Advanced Imaging Technology For Radiation Therapy
Image-guided Radiation Therapy (IGRT)
Since tumors can move between treatments, radiation oncologists at Beverly Hills Cancer Center take advantage of image-guided radiation therapy (IGRT) to help better deliver the radiation to the cancer.
IGRT involves radiation treatments guided by CT or X-ray imaging (Cone beam CT or KV matching). During IGRT treatments, doctors compare images daily, just prior to the treatment to see if the treatment needs to be adjusted. This increases the accuracy of very complex treatments.
IGRT and CBCT are used in conjunction with IMRT and 3-D conformal treatments. In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for IGRT.
CT (computed tomography) scans are the primary method used to plan radiation treatment. Other imaging techniques, including magnetic resonance imaging (MRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), and ultrasonography are also used to improve patient management in radiation therapy.
While none of these methods alone provides all of the geometric and physical information needed for treatment planning, fusion of these images provides the information needed. This is especially helpful for more complex circumstances, such as when it is difficult to detect lymph node involvement or the boundaries of primary tumors where inflammatory changes and metal artifacts are present. The addition of any one of these image datasets to the primary CT dataset provides an advantage in delineating and localizing the target.
Respiratory Gating And 4D CT
With four-dimensional computed tomography (4D CT), Beverly Hills Cancer Center radiation oncologists can determine not just where a tumor is at one time, but also its movement over time.
For example, a concern with the treatment of lung cancer is that many of these tumors move with respiration. To improve the visualization and targeting of moving tumors, we use 4D computed tomography (4DCT) imaging and respiratory gating.
A 4D CT scan is comprised of a large number of individual CT scans obtained at various phases of the respiratory cycle. This approach allows the radiation oncologist to watch the movement of the tumor with respiration. The radiation oncologist uses the 4DCT data to decide whether it is best to deliver treatment only at specific phases of breathing (“gated therapy”) or with the patient freely breathing. This technology allows us to offer among the best results in radiology in Los Angeles, and the world.
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