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Related Experiment Video

Updated: Jun 17, 2026

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy
08:17

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Published on: June 7, 2015

Dose-guided radiotherapy for lung tumors.

Angelo Piermattei1, Andrea Fidanzio, Savino Cilla

  • 1Istituto di Fisica, Università Cattolica del S. Cuore, Largo F. Vito 1, 00168, Rome, Italy. a.piermattei@rm.unicatt.it

Medical & Biological Engineering & Computing
|December 17, 2009
PubMed
Summary

This study introduces a novel in vivo dosimetry method using electronic portal imaging devices for adaptive radiotherapy. It successfully detected lung tumor anatomical changes, enabling plan adjustments and improving patient outcomes.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiotherapy Dosimetry

Background:

  • Transit in vivo dosimetry using electronic portal imaging devices (EPID) is crucial for detecting radiotherapy errors.
  • A new method utilizes correlation functions (F(w, L)) relating EPID transit signals to phantom doses, reducing workload for implementation across different linear accelerators.
  • This approach is explored for adaptive radiotherapy in lung tumors treated with 3D conformal techniques.

Purpose of the Study:

  • To assess the feasibility of a dose-guided radiotherapy (DGRT) procedure using EPID-based in vivo dosimetry for detecting inter-fraction anatomical variations in lung tumors.
  • To evaluate the effectiveness of adaptive planning triggered by dose discrepancies identified through this method.

Main Methods:

  • Developed a dosimetry method using correlation functions F(w, L) based on EPID transit signals and mid-plane phantom doses.

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  • Applied generalized correlation functions across multiple linear accelerators without extensive recalibration.
  • Used dose reconstruction at the isocenter (D(iso)) for dose-guided radiotherapy to detect anatomical changes, initiating clinical action when D(iso) differed from treatment planning system predictions (D(iso,TPS)) by >6%.

    • Main Results:

    • Twelve of twenty patients showed in vivo dose discrepancies attributed to tumor morphological changes, confirmed by new CT scans.
    • One patient with persistent dose discrepancies underwent adaptive planning, significantly reducing the irradiated lung volume and doses to organs at risk.
    • The adaptive plan decreased the lung volume receiving 2 Gy from 550 cm³ to 15 cm³ and reduced mean organ-at-risk doses by 70%.

    Conclusions:

    • The DGRT procedure using EPID-based dose reconstruction is feasible for monitoring lung tumor anatomical changes during radiotherapy.
    • Integration with radiological imaging and accurate dose calculation algorithms (pencil beam, collapsed cone convolution) enhances the effectiveness of adaptive radiotherapy.
    • This method facilitates timely plan adaptation, improving treatment precision and safety for lung cancer patients.