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A modern review of the uncertainties in volumetric imaging of respiratory-induced target motion in lung radiotherapy.
Medical Physics ( IF 3.2 ) Pub Date : 2020-06-07 , DOI: 10.1002/mp.14312
Irina Vergalasova 1 , Jing Cai 2
Affiliation  

Radiotherapy has become a critical component for the treatment of all stages and types of lung cancer, often times being the primary gateway to a cure. However, given that radiation can cause harmful side effects depending on how much surrounding healthy tissue is exposed, treatment of the lung can be particularly challenging due to the presence of moving targets. Careful implementation of every step in the radiotherapy process is absolutely integral for attaining optimal clinical outcomes. With the advent and now widespread use of stereotactic body radiation therapy (SBRT), where extremely large doses are delivered, accurate, and precise dose targeting is especially vital to achieve an optimal risk to benefit ratio. This has largely become possible due to the rapid development of image‐guided technology. Although imaging is critical to the success of radiotherapy, it can often be plagued with uncertainties due to respiratory‐induced target motion. There has and continues to be an immense research effort aimed at acknowledging and addressing these uncertainties to further our abilities to more precisely target radiation treatment. Thus, the goal of this article is to provide a detailed review of the prevailing uncertainties that remain to be investigated across the different imaging modalities, as well as to highlight the more modern solutions to imaging motion and their role in addressing the current challenges.

中文翻译:

肺部放射治疗中呼吸诱发的目标运动的体积成像不确定性的现代综述。

放射疗法已成为治疗所有阶段和类型的肺癌的重要组成部分,常常是治愈癌症的主要途径。但是,根据周围健康组织的暴露程度,放射线会导致有害的副作用,由于存在移动的靶标,对肺部的治疗尤其具有挑战性。仔细实施放射治疗过程中的每个步骤对于获得最佳临床效果绝对是必不可少的。随着立体定向身体放射疗法(SBRT)的出现和现在的广泛使用,在这种疗法中,要交付的剂量非常大,准确而精确的剂量靶向对于实现最佳的风险受益比尤其重要。由于图像引导技术的迅速发展,这在很大程度上已经成为可能。尽管成像对放射治疗的成功至关重要,但由于呼吸诱发的目标运动,成像常常会受到不确定性的困扰。过去并一直在进行大量的研究工作,旨在确认和解决这些不确定性,以提高我们更准确地针对放射治疗的能力。因此,本文的目的是提供对当前不确定性的详细审查,这些不确定性仍需在不同的成像方式之间进行研究,并着重介绍更现代的成像运动解决方案及其在解决当前挑战中的作用。过去并一直在进行大量的研究工作,旨在确认和解决这些不确定性,以提高我们更准确地针对放射治疗的能力。因此,本文的目的是提供对当前不确定性的详细审查,这些不确定性仍需在不同的成像方式之间进行研究,并着重介绍更现代的成像运动解决方案及其在解决当前挑战中的作用。过去并一直在进行大量的研究工作,旨在确认和解决这些不确定性,以提高我们更准确地针对放射治疗的能力。因此,本文的目的是对目前存在的不确定性进行详细的回顾,这些不确定性仍需在不同的成像方式中进行研究,并着重强调更现代的成像运动解决方案及其在解决当前挑战中的作用。
更新日期:2020-06-07
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