Preface |
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xvii | |
Acknowledgements |
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xix | |
Section I The Basic Foundations in Clinical Practice |
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1 | (60) |
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Chapter 1 The Concepts and Consequences of Set-up Errors |
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3 | (8) |
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3 | (1) |
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1.2 Definition Of "Set-Up Error" And How These Errors Are Classified |
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3 | (3) |
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1.2.1 Systematic and Random Errors |
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5 | (1) |
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5 | (1) |
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1.3 Consequences Of Each Type Of Error And The Impact On Treatment Delivered |
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6 | (2) |
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1.4 Correction Of Set-Up Errors |
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8 | (3) |
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Chapter 2 The Foundations of Equipment Used for Radiotherapy Verification |
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11 | (14) |
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11 | (1) |
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2.2 Immobilisation Equipment |
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11 | (4) |
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15 | (1) |
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2.3 Introduction To Imaging Science |
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15 | (1) |
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16 | (4) |
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16 | (2) |
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2.4.1.1 Considerations When Using CT |
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16 | (2) |
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18 | (1) |
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19 | (1) |
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19 | (1) |
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19 | (1) |
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2.5 Treatment Delivery And On-Treatment Verification Imaging |
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20 | (5) |
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20 | (1) |
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21 | (1) |
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22 | (1) |
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23 | (1) |
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24 | (1) |
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Chapter 3 Concepts of On-treatment Verification |
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25 | (8) |
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25 | (1) |
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25 | (4) |
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25 | (1) |
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3.2.2 Types of Reference Images |
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26 | (1) |
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26 | (1) |
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3.2.2.2 DRR-Digitally Reconstructed Radiograph |
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26 | (1) |
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3.2.2.3 DCR-Digital Composite Radiograph |
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27 | (1) |
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27 | (1) |
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3.2.3 Verification Technique |
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27 | (3) |
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28 | (1) |
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28 | (1) |
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3.2.3.3 Cone Beam CT Scans (CBCT) |
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28 | (1) |
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29 | (1) |
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3.4 Method Of Image Matching |
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30 | (1) |
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30 | (1) |
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3.4.2 Fiducial Marker Match |
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31 | (1) |
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31 | (1) |
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3.5 When To Check The Image |
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31 | (2) |
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31 | (1) |
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32 | (1) |
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32 | (1) |
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Chapter 4 Clinical Protocols and Imaging Training |
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33 | (10) |
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33 | (1) |
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34 | (1) |
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35 | (8) |
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35 | (1) |
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36 | (1) |
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37 | (2) |
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4.3.4 Does Training Need to Be Repeated? |
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39 | (1) |
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4.3.5 Student Image Training |
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40 | (3) |
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Chapter 5 Concomitant Exposures and Legal Frameworks |
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43 | (6) |
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43 | (1) |
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5.2 Concomitant Dose-definitions |
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43 | (4) |
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47 | (1) |
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5.4 Incorporation Into Practical Use |
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48 | (1) |
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Chapter 6 Foundational Principles of Protocols, Tolerances, Action Levels and Corrective Strategies |
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49 | (12) |
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49 | (1) |
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49 | (3) |
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52 | (2) |
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6.4 Corrective Strategies |
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54 | (3) |
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6.4.1 NAL Correction Strategy |
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54 | (1) |
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6.4.2 eNAL Correction Strategy |
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55 | (1) |
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6.4.3 Absolute Correction and Adaptive Radiotherapy (ART) |
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56 | (1) |
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57 | (4) |
Section II Technology and Techniques in Clinical Practice |
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61 | (68) |
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Chapter 7 Imaging Science, Imaging Equipment (Pretreatment and On-treatment) |
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63 | (40) |
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63 | (1) |
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7.2 Imaging Science Concepts |
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63 | (4) |
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64 | (1) |
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65 | (1) |
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66 | (1) |
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7.2.4 Signal-to-Noise (SNR) Ratio |
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66 | (1) |
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7.3 Characteristics Of Note For X-Ray Imaging |
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67 | (5) |
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67 | (1) |
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68 | (1) |
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7.3.3 2-D Projection Images |
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68 | (1) |
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7.3.4 Subject Contrast and X-ray Energy |
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69 | (2) |
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7.3.5 Signal-to-Noise Ratio (SNR) |
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71 | (1) |
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72 | (1) |
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7.3.7 Detective Quantum Efficiency |
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72 | (1) |
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7.4 Pretreatment Imaging Equipment |
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72 | (7) |
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7.4.1 Radioisotope Imaging |
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73 | (1) |
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7.4.2 Positron Emission Tomography |
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73 | (1) |
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7.4.3 Computed Tomography-3-D |
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74 | (1) |
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7.4.4 Computed Tomography-4-D |
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75 | (2) |
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77 | (1) |
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7.4.6 Magnetic Resonance (MR) Imaging |
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78 | (1) |
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7.5 On-Treatment Imaging On Traditional C-Arm Linacs |
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79 | (16) |
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7.5.1 Why the Need for On-treatment Verification Imaging? |
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79 | (1) |
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7.5.2 Evolution of On-treatment Imaging |
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80 | (3) |
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83 | (1) |
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7.5.4 The Active Matrix Flat-Panel Imager (AMFPI) |
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83 | (2) |
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7.5.5 Current Methods With MV and kV X-rays-2-D Imaging |
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85 | (6) |
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85 | (1) |
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7.5.5.2 Surrogates-Skin Markers (Alone) and Bony Anatomy |
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85 | (2) |
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7.5.5.3 Surrogates-Implanted Fiducial Markers |
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87 | (1) |
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7.5.5.4 Image Reference Points-Measuring Set-Up Error |
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87 | (2) |
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7.5.5.5 2-D Planar Imaging-Bony Anatomy |
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89 | (1) |
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7.5.5.6 2-D Planar Imaging-Fiducials |
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90 | (1) |
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7.5.5.7 2-D Planar Imaging-Other Technological Points |
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90 | (1) |
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7.5.6 Current Methods With MV and kV X-Rays-3-D Imaging |
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91 | (4) |
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7.5.6.1 Evolution of 3-D Imaging Dedicated for C-arm Linacs |
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91 | (1) |
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91 | (3) |
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94 | (1) |
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7.5.6.4 kV-Based CBCT Experience, Advantages, and Disadvantages |
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94 | (1) |
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7.6 On-Treatment Imaging Using In-Room X-Ray Technology On C-Arm Linacs |
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95 | (2) |
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7.6.1 In-room kV Imaging Technologies |
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95 | (1) |
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96 | (1) |
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7.6.3 2-D kV Stereoscopic In-room Imaging |
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96 | (1) |
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7.7 On-Treatment Imaging Using Nonionising Radiation Technology Around Traditional C-Arm Linacs |
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97 | (6) |
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97 | (1) |
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7.7.2 Technologies and Equipment |
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98 | (5) |
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98 | (2) |
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100 | (1) |
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7.7.2.3 Implanted Transponders |
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101 | (2) |
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Chapter 8 Clinical Practice Principles |
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103 | (18) |
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103 | (1) |
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8.2 Pretreatment Imaging Equipment |
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103 | (5) |
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8.2.1 Radioisotope Imaging |
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103 | (1) |
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8.2.2 PET Imaging and PET/CT |
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103 | (1) |
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8.2.3 Computed Tomography (CT)-3-D |
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104 | (1) |
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8.2.4 Computed Tomography (CT)-4-D |
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105 | (2) |
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107 | (1) |
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8.3 On-Treatment Imaging On Traditional C-Arm Linacs |
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108 | (4) |
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108 | (2) |
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110 | (1) |
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8.3.3 Cone-Beam CT (CBCT) |
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110 | (2) |
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112 | (1) |
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8.5 On-Treatment Imaging Using In-Room X-Ray Technology Around Traditional C-Arm Linacs |
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113 | (2) |
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113 | (1) |
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8.5.2 Stereoscopic In-room Imaging |
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113 | (2) |
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8.6 On-Treatment Imaging Using Nonionising Radiation Technology Around Traditional C-Arm Linacs |
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115 | (6) |
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115 | (1) |
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115 | (2) |
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8.6.2.1 Prostate Verification |
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115 | (1) |
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8.6.2.2 Breast Localisation |
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116 | (1) |
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8.6.2.3 Limitations of Ultrasound in Radiotherapy |
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116 | (1) |
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117 | (1) |
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118 | (1) |
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118 | (1) |
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8.6.4.2 Limitations of Surface Tracking |
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118 | (1) |
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8.6.5 Implanted Transponders |
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118 | (3) |
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Chapter 9 Quality Systems and Quality Assurance |
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121 | (8) |
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121 | (1) |
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9.2 Definitions-quality Management Systems (QMSs) |
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121 | (4) |
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9.3 Definitions-quality Assurance (QA) |
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125 | (1) |
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9.4 Definitions-qa And QMS Practicalities For On-Treatment Verification Imaging |
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126 | (3) |
Section III Advanced Issues, Techniques, and Practices |
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129 | (74) |
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Chapter 10 Alternative Technologies |
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131 | (46) |
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131 | (6) |
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131 | (1) |
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131 | (2) |
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10.1.3 On-treatment Verification Imaging |
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133 | (3) |
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10.1.4 Some Clinical Perspectives |
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136 | (1) |
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137 | (5) |
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10.2.1 The Cyberknife System |
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137 | (2) |
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10.2.2 On-treatment Verification Imaging Systems |
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139 | (1) |
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10.2.3 On-treatment Imaging Capabilities |
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140 | (2) |
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142 | (3) |
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10.3.1 The Gamma knife System-Introduction |
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142 | (1) |
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10.3.2 On-treatment Verification-First Automation |
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143 | (1) |
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10.3.3 The Gamma Knife Perfexion (GKP) System-Further Automated Verification |
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143 | (1) |
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10.3.4 On-treatment Imaging-Development of CBCT |
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144 | (1) |
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145 | (5) |
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10.4.1 The Halcyon System-Introduction |
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145 | (2) |
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10.4.2 First Version Imaging Options and Capability |
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147 | (2) |
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10.4.3 Continuing Developments |
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149 | (1) |
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150 | (3) |
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10.5.1 The Vero 4DRT System-Introduction |
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150 | (1) |
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10.5.2 Imaging Options and Capability; Initial Results |
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151 | (2) |
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153 | (8) |
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153 | (1) |
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10.6.2 Technology Changes |
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153 | (1) |
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154 | (1) |
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10.6.4 Clinical Challenges |
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155 | (2) |
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10.6.5 On-treatment Imaging |
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157 | (4) |
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10.7 MR On-Treatment Imaging |
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161 | (4) |
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161 | (1) |
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10.7.2 On-treatment MR Guidance |
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161 | (3) |
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10.7.3 Pretreatment MR and MR-Only Workflows |
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164 | (1) |
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165 | (3) |
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165 | (1) |
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10.8.2 Initial Investigations and Challenges |
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165 | (2) |
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167 | (1) |
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10.8.4 Imaging Capability |
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167 | (1) |
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10.9 Emission-Guided/Biology-Guided Radiotherapy (EGRT/BGRT) |
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168 | (2) |
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168 | (1) |
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10.9.2 Initial Design and Clinical Utility |
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168 | (2) |
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10.10 Adaptive Radiotherapy |
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170 | (7) |
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170 | (1) |
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10.10.2 Adaptive Radiotherapy Performed Off-line |
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171 | (1) |
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10.10.3 Adaptive Radiotherapy Performed On-line |
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171 | (1) |
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10.10.4 Experience With Different On-treatment Imaging Technologies |
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172 | (1) |
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10.10.5 Adaptive Radiotherapy in Clinical Use |
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173 | (4) |
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Chapter 11 Incident Reporting |
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177 | (8) |
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177 | (1) |
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177 | (1) |
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178 | (2) |
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11.4 UK Legislation And Guidance |
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180 | (2) |
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11.5 International Perspectives |
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182 | (3) |
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Chapter 12 Protocol Development and Training |
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185 | (8) |
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12.1 Protocols-The Rationale |
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185 | (1) |
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12.2 Developing Protocols For On-Treatment Verification Imaging |
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186 | (3) |
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12.3 Training-The Rationale |
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189 | (4) |
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Chapter 13 Commissioning of New On-treatment Imaging and Techniques: Integration Into the Oncology Management System |
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193 | (10) |
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193 | (1) |
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193 | (4) |
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13.3 Integration Into The Oncology Management System |
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197 | (6) |
References |
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203 | (36) |
Index |
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239 | |