scholarly journals ACTIVE INVOLVEMENT OF RADIOLOGIST IN RADIATION ONCOLOGY PRACTICE

2021 ◽  
Vol 10 (4) ◽  
pp. 3199-3201
Author(s):  
Anurag A. Luharia
Keyword(s):  
Radiation Oncology ◽  
Normal Tissue ◽  
Radiation Treatment ◽  
Imaging Modality ◽  
Tumour Volume ◽  
Target Volume ◽  
Ct Images ◽  
Radiotherapy Planning ◽  
Internal Target Volume ◽  
Radiotherapy Treatment

Advancements in Radiation Oncology from conventional to 3D conformal radiotherapy treatment demands expertise in many steps of radiation planning, the horizon of radiologist is now expanded by many folds and made radiologist as a integral part of the Radiation Oncology Department. A critical aspect of radiotherapy treatment planning (RTP) is determining how to deliver the required radiation dosage to cancer cells while minimising the exposure to normal tissue for which the prerequisite is identification and accurate delineation of tumour volume as well as normal structure resulted in an increase in the therapeutic ratio by reducing complication associated with normal tissue and allowing for higher target dosage and better local control. In modern radiotherapy CT images are the standard set of imaging modality required for the radiotherapy planning along with it many other modalities like MRI, PET or DSA are used by superimposing on original CT images in order to contour or delineate the structures defined by International Commission on Radiation Units and Measurements in Reports 50, 62 and 71 (ICRU) for radiotherapy planning which comprise of Gross tumour volume, clinical target volume, planning target volume, irradiated volume, Internal target volume and the normal structures as Organ at risk. It is self-evident that the contribution of a radiologist with a thorough knowledge of the development of these new modalities is critical for optimising the potential of these novel modes of radiation treatment delivery.

scholarly journals Advanced Imaging Techniques for Radiotherapy Planning of Gliomas

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1063
Author(s):  
Antonella Castellano ◽  
Michele Bailo ◽  
Francesco Cicone ◽  
Luciano Carideo ◽  
Natale Quartuccio ◽  
...  
Keyword(s):  
Radiation Treatment ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Clinical Results ◽  
Target Volume ◽  
Radiotherapy Planning ◽  
Tumor Control ◽  
Current Standard ◽  
Volume Delineation ◽  
Hemodynamic Information

The accuracy of target delineation in radiation treatment (RT) planning of cerebral gliomas is crucial to achieve high tumor control, while minimizing treatment-related toxicity. Conventional magnetic resonance imaging (MRI), including contrast-enhanced T1-weighted and fluid-attenuated inversion recovery (FLAIR) sequences, represents the current standard imaging modality for target volume delineation of gliomas. However, conventional sequences have limited capability to discriminate treatment-related changes from viable tumors, owing to the low specificity of increased blood-brain barrier permeability and peritumoral edema. Advanced physiology-based MRI techniques, such as MR spectroscopy, diffusion MRI and perfusion MRI, have been developed for the biological characterization of gliomas and may circumvent these limitations, providing additional metabolic, structural, and hemodynamic information for treatment planning and monitoring. Radionuclide imaging techniques, such as positron emission tomography (PET) with amino acid radiopharmaceuticals, are also increasingly used in the workup of primary brain tumors, and their integration in RT planning is being evaluated in specialized centers. This review focuses on the basic principles and clinical results of advanced MRI and PET imaging techniques that have promise as a complement to RT planning of gliomas.

Radiation oncology and functional imaging

2005 ◽  
Vol 44 (S 01) ◽  
pp. S38-S40
Author(s):  
Th. Herrmann
Keyword(s):  
Functional Imaging ◽  
Radiation Oncology ◽  
Bronchogenic Carcinoma ◽  
Brain Tumours ◽  
Tumour Volume ◽  
Target Volume ◽  
Head And Neck Tumours ◽  
Pet Ct ◽  
Surrounding Healthy Tissue ◽  
Prostate Carcinomas

Summary:PET/CT imaging is most likely to be of use in radiation oncology with patients who have poorly defined target volume areas, e.g. brain tumours, bronchogenic carcinoma, and cases of miscellaneous geographical miss. Other tumours that call for dose escalated radiotherapy, such as head and neck tumours, bronchogenic carcinoma, and prostate carcinomas may further benefit from an accurate delineation of the metabolically active tumour volume and its differentiation from surrounding healthy tissue, or tumour atelectasis.

scholarly journals Impact of 4D CT for treatment planning of moving targets: a computer-based biological evaluation

2017 ◽  
Vol 3 (2) ◽  
pp. 665-668
Author(s):  
Eike Helf ◽  
Oliver Waletzko ◽  
Christian Mehrens ◽  
Ralf Rohn ◽  
Andreas Block
Keyword(s):  
Treatment Plan ◽  
Tumour Volume ◽  
Target Volume ◽  
Biological Evaluation ◽  
Internal Target Volume ◽  
4D Ct ◽  
Tumour Control ◽  
Ct Data ◽  
Conventional Ct ◽  
The Impact

AbstractThis study deals with comparison of conventional and 4D CT (GE Lightspeed) planning on the tumour control probability (TCP), using the TCP model of the AAPM-Report Task Group 166. In the first step a VMAT treatment plan was calculated (Varian Eclipse 13.7) on basis of conventional CT data. This treatment plan was transferred to the complete 4D CT, which represents the tumour volume in motion. Due to the increased volume and the resulting decrease of tumour coverage the TCP went down from 97,6% to 91,2%. After adding an internal target volume (ITV, ICRU 62) to the conventional CT according to our clinical protocols (1,0 cm cc and 0,3 cm axial plane) the TCP increased to 98,0% when applying the conventional plan to the 4D CT. This finding demonstrates the need of 4D CT for moving tumours in chest and abdomen region.Average IPs with increasing width have been created to evaluate the impact on the TCP and the non-malignant tissue. Our observations had shown that heart, lung and spinal cord radiation exposure did not correlate to chosen respiration segment. This could be explained by the extremely slight ratio of the planning target volume and the irradiated normal tissue.This procedure enables us to evaluate the efficacy of treatment plans. Furthermore, optimizing trials like the influence of respiration-gated RT, setting individual margins and fitting planning objectives and parameters are still under investigation.

A technique of using gated-CT images to determine internal target volume (ITV) for fractionated stereotactic lung radiotherapy

2006 ◽  
Vol 78 (2) ◽  
pp. 177-184 ◽  
Author(s):  
Jian-Yue Jin ◽  
Munther Ajlouni ◽  
Qing Chen ◽  
Fang-Fang Yin ◽  
Benjamin Movsas
Keyword(s):  
Target Volume ◽  
Ct Images ◽  
Internal Target ◽  
Internal Target Volume ◽  
Lung Radiotherapy

Radiotherapy planning: PET/CT scanner performances in the definition of gross tumour volume and clinical target volume

2005 ◽  
Vol 32 (12) ◽  
pp. 1392-1399 ◽  
Author(s):  
Ernesto Brianzoni ◽  
Gloria Rossi ◽  
Sergio Ancidei ◽  
Alfonso Berbellini ◽  
Francesca Capoccetti ◽  
...  
Keyword(s):  
Clinical Target Volume ◽  
Tumour Volume ◽  
Target Volume ◽  
Radiotherapy Planning ◽  
Gross Tumour Volume ◽  
Ct Scanner ◽  
Pet Ct ◽  
Definition Of

FDG-PET/CT imaging for staging and definition of tumor volumes in radiation treatment planning in non-small cell lung cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7574-7574 ◽  
Author(s):  
Y. Xu ◽  
S. Ma ◽  
D. Yu ◽  
J. Wang ◽  
L. Zhang ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Fdg Pet ◽  
Radiation Treatment ◽  
Target Volume ◽  
Ct Images ◽  
Planning System ◽  
Treatment Planning System ◽  
Volume Delineation ◽  
Pet Ct ◽  
Fdg Pet Ct

7574 Background: 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) /computed tomography (CT) has a potential improvement for staging and radiation treatment (RT) planning of various tumor sites. But from a clinical standpoint, the open questions are essentially the following: to what extent does PET/CT change the target volume? Can PET/CT reduce inter-observer variability in target volume delineation? We analyzed the use of FDG-PET/ CT images for staging and evaluated the impact of FDG- PET/CT on the radiotherapy volume delineation compared with CT in patients with non-small cell lung cancer (NSCLC) candidates for radiotherapy. Intraobserver variation in delineating tumor volumes was also observed. Methods: Twenty-three patients with stage I-III NSCLC were enrolled in this pilot study and were treated with fractionated RT based therapy with or without chemotherapy. FDG-PET/CT scans were acquired within 2 weeks prior to RT. PET and CT data sets were sent to the treatment planning system Pinnacle through compact disc. The CT and PET images were subsequently fused by means of a dedicated radiation treatment planning system. Gross Tumor Volume (GTV) was contoured by four radiation oncologists respectively on CT (CT-GTV) and PET/CT images (PET/CT-GTV). The resulting volumes were analyzed and compared. Results: For the first phase, two radiation oncologists outlined together the contours achieving a final consensus. Based on PET/CT, changes in TNM categories occurred in 8/23 cases (35%). Radiation targeting with fused FDG-PET and CT images resulted in alterations in radiation therapy planning in 12/20 patients (60%) by comparison with CT targeting. The most prominent changes in GTV have been observed in cases with atelectasis. For the second phase was four intraobserver variation in delineating tumor volumes. The mean ratio of largest to smallest CT-based GTV was 2.31 (range 1.01–5.96). The addition of the PET data reduced the mean ratio to 1.46 (range 1.12–2.27). Conclusions: PET/CT fusion images could have a potential impact on both tumor staging and treatment planning. Implementing matched PET/CT reduced observer variation in delineating tumor volumes significantly with respect to CT only. [Table: see text]

Implementation and efficacy of a large-scale radiation oncology case-based peer-review quality program across a multinational cancer network.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 1-1
Author(s):  
Ethan B. Ludmir ◽  
Karen E. Hoffman ◽  
Anuja Jhingran ◽  
Mee-Chung Puscilla Ip ◽  
Seth D. Frey ◽  
...  
Keyword(s):  
Peer Review ◽  
Radiation Oncology ◽  
Large Scale ◽  
Radiation Treatment ◽  
Target Volume ◽  
National Standards ◽  
Case Volume ◽  
Target Volume Delineation ◽  
Volume Delineation ◽  
Cancer Network

1 Background: With rapid community expansion of academic cancer centers, ensuring high-quality delivery of care across all affiliated network sites is critical. Here we report the results of a radiation oncology peer-review system implemented across a large multinational cancer network. Methods: Weekly radiation oncology peer-review conferences were held between network centers and the main campus of a major cancer system; results of standardized peer-review for each case were recorded. Peer-review resulted in each case being scored as concordant or nonconcordant on initial review; nonconcordance was based on institutional guidelines, national standards, and/or expert opinion. Results: Between 2014 and 2018, 28,730 patient radiation treatment plans underwent peer-review at 10 network centers. The peer-review case volume increased over this study period, from 1,420 cases in 2014 to 9,112 in 2018, concomitant with network expansion. Examining cases reviewed in 2018 (N = 9,112), the most-commonly reviewed cases by disease site were breast (28.9%), head and neck (HN; 13.9%), and lung (12.6%). Of all cases in 2018, 452 (5.0%) were deemed nonconcordant. Higher nonconcordance rates were noted for HN cases (14.0%), and lower rates for lung cases (2.3%; p < 0.001). Of nonconcordant HN cases, the majority (69.5%) were deemed nonconcordant based on target volume delineation. Of nonconcordant breast cases, most (67.1%) were nonconcordant based on radiation field design. For centers added to the network during the study period, we observed a significant decrease in the nonconcordance rate over time after joining the network (average annual decrease of 5.4% in nonconcordant cases; p < 0.001). Conclusions: These data demonstrate the feasibility and efficacy of a large-scale multinational cancer network radiation oncology weekly peer-review program. Nonconcordance rates were highest for HN cases, primarily due to target volume delineation. With improved nonconcordance rates for newly-added network centers, these results offer the promise of improving the quality of radiotherapy delivery across an extensive cancer network with a major academic center as the nucleus.

SU-D-110-06: Delineation of Target Volume Based on FDG PET-CT Images and Its Effect on Tumor and Normal Tissue Doses

2011 ◽  
Vol 38 (6Part3) ◽  
pp. 3388-3388
Author(s):  
T De La Fuente Herman ◽  
H Ortega ◽  
S Thompson ◽  
T Herman ◽  
S Ahmad
Keyword(s):  
Fdg Pet ◽  
Normal Tissue ◽  
Target Volume ◽  
Ct Images ◽  
Pet Ct ◽  
Fdg Pet Ct

Prostate cancer

2019 ◽  
pp. 224-262
Author(s):  
Linus Benjamin ◽  
Alison Tree ◽  
David Dearnaley
Keyword(s):  
Prostate Cancer ◽  
Treatment Outcome ◽  
Palliative Radiotherapy ◽  
Target Volume ◽  
Seminal Vesicles ◽  
Radiotherapy Planning ◽  
Radical Radiotherapy ◽  
Future Developments ◽  
Radiotherapy Treatment

Chapter 10 discusses prostate cancer and includes discussion on indications including radical radiotherapy to prostate ± seminal vesicles, pelvic radiotherapy, post-prostatectomy radiotherapy, palliative radiotherapy to prostate ± pelvis, palliative radiotherapy to metastases, and breast bud radiotherapy for the prevention or treatment of gynaecomastia, radical radiotherapy planning, target volume definition , dose distribution, implementation, verification, dose prescription, toxicity and care during treatment, the role of hormonal therapy in combination with radical radiotherapy, treatment outcome, and future developments.

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