Computer-Controlled Radiation Therapy

Mb, Levene; Pk, Kijewski; Lm, Chin; Be, Bjärngard; Hellman, Samuel

doi:10.1148/129.3.769

Cited by 53 publications

(11 citation statements)

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“…[7][8][9][10][11][12][13][14][15][16][17][18][19][20] The concept of shielding normal tissues dynamically had been suggested since 1960's. [21][22][23] Computer controlled approaches were attempted by Levene et al 24 before the emergence of high speed computing. Today, the MLC is used in a wide variety of designs.…”

Section: Introductionmentioning

confidence: 99%

Beam characteristics of a retrofitted double‐focused multileaf collimator

et al. 1998

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Multileaf collimators (MLCs) are generally believed to be convenient and cost-effective tools for intensity modulation and conformal therapy. They are becoming a standard feature on new accelerators; however, the older units can be retrofitted with modern MLCs. Before such a unit can be clinically used, the beam characteristics must be verified. In this study the beam characteristics of a Siemens double-focused MLC retrofitted to an MD2 linear accelerator are presented. The head leakage along with inter- and intra-leaf radiation transmission were measured using film. The collimator (Sc), phantom (Sp), total (Scp) scatter factors, central axis depth dose, beam profiles for off-axis ratios, penumbra, and surface dose were evaluated for square, rectangular, and irregularly shaped fields. The maximum head leakage was estimated to be < 0.05% in any plane at a distance of 1 m and maximum transmission through the MLC leaves was estimated to be < 1.4% and < 1.1% for the 10 MV and 6 MV beams, respectively. The maximum differences between pre- and post-MLC installation data for the Sc and Scp were < or = 0.7% and < or = 1.4%, respectively. Similarly, the percent depth dose data for all fields and both beam energies were within 1.5% of the original data. The beam profiles measured at various depths were also in agreement with those of the pre-MLC installation data. The measured beam penumbra (20%-80%) showed a range of 7.8 mm-11.0 mm for the 6 MV and 8.4 mm-11.1 mm for the 10 MV beams from smallest to largest fields. These ranges differ by less than a millimeter from those of the old data. The surface dose measurements were slightly lower than the conventional jaw values suggesting that MLC does not produce significant electron contamination. It is concluded that the retrofitted MLC maintains the integrity of the original beam and may provide a cost-effective conformal therapy.

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Section: Introductionmentioning

confidence: 99%

Beam characteristics of a retrofitted double‐focused multileaf collimator

et al. 1998

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“…The underlying concept of IMRT was described as early as 1978 (42), but the hardware and software needed to implement it was not widely available until the late 1990s. The beam intensity patterns of IMRT are so complex that a different type of treatment planning algorithm was designed, called inverse planning.…”

Section: Advances In Perspectivementioning

confidence: 99%

Advances in Radiotherapy and Implications for the Next Century: A Historical Perspective

2009

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The use of ionizing radiation for the treatment of cancer dates back to the late 19th century, remarkably soon after Roentgen described X-rays in 1895 and the use of brachytherapy after Marie and Pierre Curie discovered radium in 1898. These initial efforts stimulated a revolution of conceptual and technological innovations throughout the 20th century, forming the basis of the safe and effective therapies used today. Perhaps the most important of these developments has been the paradigm of fractionated dose delivery, technologic advances in X-ray production and delivery, improvements in imaging and computer-based treatment planning, and evolving models that predict how cancers behave and how they should be approached therapeutically. The radiobiological discoveries over the past century have likewise been revolutionary. There is now a tremendous body of knowledge about cancer biology and how radiation affects human tissue on the cellular level. Bringing these laboratory discoveries and techniques to the clinic is the key challenge.Radiotherapy has become a standard treatment option for a wide range of malignancies. The U.S. Surveillance, Epidemiology, and End Results data show that radiation is commonly included in primary oncologic interventions. Between 1991 and 1996, for example, radiotherapy was used in the initial management of 32.9% of prostate cancers and of 44.1% of lung cancers in the United States (1). When subsequent palliative interventions are also considered, more than half of cancer patients require radiotherapy during at least one point in their care.The history of radiotherapy is rich with colorful and important characters, and it would be difficult to recognize all of those individuals. Juan del Regato (2) has written an outstanding series of profiles on radiological oncologists, which we highly recommend to the interested reader. In this article, we will review some of the pioneers and critical advances that led to our current understanding of radiation effects on human tissue and to the present state of radiotherapy. We hope to convince readers that much of this history remains relevant to the challenges we are likely to face in the future.

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“…The application of computed tomography (CT) in the 1970s to generate beam's-eye view images spurred the development of CT-based treatment simulation and planning for 3DCRT [1,2]. The benefit of conformal therapy lies in targeting the tumor area with smaller radiation fields while sparing the surrounding critical organs.…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of a free-moving abdominal mass with radiation therapy guided by cone-beam computed tomography: a case report

et al. 2010

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IntroductionBecause tumors in the abdomen can change position, targeting these tumors for radiation therapy should be done with caution; use of daily image-guided radiation therapy is advised.Case presentationWe report the case of a 72-year-old Caucasian man with recurrent mantle cell lymphoma who was referred for palliative radiation therapy for an abdominopelvic tumor. Computed tomography was used to generate images for radiation treatment planning. Comparison of those planning images with a positron emission tomography/computed tomography scan ordered during the planning period revealed that the tumor had moved from one side of the abdomen to the other during the three-day interval between scans. To account for this unusual tumor movement, we obtained a second set of planning computed tomography scans and used a Varian cone-beam computed tomography scanner with on-board imaging capability to target the tumor before each daily treatment session, leading to successful treatment and complete resolution of the mass.ConclusionAbdominal masses associated with the mesentery should be considered highly mobile; thus, radiation therapy for such masses should be used with the utmost caution. Modern radiation therapy techniques offer the ability to verify the tumor location in real time and shift the treatment ports accordingly over the course of treatment.

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Computer-Controlled Radiation Therapy

Cited by 53 publications

References 0 publications

Beam characteristics of a retrofitted double‐focused multileaf collimator

Beam characteristics of a retrofitted double‐focused multileaf collimator

Advances in Radiotherapy and Implications for the Next Century: A Historical Perspective

Successful treatment of a free-moving abdominal mass with radiation therapy guided by cone-beam computed tomography: a case report

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