☆ 4.4 Review

SBRT targets that move with respiration

PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS (2018)

期刊

PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS

卷 56, 期 -, 页码 19-24

出版社

ELSEVIER SCI LTD

DOI: 10.1016/j.ejmp.2018.10.021

关键词

SBRT; Respiratory motion management; MRI linac; Dynamic MLC; Image-guided treatment

类别

Radiology, Nuclear Medicine & Medical Imaging

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摘要

The technology of treating SBRT targets that move with respiration has undergone profound changes over the last 20 years. This review article summarizes modern image guidance to localize the target in real-time to account for intra-fraction motion. The state-of-the art respiratory motion compensation techniques will be discussed, including the determination and application of appropriate margins. This includes compression, gating and breath-hold, including the use of audiovisual feedback to manage motion. Approaches to real-time tracking include the use of hybrid external-internal imaging to build a skin-to-tumor correlation, which can then be tracked with a mobile robot (CyberKnife Synchrony, clinical since 2003) as well as the use of non-ionizing electromagnetic tumor surrogate localization followed by real-time tracking with a moving MLC (in clinical trials in Europe and Australia). Lastly, the clinical application of real-time MRI soft-tissue imaging to deliver adaptive, iso-toxic treatments will be presented.

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