Image-Guided
Radiation Therapy
MUHAMMED ANEES.K
MSc RADIATION PHYSICS
UNIVERSITYOF CALICUT
1
The process of frequent imaging (2D / 3D),
before and during course of radiation treatment
merit
static &
mobile
targets 2
or
I
G
-
I
M
R
T
or
I
G
R
T
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4
Elekta's Synergy
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Varian's Trilogy
TREATMENT with IGRT
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On-Board
Imagers
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ON-BOARD IMAGERS
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9
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1- Portal & Radiographic Imagers
(a)
(b)
256 × 256
solid
state
detectors
Two
Imaging
system
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Electronic Portal Imaging Device (EPID)
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On-board
imaging
EPID
Cone beam CT
256 × 256
solid
state
detectors
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See the
difference
OBI
Gives 2-D
Images
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2- In-Room CT-Scanner
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High-Resolution
3-D Patient Anatomy
Help toTarget
Localization
Dose Distribution
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3 Cone Beam ComputedTomography
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Cone Beam Formation
Cone Beam
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Kilo voltage Cone-Beam CT
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Mega voltage Cone-Beam CT
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Advantages of Mv-CBCT over Kv-CBCT
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Advantages of kV-CBCT over MV-CBCT
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4- Helical Tomotherapy
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MV-CT
image
Acquisition
IMRT
Treatment
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HelicalTomotherapy
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continue…,
Linac
Ring Gantry
Couch
Multi Leaf
Collimator
Imaging Detector
Beam Stop
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5- ULTRASOUND

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Ultrasound Systems
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US
2-D or 3-D ultrasound
imaging system
integrated with
Medical Linac
BAT system
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What Can we do With the Images ?
or
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WHY IGRT ?
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WHY IGRT ?
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Management of Respiratory Motion
4D- ComputedTomography Real-TimeTumorTracking
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1, 4-D Computed Tomography
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39
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4-D CT Continue…,
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4-D CT Data Acquisition
Prospective Gating Retrospective Gating
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images are collected only at one
phase of the respiratory cycle
Or Registration of the CT images
After Data of Respiratory Phases the have been acquired
1, Prospective Gating
scan data are
acquired at all
phases of
respiration and the
correlation
2. Retrospective Gating
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the beam on
only at the
selected times of
respiration
Including
both
Inspiration
and
Expiration
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2, Real-TimeTumorTracking
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Real-TimeTumor Tracking
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Electromagnetic
FieldTracking
Fluoroscopy-BasedTracking Systems
These systems are discussed below as examples…….,
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Fluoroscopy-BasedTracking Systems
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1- Room-Mounted Systems
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Room-Mounted Systems
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continue…,
2-Linac Gantry-Mounted Systems
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3-Robotic Systems
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Conformal dose
Distribution for
Irregularly tumors
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Electromagnetic FieldTracking
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MRI–Guided RadiationTherapy
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MRI–Guided Radiation Therapy
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MRI–Guided RadiationTherapy
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REFERENCE
 Treatment Planning in Radiation Oncology by F M Khan
 Physics of RadiationTherapy (4th Edition ) by F M Khan
 Overview of Image-Guided RadiationTherapy by Lei xing,
Ph.D,BrianThorndyke, Ph.D ,University of Stanford
 IMRT, IGRT, SBRT – Advances in theTreatment Planning
and Delivery of Radiotherapy by John L. Meyer
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Image guided radiation therapy (IGRT)