scholarly journals Modern Imaging Techniques and Their Role in Contact Radiation Therapy (Brachytherapy) Planning

2021 ◽  
Vol 102 (5) ◽  
pp. 268-275
Author(s):  
N. V. Nudnov ◽  
V. A. Titova
Keyword(s):  
At Risk ◽  
Radiation Therapy ◽  
Imaging Techniques ◽  
Organs At Risk ◽  
Subjective Assessment ◽  
Diagnostic Study ◽  
Mathematical Tool ◽  
Positron Emission ◽  
Promising Area ◽  
High Level

The paper considers an algorithm for the diagnostic study of patients with cancer of different localization, the possibility and feasibility of involving imaging techniques in radiation therapy and brachytherapy (BT) planning. The most widely used ultrasound in BT planning does not exclude a subjective assessment of the boundaries of the tumor and organs at risk, as well as the inaccuracies caused by endostatic devices. Magnetic resonance imaging (MRI) provides a high level of achievement of the criteria necessary for BT planning, but it has financial constraints and the need for individual selection of research conditions. Computed tomography (CT) is the most effective technique for visualizing the tumor, endostatic devices, and organs at risk for BT 3D planning. The involvement of MRI and positron emission tomography with CT in BT planning is a promising area that requires equipping with a mathematical tool for double and triple contouring of the tumor and organs at risk and for defining protection priorities. The prescribed and used focal dose should be controlled by direct dosimetry methods to ensure quality assurance.

Normal-tissue toxicities of thoracic radiation therapy: esophagus, lung, and spinal cord as organs at risk

2004 ◽  
Vol 18 (1) ◽  
pp. 131-160 ◽  
Author(s):  
Maria Werner-Wasik ◽  
Xiaoli Yu ◽  
Lawrence B Marks ◽  
Timothy E Schultheiss
Keyword(s):  
Spinal Cord ◽  
At Risk ◽  
Radiation Therapy ◽  
Normal Tissue ◽  
Organs At Risk ◽  
Thoracic Radiation

scholarly journals PUB113 Organs at Risk Contouring in Lung Cancer Radiation Therapy: An Anatomo-Radiological Atlas

2017 ◽  
Vol 12 (1) ◽  
pp. S1512-S1513
Author(s):  
Maria Taraborrelli ◽  
Marianna Nuzzo ◽  
Annamaria Vinciguerra ◽  
Marianna Trignani ◽  
Francesca Perrotti ◽  
...  
Keyword(s):  
Lung Cancer ◽  
At Risk ◽  
Radiation Therapy ◽  
Organs At Risk

scholarly journals Development and Implementation of Proton Therapy for Hodgkin Lymphoma: Challenges and Perspectives

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3744
Author(s):  
Pierre Loap ◽  
Ludovic De Marzi ◽  
Alfredo Mirandola ◽  
Remi Dendale ◽  
Alberto Iannalfi ◽  
...  
Keyword(s):  
At Risk ◽  
Radiation Therapy ◽  
Hodgkin Lymphoma ◽  
Proton Therapy ◽  
Early Stage ◽  
Organs At Risk ◽  
Intensity Modulated Radiation Therapy ◽  
Progression Free Survival ◽  
Treatment Techniques ◽  
Increased Risk

Consolidative radiation therapy for early-stage Hodgkin lymphoma (HL) improves progression-free survival. Unfortunately, first-generation techniques, relying on large irradiation fields, were associated with an increased risk of secondary cancers, and of cardiac and lung toxicity. Fortunately, the use of smaller target volumes combined with technological advances in treatment techniques currently allows efficient organs-at-risk sparing without altering tumoral control. Recently, proton therapy has been evaluated for mediastinal HL treatment due to its potential to significantly reduce the dose to organs-at-risk, such as cardiac substructures. This is expected to limit late radiation-induced toxicity and possibly, second-neoplasm risk, compared with last-generation intensity-modulated radiation therapy. However, the democratization of this new technique faces multiple issues. Determination of which patient may benefit the most from proton therapy is subject to intense debate. The development of new effective systemic chemotherapy and organizational, societal, and political considerations might represent impediments to the larger-scale implementation of HL proton therapy. Based on the current literature, this critical review aims to discuss current challenges and controversies that may impede the larger-scale implementation of mediastinal HL proton therapy.

Intensity-modulated radiation therapy (IMRT): Differences in target volumes and improvement in clinically relevant doses to small bowel in rectal carcinoma.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 586-586
Author(s):  
H. Mok ◽  
C. H. Crane ◽  
T. Briere ◽  
S. Beddar ◽  
M. E. Delclos ◽  
...  
Keyword(s):  
At Risk ◽  
Rectal Cancer ◽  
Radiation Therapy ◽  
Small Bowel ◽  
Rectal Carcinoma ◽  
Organs At Risk ◽  
Intensity Modulated Radiation Therapy ◽  
Preoperative Treatment ◽  
Conformal Radiation Therapy ◽  
Intensity Modulated

586 Background: In the treatment of rectal cancer, a strong dose-volume relationship exists between the amount of small bowel receiving low- to intermediate-doses of radiation and the rates of acute, severe gastrointestinal toxicity. Highly conformal treatment approaches, such as intensity-modulated radiation therapy (IMRT), may reduce dose to adjacent organs-at-risk (OAR). We performed a dosimetric evaluation of IMRT compared to 3-dimensional conformal radiation therapy (3DCRT) in standard, preoperative treatment for rectal cancer. Methods: Using RTOG consensus contouring atlas, treatment volumes were generated for ten patients treated preoperatively, with IMRT plans compared to 3DCRT plans derived from classic anatomic landmarks, as well as modified 3DCRT plans treating the RTOG consensus volume. The patients were all T3, were node-negative (N=1) or node–positive (N=9), and were planned to a total dose of 45-Gy. Bowel displacement was achieved using a carbon-fiber bellyboard apparatus with prone positioning. Results: IMRT plans had superior PTV coverage, dose homogeneity, and conformality in treatment of the gross disease and at-risk nodal volume, in comparison to 3DCRT. Additionally, in comparison to the modified 3DCRT plans, IMRT achieved a concomitant reduction in doses to the bowel, bladder, pelvic bones, and femoral heads, with an improvement in absolute volumes of small bowel receiving dose levels known to induce clinically-relevant acute toxicity. In the six patients with the highest volume of small bowel (range: 209-537-cc), the volume of bowel receiving 15-Gy was reduced from a median of 224-cc in the modified 3DCRT plans to 185-cc with IMRT. Also, the IMRT volumes were typically larger than that covered by classic 3DCRT fields, without incurring penalty with respect to adjacent OAR. Conclusions: For rectal carcinoma, IMRT, compared to 3DCRT, yielded plans with superior target coverage, homogeneity, and conformality, while lowering dose to adjacent OAR. This is despite treating larger volumes, raising the possibility of a clinically-relevant improvement in the therapeutic ratio through the use of IMRT with a belly-board apparatus. No significant financial relationships to disclose.

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