Image guidance for precise conformal radiotherapy
Image guidance for precise conformal radiotherapy
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DOI：
10.1016/s0360-3016(03)00090-7
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发表时间：
2003-05-01
影响因子：
7
通讯作者：
Mehta, M
中科院分区：
文献类型：
--
作者：
Mackie, TR;Kapatoes, J;Mehta, M
目的：综述影像引导精确适形放射治疗的现状，并描述螺旋断层放疗与为常规放疗所开发的影像引导实践相比情况如何。
方法与材料：影像引导正开始成为放射治疗计划、实施和验证的基本依据。放射治疗计划要求在疾病的范围确定和定位上更加精确。当无法达到更高精度时，可能需要采用适形避让方法，即除了存在敏感正常组织的部位外，疾病扩展的边界要足够大。放射治疗的实施要求在治疗体积的界定上有更好的精度，必要时需每日进行。螺旋断层放疗被设计为利用CT成像技术来计划、实施并验证治疗是否按计划进行。文中描述了螺旋断层放疗实现这一目标的影像引导过程。
结果：展示了影像引导调强放射治疗的螺旋断层放疗过程结果的实例。这些过程包括兆伏级CT采集、CT图像的自动分割、利用CT图像集进行剂量重建、CT图像的变形配准以及重新优化。
结论：影像引导精确适形放射治疗可作为一种治疗肿瘤同时保护关键结构的工具。螺旋断层放疗从一开始就被设计为一个集成的影像引导调强放射治疗系统，并允许基于兆伏级CT图像的新型验证过程得以实施。（C）2003爱思唯尔公司
Purpose: To review the state of the art in image-guided precision conformal radiotherapy and to describe how helical tomotherapy compares with the image-guided practices being developed for conventional radiotherapy.Methods and Materials: Image guidance is beginning to be the fundamental basis for radiotherapy planning, delivery, and verification. Radiotherapy planning requires more precision in the extension and localization of disease. When greater precision is not possible, conformal avoidance methodology may be indicated whereby the margin of disease extension is generous, except where sensitive normal tissues exist. Radiotherapy delivery requires better precision in the definition of treatment volume, on a daily basis if necessary. Helical tomotherapy has been designed to use CT imaging technology to plan, deliver, and verify that the delivery has been carried out as planned. The image-guided processes of helical tomotherapy that enable this goal are described.Results: Examples of the results of helical tomotherapy processes for image-guided intensity-modulated radiotherapy are presented. These processes include megavoltage CT acquisition, automated segmentation of CT images, dose reconstruction using the CT image set, deformable registration of CT images, and reoptimization.Conclusion: Image-guided precision conformal radiotherapy can be used as a tool to treat the tumor yet spare critical structures. Helical tomotherapy has been designed from the ground up as an integrated image-guided intensity-modulated radiotherapy system and allows new verification processes based on megavoltage CT images to be implemented. (C) 2003 Elsevier Inc.