2019
DOI: 10.1088/1361-6560/ab2ba8
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Real-time intrafraction motion monitoring in external beam radiotherapy

Abstract: Radiotherapy (RT) aims to deliver a spatially conformal dose of radiation to tumours while maximizing the dose sparing to healthy tissues. However, the internal patient anatomy is constantly moving due to respiratory, cardiac, gastrointestinal and urinary activity. The long term goal of the RT community to ‘see what we treat, as we treat’ and to act on this information instantaneously has resulted in rapid technological innovation. Specialized treatment machines, such as robotic or gimbal-steered linear accele… Show more

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Cited by 164 publications
(194 citation statements)
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References 337 publications
(473 reference statements)
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“…These include partial Fourier acquisition, different k-space read-out strategies and the use of deep learning to shorten reconstruction times [24,26]. Parallel imaging capabilities of today's clinical MR-linacs are also still constrained by the available hardware [25,41,44]. The development of faster sequences could enable motion monitoring of the heart, which could be either used to achieve heart dose reduction [45] or to guide cardiac ablation interventions with MR-linacs in the future [46,47].…”
Section: Imaging For Motion Monitoringmentioning
confidence: 99%
See 1 more Smart Citation
“…These include partial Fourier acquisition, different k-space read-out strategies and the use of deep learning to shorten reconstruction times [24,26]. Parallel imaging capabilities of today's clinical MR-linacs are also still constrained by the available hardware [25,41,44]. The development of faster sequences could enable motion monitoring of the heart, which could be either used to achieve heart dose reduction [45] or to guide cardiac ablation interventions with MR-linacs in the future [46,47].…”
Section: Imaging For Motion Monitoringmentioning
confidence: 99%
“…In clinical practice as well as in research studies, the sagittal slice orientation has been most often used for cine MRI [24,32], but as MR imaging allows for arbitrary slice orientations, the impact of different orientations on the tumor tracking accuracy has been evaluated [25,43]. No consensus has been found yet [44], but the ideal slice orientation and position might be entity-and patient-specific [43] and depend on the beam angle [48].…”
Section: Imaging For Motion Monitoringmentioning
confidence: 99%
“…These new hybrid systems for MRgRT do not only offer three-dimensional MRI for soft tissue target and organ at risk visualization, but also allow for continuous cine-MRI before as well as during treatment [12,13]. Cine-MRI during treatment enables advanced motion management based on real-time soft tissue anatomic feedback such as treatment beam gating [11,16,17]. This eliminates the need for invasive implantation of fiducial markers as well as the application of internal target volumes (ITV) in order to account for intrafractional motion, and thereby offers the potential for margin reduction and hence a lower risk of ensuing toxicity [18].…”
Section: Introductionmentioning
confidence: 99%
“…There are high expectations regarding RAR without fiducial markers, such as on-line MRI in the treatment room, for the treatment of liver tumors. However, only 2dimensional MRI movies have been used thus far [26]. In addition, automatic real-time contouring of liver tumors with MRI are not always sufficiently accurate for automatic 22 gating of irradiation [26].…”
Section: Rgptmentioning
confidence: 99%
“…However, only 2dimensional MRI movies have been used thus far [26]. In addition, automatic real-time contouring of liver tumors with MRI are not always sufficiently accurate for automatic 22 gating of irradiation [26]. Therefore, it remains important to implant fiducial markers into the liver in real-world RAR.…”
Section: Rgptmentioning
confidence: 99%