Computed tomography guided management of interfractional patient variation.
Interfractional patient variation occurs regularly and considerably during the radiotherapy course. Consequently, a generic but large planning target margin has to be applied when patient treatment plan design based on a single pre-treatment computed tomography scan is used to guide multifraction radiation treatment, which creates a major limiting factor for radiotherapy improvement. Planning target margins can be significantly reduced using multiple (or 4-dimensional) image feedback management in the routine treatment process. The most effective method in multiple-image feedback management of radiotherapy is the adaptive control methodology. The adaptive radiotherapy technique aims to customize each patient's treatment plan to patient-specific variation by evaluating and characterizing the systematic and random variations through image feedback and including them in adaptive planning. Adaptive radiotherapy will become a new treatment standard, in which a predesigned adaptive treatment strategy, including the schedules of imaging and replanning, will eventually replace the predesigned treatment plan in the routine clinical practice.
Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI 48073, USA. dyan@beaumont.edu
Di
D
Yan
David
D
Lockman
Alvaro
A
Martinez
John
J
Wong
Donald
D
Brabbins
Frank
F
Vicini
Jian
J
Liang
Larry
L
Kestin
D019583:Dose Fractionation, Radiation; D006801:Humans; D009068:Movement; D009369:Neoplasms / Q000532:radiotherapy*; D015641:Radiography, Interventional; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D011881:Radiotherapy, Computer-Assisted / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed