Department of Radiation Oncology, Stanford University, Palo Alto, CA, USA.
Sirius Medicine LLC, Half Moon Bay, CA, USA.
Phys Med. 2020 Nov;79:103-112. doi: 10.1016/j.ejmp.2020.11.001. Epub 2020 Nov 19.
Kilovoltage (kV) x-rays are most commonly used for diagnostic imaging due to their sensitivity to tissue composition. In radiation therapy (RT), due to their fast attenuation, kV x-rays are typically only used for superficial irradiation of skin cancer and for intra-operative RT (IORT). Recently, however, a number of kV RT techniques have emerged. In this review article, we provide a brief overview of the use of kV x-rays for RT. Various kV x-ray source technologies suitable for RT, such as conventional x-ray tubes as well as novel x-ray sources, are first described. This x-ray source section is then followed by a section on their implementation in terms of clinical, veterinary and preclinical applications. Specifically, IORT, superficial RT and dose enhancement with iodine and gold nanoparticles, as well as microbeam RT and FLASH RT are discussed in this context. Then, a number of kV x-ray RT applications in modeling and proof-of-principle stages, such as breast external beam RT with rotational sources, kilovoltage arc therapy and the BriXS Compton pulsed x-ray sources, are reviewed. Finally, some clinical and economic considerations for the development of kV RT techniques are discussed.
千伏（kV）X 射线由于对组织成分敏感，最常用于诊断成像。在放射治疗（RT）中，由于其快速衰减，kV X 射线通常仅用于皮肤癌的浅表照射和术中放射治疗（IORT）。然而，最近出现了许多千伏 RT 技术。在这篇综述文章中，我们简要概述了 kV X 射线在 RT 中的应用。首先描述了适用于 RT 的各种 kV X 射线源技术，例如常规 X 射线管以及新型 X 射线源。然后在临床、兽医和临床前应用方面介绍了它们的实现情况。具体来说，在这个背景下讨论了 IORT、浅表 RT 和碘和金纳米颗粒的剂量增强、微束 RT 和 FLASH RT。然后，回顾了一些在建模和原理验证阶段的 kV X 射线 RT 应用，例如旋转源的乳房外部束 RT、千伏弧形治疗和 BriXS 康普顿脉冲 X 射线源。最后，讨论了开发 kV RT 技术的一些临床和经济考虑因素。
