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Image-Guided
Radiation Therapy
MUHAMMED ANEES.K
MSc RADIATION PHYSICS
UNIVERSITYOF CALICUT
1
The process of frequent imaging (2D / 3D),
before and during course of radiation treatment
merit
static &
mobile
targets 2
or
I
G
-
I
M
R
T
or
I
G
R
T
3
4
Elekta's Synergy
5
Varian's Trilogy
TREATMENT with IGRT





6
On-Board
Imagers
7
ON-BOARD IMAGERS
8
9
10
1- Portal & Radiographic Imagers
(a)
(b)
256 × 256
solid
state
detectors
Two
Imaging
system
11
Electronic Portal Imaging Device (EPID)




12
On-board
imaging
EPID
Cone beam CT
256 × 256
solid
state
detectors
13
See the
difference
OBI
Gives 2-D
Images
14
15
2- In-Room CT-Scanner
16
High-Resolution
3-D Patient Anatomy
Help toTarget
Localization
Dose Distribution
17
18
3 Cone Beam ComputedTomography
19
Cone Beam Formation
Cone Beam
20
Kilo voltage Cone-Beam CT
21
Mega voltage Cone-Beam CT
22
Advantages of Mv-CBCT over Kv-CBCT
23
Advantages of kV-CBCT over MV-CBCT
24
25
4- Helical Tomotherapy
26
MV-CT
image
Acquisition
IMRT
Treatment
27
HelicalTomotherapy
28
continue…,
Linac
Ring Gantry
Couch
Multi Leaf
Collimator
Imaging Detector
Beam Stop
29
30
5- ULTRASOUND

31
Ultrasound Systems
32
US
2-D or 3-D ultrasound
imaging system
integrated with
Medical Linac
BAT system
33
What Can we do With the Images ?
or
34
WHY IGRT ?
35
WHY IGRT ?
36
Management of Respiratory Motion
4D- ComputedTomography Real-TimeTumorTracking
37
1, 4-D Computed Tomography
38
39
40
4-D CT Continue…,
41
4-D CT Data Acquisition
Prospective Gating Retrospective Gating
42
43
images are collected only at one
phase of the respiratory cycle
Or Registration of the CT images
After Data of Respiratory Phases the have been acquired
1, Prospective Gating
scan data are
acquired at all
phases of
respiration and the
correlation
2. Retrospective Gating
44
the beam on
only at the
selected times of
respiration
Including
both
Inspiration
and
Expiration
45
2, Real-TimeTumorTracking
46
Real-TimeTumor Tracking
47
Electromagnetic
FieldTracking
Fluoroscopy-BasedTracking Systems
These systems are discussed below as examples…….,
48
Fluoroscopy-BasedTracking Systems
49
1- Room-Mounted Systems
50
Room-Mounted Systems
51
continue…,
2-Linac Gantry-Mounted Systems
52
53
3-Robotic Systems
54
55
Conformal dose
Distribution for
Irregularly tumors
56
Electromagnetic FieldTracking
57
58
MRI–Guided RadiationTherapy
59
MRI–Guided Radiation Therapy
60
MRI–Guided RadiationTherapy
61
REFERENCE
 Treatment Planning in Radiation Oncology by F M Khan
 Physics of RadiationTherapy (4th Edition ) by F M Khan
 Overview of Image-Guided RadiationTherapy by Lei xing,
Ph.D,BrianThorndyke, Ph.D ,University of Stanford
 IMRT, IGRT, SBRT – Advances in theTreatment Planning
and Delivery of Radiotherapy by John L. Meyer
62
63

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