm, the most prevalent standard for acceptance testing and QA [87]. Nine centers (all of which passed the Radiological Physics Center’s phantom irradiation) planned, delivered, measured, and analyzed these tests, and the findings were used to create confidence levels for use as reference by other institutions attempting the same tests.

E. Court et al. Fig. 2 (a) Leaf trajectory as a function of dose index for a step-and-shoot IMRT delivery. 00 -6 -4 -2 0 Leaf Positions (cm) 2 4 Fig. 3 (a) Leaf trajectories as a function of dose index for dynamic multileaf collimator (MLC) delivery. (b) is the resulting intensity fluence (From Xia and Verhey [133]) is possible with a less advanced treatment machine. Also, importantly, step-andshoot IMRT typically requires less MUs than dynamic IMRT. In sliding-window IMRT delivery, the MLCs move across the target volume while the radiation is on [8, 13, 40, 113].

3 Image-Guided IMRT IMRT alone can achieve impressive dose distributions, reducing toxicity to normal tissues. , IGRT). Moreover, realizing these planned dose distributions over a treatment course lasting days or weeks requires highly accurate patient setup, particularly when taking advantage of tight dose distributions could lead to use of margins as small as 3–5 mm [30]. Many approaches are used for IGRT, including orthogonal (or stereotactic) kilovoltage or megavoltage x-ray imaging and CT imaging (cone beam or CT on rails), and MRI-guided treatments are only a few years away [57, 83, 102, 109].

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