Lefkopoulos D, Ferreira I, Isambert A, Le Péchoux C, Mornex F
Service de physique médicale, institut Gustave-Roussy, 39, rue Camille-Desmoulins, 94805 Villejuif cedex, France.
Cancer Radiother. 2007 Jan-Feb;11(1-2):23-31. doi: 10.1016/j.canrad.2006.10.001. Epub 2006 Nov 17.
These last years, the new irradiation techniques as the conformal 3D radiotherapy and the IMRT are strongly correlated with the technological developments in radiotherapy. The rigorous definition of the target volume and the organs at risk required by these irradiation techniques, imposed the development of various image guided patient positioning and target tracking techniques. The availability of these imaging systems inside the treatment room has lead to the exploration of performing real-time adaptive radiation therapy. In this paper we present the different image guided radiotherapy (IGRT) techniques and the adaptive radiotherapy (ART) approaches. IGRT developments are focused in the following areas: 1) biological imaging for better definition of tumor volume; 2) 4D imaging for modeling the intra-fraction organ motion; 3) on-board imaging system or imaging devices registered to the treatment machines for inter-fraction patient localization; and 4) treatment planning and delivery schemes incorporating the information derived from the new imaging techniques. As this paper is included in the "Cancer-Radiotherapie" special volume dedicated to the lung cancers, in the description of the different IGRT techniques we try to present the lung tumors applications when this is possible.
近年来,新的放射治疗技术如适形3D放疗和调强放疗与放射治疗的技术发展密切相关。这些放射治疗技术对靶区体积和危及器官的精确界定,推动了各种图像引导的患者定位和靶区跟踪技术的发展。治疗室内这些成像系统的可用性促使人们探索实施实时自适应放射治疗。在本文中,我们介绍了不同的图像引导放射治疗(IGRT)技术和自适应放射治疗(ART)方法。IGRT的发展集中在以下几个方面:1)用于更好地界定肿瘤体积的生物成像;2)用于模拟分次治疗期间器官运动的4D成像;3)与治疗机器配准的机载成像系统或成像设备,用于分次治疗间的患者定位;4)纳入从新成像技术获得的信息的治疗计划和实施方案。由于本文收录于专门论述肺癌的“癌症-放射治疗”特刊,在介绍不同的IGRT技术时,我们尽可能尝试展示其在肺肿瘤方面的应用。