Contemporary IMRT: Developing Physics and Clinical Implementation

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CRC Press, 01.10.2004 - 492 Seiten
The most important radiotherapy modality used today, intensity modulated radiation therapy (IMRT), is the most technologically advanced radiotherapy cancer treatment available, rapidly replacing conformal and three-dimensional techniques. Because of these changes, oncologists and radiotherapists need up-to-date information gathered by physicists and engineers. Focusing on new developments and the preliminary clinical implementation, Contemporary IMRT: Developing Physics and Clinical Implementation discusses the relationship between these advances and applications.

Capturing contemporary technological advances, the book reviews modern applications of IMRT and shows how IMRT is used now and how it will be used in the future. The book begins with a historical background of IMRT as well as a discussion of the current state of IMRT. It also covers technical solutions that have been commercialized, such as the sliding window technique, step-and-shoot, tomotherapy, and the Cyberknife. The final chapter explores imaging developments and new planning methods, including gradient-descent and split modulation.

Covering recent advancements in IMRT and showing how these techniques and devices have been implemented, Contemporary IMRT: Developing Physics and Clinical Implementation provides state-of-the-art findings for oncologists, radiotherapists, radiographers, physicists, and engineers.
 

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Inhalt

Intensitymodulated radiation therapy IMRT General statements and points of debate
1
12 Criticism of the philosophy of IMRT
10
Developments in rotation IMRT and tomotherapy
18
212 Matchline concerns and solutions
21
213 Energy considerations
23
214 Concerns about increased treatment time
24
215 Machine features
25
22 University of Wisconsin machine for tomotherapy
26
568 Paediatric medulloblastoma IMRT
210
57 Breast IMRT
211
572 Other reports of techniques using small topup fields
214
573 EPIDbased techniques for breast IMRT
216
574 Modified wedge technique
218
577 Reduced complications observed following breast IMRT
220
578 Combination of IMRT with chargedparticle irradiation
222
59 Lung cancer IMRT
224

222 Generation and use of megavoltage computed tomography MVCT images
28
223 Clinical application
33
224 Commissioning issues
34
225 Verification of MIMiC and University of Wisconsin tomotherapy
35
24 Tomotherapy with an MLC
37
25 Summary
38
Developments in IMRT using a multileaf collimator MLC physics
39
31 New sequencersinterpreters
46
312 Sequencing multiplestatic MLC fieldsclusters
47
313 Nonuniform spatial and fluence steps
50
314 Minimizing the number of segments
51
315 IMFAST
53
317 Sequencers exploiting MLC rotation
56
318 Comparison of dynamic MLC dMLC and multiple static field MSF techniques
58
319 Varian MLC and HELIOS planning system
61
3110 Developments in Elekta IMRT
62
3111 Other interpreters
63
3112 The effect of removing the flattening filter
66
322 Factoring in delivery physics
68
3222 Using leakage and scatter knowledge in the MSFMLC technique
70
323 The effect of rounded leaf ends lightfield to radiationfield discrepancy in IMRT
73
33 Dose calculation for IMRT
74
331 Application of colour theory
75
332 Penumbra sharpening for IMRT
76
34 Features of MLC delivery of IMRT
77
343 Leafspeed limitations
80
344 Stability of accelerator and delivery of a small number of MUs and small fieldsizes
81
35 Dynamic arc therapy
84
36 Combining stepandshoot and dynamic delivery for dMLC
86
37 IMATtechnical issues
89
371 IMAT in clinical use
92
372 IMAT modified to aperturemodulatedarc therapy AMAT
94
38 New ideas related to the dMLC technique
95
39 Compensators and comparisons of compensator and MLCbased IMRT
96
392 Use of compensators for IMRT
97
393 Comparison of compensator and MLCbased IMRT
105
310 Optimum width of leaves for an MLC
106
311 MicroMLCs for IMRT
107
3112 Varian virtual MLC
108
3114 Radionics microMLC
109
3115 BrainLAB microMLC
110
3116 DKFZoriginating microMLCs
111
31162 New DKFZ microMLC
112
3119 Multilevel MLC
115
312 Increasing the spatial resolution of a conventional MLC
116
313 Verification of MLCdelivered IMRT
120
3132 Other EPID designs
124
3134 Extraction of anatomical images from portal images generated during IMRT
125
3135 Blockingtraylevel measurement
126
3136 The twolevel MLC
127
3137 Waterbeamimaging system WBIS
129
3138 Integrated portal fluence and portal dosimetry
131
3139 IMRT verification phantom measurements
132
31310 Verification by software techniques
138
31311 Comparison of delivered modulated fluence profile with planpredicted modulated profile
141
31312 Verification of canine and human IMRT using invivo dosimetry
143
31313 Polyacrylamide gel PAG dosimetry for IMRT verification
144
313132 PAG readout techniques
145
313133 Use of PAGs for IMRT verification
147
313134 New PAGs
150
314 Quality assurance QA of MLC delivery
152
3142 Routine QA of MLC leaf movement
153
3143 Modelling the effects of MLC error
158
315 Summary
159
Developments in IMRT not using an MLC
161
42 The design of the shuttling MLC SMLC
168
43 IMRT with the jawsplusmask technique
169
44 The variable aperture collimator VAC
174
45 Onedimensional IMRT
176
46 Summary
177
Clinical IMRTevidencebased medicine?
179
51 IMRT of the prostate showing measurable clinical benefit
183
52 Comparison of treatment techniques for the prostate
187
53 Royal Marsden NHS Foundation Trust pelvic and other IMRT
192
54 Comparison of IMRT with conformal radiotherapy CFRT for complex shaped tumours
197
55 IMRT for wholepelvic and gynaecological radiotherapy
199
56 Headandneck IMRT
201
561 Thyroid IMRT
202
562 Nasopharynx IMRT
203
563 Oropharynx IMRT
204
564 Oropharynx and nasopharynx IMRT
205
566 Evidence for parotid sparing
206
567 Meningioma IMRT
209
510 Scalp IMRT
225
511 Other clinical IMRT reportsvarious tumour sites
227
512 Summary
228
3D planning for CFRT and IMRT Developments in imaging for planning and for assisting therapy
230
62 Determination of the GTV CTV and PTV the influence of 3D medical imaging
231
623 Margin definition
232
624 Use of magnetic resonance for treatment planning
234
6242 Use of contrast agents
236
6243 Planning based on MR images alone
237
6245 Increased protection of structures
240
6246 Monitoring the response to radiotherapy via MRI
241
625 Use of functional information from SPECT and PET for treatment planning
242
6252 Headandneck imaging
244
6253 Lung imaging
246
6254 Paraaortic lymph node PALN imaging
247
6255 Combined PETCT scanning
248
626 Use of pathology specimens to compare with GTV and PTV
250
631 Gradientdescent inverse planning
251
634 Maximum entropy inverse planning
252
635 Genetic algorithms
253
636 Singlestep inverse planning
254
637 Simulated particle dynamics
255
638 Optimization of surrogate parameters in beam space
257
639 Comparison of inverseplanning techniques
259
6310 Features and comparison of commercial planning algorithms
261
6311 Dependences of IMRT plans on target geometry
262
6312 Multiple local minima and the global minimum in optimization
263
6313 Sampling the dose matrix for IMRT optimization speedup
266
6314 Creating a uniform PTV dose in IMRT cost tuning
269
63151 Voxeldependent IFs
271
6316 Biological and physical optimization
273
6317 Pareto optimal IMRT
275
6319 Split modulation
276
6320 Summary on inverseplanning techniques
278
641 Segmental inverse planning at Thomas Jefferson University TJU
279
642 Aperturebased planning at the University of Ghent
280
643 Direct aperture optimization DAO at the University of Maryland
284
644 DAO wobbling the MLC leaf positions
286
646 Summary on aperturebased IMRT
287
65 Smoothing IMBs
288
653 Smoothing technique from the Memorial Sloan Kettering Cancer Institute
290
655 Smoothing technique in the Nucletron PLATO TPS
292
658 Smoothing techniques at University of California San Francisco
293
6510 Summary on smoothing
294
66 Incorporating MLC equipment constraints in inverse planning
295
67 Beam direction optimization
296
68 Monte Carlo dose calculation
305
682 Determination of photon spectrum and phase space data for Monte Carlo calculations
307
684 MCDOSE
310
685 Speeding up Monte Carlo dose calculations
312
686 Monte Carlo calculation accuracy and error
313
688 Monte Carlo calculations in tomotherapy
315
6810 Other reports on Monte Carlo dosimetry
316
69 Energy in IMRT
317
610 Measuring and accounting for patienttumour movement
319
6102 Some observations of the effects of movement
320
6103 Optical imaging for movement correction
321
6031 Breast movement
323
61042 Intrafraction and interfraction lung movement measurements
327
6105 Ultrasound measurement of position
329
61051 The NOMOS BAT
331
61052 Other ultrasound systems developed
335
6106 Magnetic monitoring of position
337
61072 Gating based on xray fluoroscopic measurements
339
61073 Imaging and therapy gated by respiration monitor
341
61074 Measurements using oscillating phantoms
343
61075 Evidence against the need for gating
345
6108 Robotic feedback
346
6109 Heldbreath selfgating
347
61010 Intervention for immobilization
348
61012 Calculating the effect of tissue movement
351
610122 Use of multiple CT datasets and adaptive IMRT
352
610123 Modelling the effect of intrafraction movement
359
610124 Modelling setup inaccuracy
367
610125 Modelling the movement of OARs
368
6112 Flatpanel imaging for kVCT
372
612 MRI and IMRT simultaneously
374
613 IMRT using mixed photons and electrons
376
Epilogue
379
References
382
Index
464
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