[Image-guided radiation therapy. Paradigm change in radiation therapy]
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1Klinik für Strahlentherapie und Radioonkologie, Universitätsmedizin Mannheim der Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim. Frederik.wenz@umm.de
Clinical Issue:
The introduction of image-guided radiotherapy (IGRT) has changed the workflow in radiation oncology more dramatically than any other innovation in the last decades.
Standard Treatment:
Imaging for treatment planning before the initiation of the radiotherapy series does not take alterations in patient anatomy and organ movement into account.
Treatment Innovations:
The principle of IGRT is the temporal and spatial connection of imaging in the treatment position immediately before radiation treatment.
Diagnostic Assessment:
The actual position and the target position are compared using cone-beam computed tomography (CT) or stereotactic ultrasound.
Performance:
The IGRT procedure allows a reduction of the safety margins and dose to normal tissue without an increase in risk of local recurrence.
Achievements:
In the future the linear treatment chain in radiation oncology will be developed based on the closed-loop feedback principle.
Practical Recommendations:
The IGRT procedure is increasingly being used especially for high precision radiotherapy, e.g. for prostate or brain tumors.
