Image guidance for FLASH radiotherapy.
Image guidance for FLASH radiotherapy.
复制标题
DOI：
10.1002/mp.15662
复制
发表时间：
2022-06
期刊：
影响因子：
3.8
通讯作者：
Parodi, Katia
中科院分区：
文献类型：
--
作者：
El Naqa, Issam;Pogue, Brian W.;Zhang, Rongxiao;Oraiqat, Ibrahim;Parodi, Katia
FLASH放射治疗（FLASH-RT）是一种新兴的超高剂量（40 Gy/s）放射治疗，与传统放射治疗相比，它有望通过限制毒性来提高治疗潜力，同时保持类似的肿瘤根除效果。图像引导是现代放射治疗的一个重要组成部分，应加以利用，以满足FLASH-RT新出现的特殊需求，以及在短时间内规划和提供这种超高剂量时的相关高风险。因此，本文将详细阐述FLASH-RT治疗整个链中的成像要求和可能的解决方案，从计划，通过在线体内成像和剂量测定的设置和交付，直到生物机制和治疗反应的评估。在患者设置和交付中，比传统RT更高的时间采样应确保短期治疗精确地交付到目标区域。此外，传统的成像工具，如锥束计算机断层扫描（CBCT）将继续在改善分娩前的患者设置方面发挥重要作用，而基于磁共振成像（MRI）或正电子发射断层扫描（PET）的技术可能对Linac或粒子FLASH治疗非常有价值，以监测和跟踪分娩过程中的解剖变化。在计划或评估结果时，定量功能成像可以补充常规成像，以更准确地利用FLASH效应的生物窗口，选择或验证组织氧和FLASH- rt递送相关时间尺度上的现有或短暂缺氧等因素。也许目前最重要的是，这些工具可能有助于提高对肿瘤和正常组织中FLASH-RT反应的生物学机制的理解。FLASH的高剂量沉积提供了利用脉冲对脉冲成像工具（如Cherenkov或辐射声发射成像）的机会。这些可以分别提供单独的脉冲映射或评估表面或组织深度的3D剂量传递。总之，现代放射治疗中最有前途的成分应该用于更安全的FLASH-RT应用，新的有前途的发展可以推进，以满足其新的需求，同时也利用新的机会，以前所未有的剂量率脉冲递送的独特性，开启生物图像引导和超快速，基于脉冲的体内剂量测定的新时代。
FLASH radiotherapy (FLASH-RT) is an emerging ultra-high dose (>40 Gy/s) delivery that promises to improve the therapeutic potential by limiting toxicities compared to conventional RT while maintaining similar tumor eradication efficacy. Image-guidance is an essential component of modern RT that should be harnessed to meet the special emerging needs of FLASH-RT and its associated high risks in planning and delivering of such ultra-high doses in short period of times. Hence, this contribution will elaborate on the imaging requirements and possible solutions in the entire chain of FLASH-RT treatment, from the planning, through the setup and delivery with online in vivo imaging and dosimetry, up to the assessment of biological mechanisms and treatment response. In patient setup and delivery, higher temporal sampling than in conventional RT should ensure that the short treatment is delivered precisely to the targeted region. Additionally, conventional imaging tools such as cone-beam computed tomography (CBCT) will continue to play an important role in improving patient setup prior to delivery, while techniques based on magnetic resonance imaging (MRI) or positron-emission-tomography (PET) may be extremely valuable for either Linac or particle FLASH therapy, to monitor and track anatomical changes during delivery. In either planning or assessing outcomes, quantitative functional imaging could supplement conventional imaging for more accurate utilization of the biological window of the FLASH effect, selecting for or verifying things such as tissue oxygen and existing or transient hypoxia on the relevant time scales of FLASH-RT delivery. Perhaps most importantly at this time, these tools might help improve the understanding of the biological mechanisms of FLASH-RT response in tumor and normal tissues. The high dose deposition of FLASH provides an opportunity to utilize pulse-to-pulse imaging tools such as Cherenkov or radiation acoustic emission imaging. These could provide individual pulse mapping or assessing the 3D dose delivery superficially or at tissue depth, respectively. In summary, the most promising components of modern RT should be used for safer application of FLASH-RT, and new promising developments could be advanced to cope with its novel demands but also exploit new opportunities in connection with the unique nature of pulsed delivery at unprecedented dose rates, opening a new era of biological image guidance and ultra-fast, pulse-based in vivo dosimetry.
登录
查看更多内容
影响因子：
3.8
作者：
Favaudon V;Labarbe R;Limoli CL
通讯作者：
Limoli CL
影响因子：
3.5
作者：
Dickmann, J.;Sarosiek, C.;Dedes, G.
通讯作者：
Dedes, G.
DOI：
10.1016/j.ijrobp.2021.03.056
发表时间：
2021-09-01
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Cao X;Zhang R;Esipova TV;Allu SR;Ashraf R;Rahman M;Gunn JR;Bruza P;Gladstone DJ;Williams BB;Swartz HM;Hoopes PJ;Vinogradov SA;Pogue BW
通讯作者：
Pogue BW
影响因子：
5.7
作者：
Boscolo, Daria;Scifoni, Emanuele;Fuss, Martina C.
通讯作者：
Fuss, Martina C.
DOI：
10.1016/j.ijrobp.2020.10.021
发表时间：
2021-03-15
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Glide-Hurst CK;Lee P;Yock AD;Olsen JR;Cao M;Siddiqui F;Parker W;Doemer A;Rong Y;Kishan AU;Benedict SH;Li XA;Erickson BA;Sohn JW;Xiao Y;Wuthrick E
通讯作者：
Wuthrick E