Dynamic targeting image-guided radiotherapy

Journal Article · Sat Jul 01 00:00:00 EDT 2006 · Medical Dosimetry

DOI:https://doi.org/10.1016/j.meddos.2005.12.014· OSTI ID:20783360

Huntzinger, Calvin ^[1]; Munro, Peter ^[1]; Johnson, Scott ^[1]; Miettinen, Mika ^[1]; Zankowski, Corey ^[1]; Ahlstrom, Greg ^[2]; Glettig, Reto ^[3]; Filliberti, Reto ^[3]; Kaissl, Wolfgang ^[3]; Kamber, Martin ^[3]; Amstutz, Martin ^[3]; Bouchet, Lionel ^[4]; Klebanov, Dan ^[4]; Mostafavi, Hassan ^[5]; Stark, Richard ^[1]

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1. Varian Medical Systems, Palo Alto, CA (United States)
2. Varian Medical Systems, Crawley (United Kingdom)
3. Varian Medical Systems, Baden (Switzerland)
4. Varian Medical Systems, Holliston, MA (United States)
5. Varian Medical Systems, Mountain View, CA (United States)

Volumetric imaging and planning for 3-dimensional (3D) conformal radiotherapy and intensity-modulated radiotherapy (IMRT) have highlighted the need to the oncology community to better understand the geometric uncertainties inherent in the radiotherapy delivery process, including setup error (interfraction) as well as organ motion during treatment (intrafraction). This has ushered in the development of emerging technologies and clinical processes, collectively referred to as image-guided radiotherapy (IGRT). The goal of IGRT is to provide the tools needed to manage both inter- and intrafraction motion to improve the accuracy of treatment delivery. Like IMRT, IGRT is a process involving all steps in the radiotherapy treatment process, including patient immobilization, computed tomogaphy (CT) simulation, treatment planning, plan verification, patient setup verification and correction, delivery, and quality assurance. The technology and capability of the Dynamic Targeting{sup TM} IGRT system developed by Varian Medical Systems is presented. The core of this system is a Clinac (registered) or Trilogy{sup TM} accelerator equipped with a gantry-mounted imaging system known as the On-Board Imager{sup TM} (OBI). This includes a kilovoltage (kV) x-ray source, an amorphous silicon kV digital image detector, and 2 robotic arms that independently position the kV source and imager orthogonal to the treatment beam. A similar robotic arm positions the PortalVision{sup TM} megavoltage (MV) portal digital image detector, allowing both to be used in concert. The system is designed to support a variety of imaging modalities. The following applications and how they fit in the overall clinical process are described: kV and MV planar radiographic imaging for patient repositioning, kV volumetric cone beam CT imaging for patient repositioning, and kV planar fluoroscopic imaging for gating verification. Achieving image-guided motion management throughout the radiation oncology process requires not just a single product, but a suite of integrated products to manipulate all patient data, including images, efficiently and effectively.

• OSTI ID: 20783360
• Journal Information: Medical Dosimetry, Vol. 31, Issue 2; Other Information: DOI: 10.1016/j.meddos.2005.12.014; PII: S0958-3947(05)00200-1; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0958-3947
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ACCELERATORS
ACCURACY
BEAMS
CORRECTIONS
ERRORS
IMAGES
PATIENTS
PLANNING
QUALITY ASSURANCE
RADIOTHERAPY
VERIFICATION
X-RAY SOURCES