Imaging and image-guided radiation therapy in liver cancer.

Imaging and image-guided radiation therapy in liver cancer.
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DOI:
10.1016/j.semradonc.2011.05.001
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发表时间:
2011-10
影响因子:
3.5
通讯作者:
Brock, Kristy K.
Brock, Kristy K.
中科院分区:
医学2区
文献类型:
--
作者:
Brock, Kristy K.

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放射治疗计划和交付的影像学是肝癌放射计划过程的关键组成部分。由于肝脏肿瘤与周围肝脏缺乏固有的对比,因此需要在规划CT上进行静脉造影剂以准确描绘目标。造影的适当分期是肿瘤特异性的,动脉期显像通常用于确定肝细胞癌,静脉期显像用于诊断与肝细胞癌和大多数类型肝转移相关的血管血栓。每天的呼吸运动和肝脏位置的变化可能是实质性的,需要在放射计划和治疗时考虑。许多类型的综合成像-辐射治疗系统和图像引导策略可用于在治疗交付时产生体积和/或平面成像,以减少可能发生的几何变化的负面影响。图像引导放射治疗(IGRT)可以提高放射治疗的精度,因此规定的剂量更有可能代表实际交付的剂量。
Imaging for radiation therapy treatment planning and delivery is a critical component of the radiation planning process for liver cancer. Due to the lack of inherent contrast between liver tumors and the surrounding liver, intravenous contrast is required for accurate target delineation on the planning CT. The appropriate phase of contrast is tumor specific, with arterial phase imaging usually used to define hepatocellular carcinoma, and venous phase imaging for vascular thrombosis related to hepatocellular carcinoma and most types of liver metastases. Breathing motion and changes in the liver position day-to-day may be substantial and need to be considered at the time of radiation planning and treatment. Many types of integrated imaging-radiation treatment systems and image guidance strategies are available to produce volumetric and/or planar imaging at the time of treatment delivery to reduce the negative impact of geometric changes that may occur. Image guided radiation therapy (IGRT) can improve the precision of radiation therapy, so that the prescribed doses are more likely to represent those actually delivered.
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