TY - JOUR
T1 - Advances in 4D radiation therapy for managing respiration
T2 - Part II - 4D treatment planning
AU - Rosu, Mihaela
AU - Hugo, Geoffrey D.
N1 - Funding Information:
We would like to thank Matthias Söhn for assisting with literature review. This publication was made possible by grant number NIH P01CA116602 from the U.S. National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
PY - 2012/12
Y1 - 2012/12
N2 - The development of 4D CT imaging technology made possible the creation of patient models that are reflective of respiration-induced anatomical changes by adding a temporal dimension to the conventional 3D, spatial-only, patient description. This had opened a new venue for treatment planning and radiation delivery, aimed at creating a comprehensive 4D radiation therapy process for moving targets. Unlike other breathing motion compensation strategies (e.g. breath-hold and gating techniques), 4D radiotherapy assumes treatment delivery over the entire respiratory cycle - an added bonus for both patient comfort and treatment time efficiency. The time-dependent positional and volumetric information holds the promise for optimal, highly conformal, radiotherapy for targets experiencing movements caused by respiration, with potentially elevated dose prescriptions and therefore higher cure rates, while avoiding the uninvolved nearby structures. In this paper, the current state of the 4D treatment planning is reviewed, from theory to the established practical routine. While the fundamental principles of 4D radiotherapy are well defined, the development of a complete, robust and clinically feasible process still remains a challenge, imposed by limitations in the available treatment planning and radiation delivery systems.
AB - The development of 4D CT imaging technology made possible the creation of patient models that are reflective of respiration-induced anatomical changes by adding a temporal dimension to the conventional 3D, spatial-only, patient description. This had opened a new venue for treatment planning and radiation delivery, aimed at creating a comprehensive 4D radiation therapy process for moving targets. Unlike other breathing motion compensation strategies (e.g. breath-hold and gating techniques), 4D radiotherapy assumes treatment delivery over the entire respiratory cycle - an added bonus for both patient comfort and treatment time efficiency. The time-dependent positional and volumetric information holds the promise for optimal, highly conformal, radiotherapy for targets experiencing movements caused by respiration, with potentially elevated dose prescriptions and therefore higher cure rates, while avoiding the uninvolved nearby structures. In this paper, the current state of the 4D treatment planning is reviewed, from theory to the established practical routine. While the fundamental principles of 4D radiotherapy are well defined, the development of a complete, robust and clinically feasible process still remains a challenge, imposed by limitations in the available treatment planning and radiation delivery systems.
KW - 4D
KW - Imaging
KW - Radiation therapy
KW - Respiration management
KW - Treatment planning
UR - http://www.scopus.com/inward/record.url?scp=84870241743&partnerID=8YFLogxK
U2 - 10.1016/j.zemedi.2012.06.011
DO - 10.1016/j.zemedi.2012.06.011
M3 - Article
C2 - 22796324
AN - SCOPUS:84870241743
SN - 0939-3889
VL - 22
SP - 272
EP - 280
JO - Zeitschrift fur Medizinische Physik
JF - Zeitschrift fur Medizinische Physik
IS - 4
ER -