Online Adaptive Radiation Therapy
The current paradigm of radiation therapy has the treatment planned on a snapshot dataset of the patient's anatomy taken at the time of simulation. Throughout the course of treatment, this snapshot may vary from initial simulation. Although there is the ability to image patients within the trea...
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| Published in | International journal of radiation oncology, biology, physics Vol. 99; no. 4; pp. 994 - 1003 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
15.11.2017
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| Subjects | |
| Online Access | Get full text |
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| Abstract | The current paradigm of radiation therapy has the treatment planned on a snapshot dataset of the patient's anatomy taken at the time of simulation. Throughout the course of treatment, this snapshot may vary from initial simulation. Although there is the ability to image patients within the treatment room with technologies such as cone beam computed tomography, the current state of the art is largely limited to rigid-body matching and not accounting for any geometric deformations in the patient's anatomy. A plan that was once attuned to the initial simulation can become suboptimal as the treatment progresses unless improved technologies are brought to bear. Adaptive radiation therapy (ART) is an evolving paradigm that seeks to address this deficiency by accounting for ongoing changes in the patient's anatomy and/or physiology during the course of treatment, affording an increasingly more accurate targeting of disease. ART relies on several components working in concert, namely in-room treatment image guidance, deformable image registration, automatic recontouring, plan evaluation and reoptimization, dose calculation, and quality assurance. Various studies have explored how a putative ART solution would improve the current state of the art of radiation therapy—some centers have even clinically implemented online adaptation. These explorations are reviewed here for a variety of sites. |
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| AbstractList | The current paradigm of radiation therapy has the treatment planned on a snapshot dataset of the patient's anatomy taken at the time of simulation. Throughout the course of treatment, this snapshot may vary from initial simulation. Although there is the ability to image patients within the treatment room with technologies such as cone beam computed tomography, the current state of the art is largely limited to rigid-body matching and not accounting for any geometric deformations in the patient's anatomy. A plan that was once attuned to the initial simulation can become suboptimal as the treatment progresses unless improved technologies are brought to bear. Adaptive radiation therapy (ART) is an evolving paradigm that seeks to address this deficiency by accounting for ongoing changes in the patient's anatomy and/or physiology during the course of treatment, affording an increasingly more accurate targeting of disease. ART relies on several components working in concert, namely in-room treatment image guidance, deformable image registration, automatic recontouring, plan evaluation and reoptimization, dose calculation, and quality assurance. Various studies have explored how a putative ART solution would improve the current state of the art of radiation therapy—some centers have even clinically implemented online adaptation. These explorations are reviewed here for a variety of sites. Abstract The current paradigm of radiation therapy has the treatment planned on a snapshot data set of the patient anatomy taken at the time of simulation. Throughout the course of treatment, this snapshot may vary from initial simulation. Although there is the ability to image patients within the treatment room with technologies like cone-beam computed tomography (CBCT), the current state-of-the-art is largely limited to rigid body matching and not accounting for any geometric deformations in the patient anatomy. A plan that was once attuned to the initial simulation can become sub-optimal as the treatment progresses unless improved technologies are brought to bear. Adaptive radiation therapy (ART) is an evolving paradigm that seeks to address this deficiency by accounting for ongoing changes in the patient anatomy and/or physiology during the course of treatment, affording an increasingly more accurate targeting of disease. ART relies upon several components working in concert, namely: in-room treatment image guidance, deformable image registration (DIR), automatic re-contouring, plan evaluation and re-optimization, dose calculation, and quality assurance. Various studies have explored how a putative ART solution would improve the current state-of-the-art of radiation therapy—some centers have even clinically implemented online adaptation. These explorations are reviewed here for a variety of sites. The current paradigm of radiation therapy has the treatment planned on a snapshot dataset of the patient's anatomy taken at the time of simulation. Throughout the course of treatment, this snapshot may vary from initial simulation. Although there is the ability to image patients within the treatment room with technologies such as cone beam computed tomography, the current state of the art is largely limited to rigid-body matching and not accounting for any geometric deformations in the patient's anatomy. A plan that was once attuned to the initial simulation can become suboptimal as the treatment progresses unless improved technologies are brought to bear. Adaptive radiation therapy (ART) is an evolving paradigm that seeks to address this deficiency by accounting for ongoing changes in the patient's anatomy and/or physiology during the course of treatment, affording an increasingly more accurate targeting of disease. ART relies on several components working in concert, namely in-room treatment image guidance, deformable image registration, automatic recontouring, plan evaluation and reoptimization, dose calculation, and quality assurance. Various studies have explored how a putative ART solution would improve the current state of the art of radiation therapy-some centers have even clinically implemented online adaptation. These explorations are reviewed here for a variety of sites.The current paradigm of radiation therapy has the treatment planned on a snapshot dataset of the patient's anatomy taken at the time of simulation. Throughout the course of treatment, this snapshot may vary from initial simulation. Although there is the ability to image patients within the treatment room with technologies such as cone beam computed tomography, the current state of the art is largely limited to rigid-body matching and not accounting for any geometric deformations in the patient's anatomy. A plan that was once attuned to the initial simulation can become suboptimal as the treatment progresses unless improved technologies are brought to bear. Adaptive radiation therapy (ART) is an evolving paradigm that seeks to address this deficiency by accounting for ongoing changes in the patient's anatomy and/or physiology during the course of treatment, affording an increasingly more accurate targeting of disease. ART relies on several components working in concert, namely in-room treatment image guidance, deformable image registration, automatic recontouring, plan evaluation and reoptimization, dose calculation, and quality assurance. Various studies have explored how a putative ART solution would improve the current state of the art of radiation therapy-some centers have even clinically implemented online adaptation. These explorations are reviewed here for a variety of sites. |
| Author | Kim, Anthony Al-Ward, Shahad Lim-Reinders, Stephanie Keller, Brian M. Sahgal, Arjun |
| Author_xml | – sequence: 1 givenname: Stephanie surname: Lim-Reinders fullname: Lim-Reinders, Stephanie organization: Sunnybrook Health Sciences Centre/Odette Cancer Centre, Toronto, Ontario, Canada – sequence: 2 givenname: Brian M. surname: Keller fullname: Keller, Brian M. organization: Sunnybrook Health Sciences Centre/Odette Cancer Centre, Toronto, Ontario, Canada – sequence: 3 givenname: Shahad orcidid: 0000-0002-4457-284X surname: Al-Ward fullname: Al-Ward, Shahad organization: Sunnybrook Health Sciences Centre/Odette Cancer Centre, Toronto, Ontario, Canada – sequence: 4 givenname: Arjun surname: Sahgal fullname: Sahgal, Arjun organization: Sunnybrook Health Sciences Centre/Odette Cancer Centre, Toronto, Ontario, Canada – sequence: 5 givenname: Anthony orcidid: 0000-0003-2609-6912 surname: Kim fullname: Kim, Anthony email: Anthony.Kim@sunnybrook.ca organization: Sunnybrook Health Sciences Centre/Odette Cancer Centre, Toronto, Ontario, Canada |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28916139$$D View this record in MEDLINE/PubMed https://www.osti.gov/biblio/22723047$$D View this record in Osti.gov |
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| Snippet | The current paradigm of radiation therapy has the treatment planned on a snapshot dataset of the patient's anatomy taken at the time of simulation. Throughout... Abstract The current paradigm of radiation therapy has the treatment planned on a snapshot data set of the patient anatomy taken at the time of simulation.... |
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| SubjectTerms | Breast Neoplasms - diagnostic imaging Breast Neoplasms - radiotherapy COMPUTERIZED TOMOGRAPHY Cone-Beam Computed Tomography - methods Female Head and Neck Neoplasms - diagnostic imaging Head and Neck Neoplasms - radiotherapy Hematology, Oncology and Palliative Medicine Humans IMAGE PROCESSING Male Neoplasms - diagnostic imaging Neoplasms - radiotherapy Organs at Risk - diagnostic imaging Pancreatic Neoplasms - diagnostic imaging Pancreatic Neoplasms - radiotherapy PATIENTS Prostatic Neoplasms - diagnostic imaging Prostatic Neoplasms - radiotherapy Quality Assurance, Health Care RADIATION DOSES Radiology RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted - methods Radiotherapy Planning, Computer-Assisted - standards Radiotherapy, Image-Guided - methods Radiotherapy, Image-Guided - standards Radiotherapy, Intensity-Modulated - methods Radiotherapy, Intensity-Modulated - standards SIMULATION Urinary Bladder Neoplasms - diagnostic imaging Urinary Bladder Neoplasms - radiotherapy Uterine Cervical Neoplasms - diagnostic imaging Uterine Cervical Neoplasms - radiotherapy Workflow |
| Title | Online Adaptive Radiation Therapy |
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