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Image-guided radiotherapy for prostate cancer.

Audrey Dang1, Patrick A Kupelian1, Minsong Cao1

  • 1Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, California, USA.

Translational Andrology and Urology
|July 28, 2018
PubMed
Summary

Image-guided radiotherapy (IGRT) enhances intensity-modulated radiotherapy (IMRT) for prostate cancer by addressing daily anatomical changes. This review covers IGRT

Keywords:
Calypso 4DProstate cancerViewRaycine magnetic resonance imaging (cine MRI)cone beam computed tomography (CBCT)electromagnetic transpondersimage-guided radiotherapy technology (IGRT)intensity-modulated radiation therapy (IMRT)intraprostatic fiducial markers (FM)magnetic resonance imaging-guidance (MRI-guidance)stereoscopic X-ray imagingstereotactic body radiotherapy (SBRT)ultrasound (US)

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Area of Science:

  • Radiation oncology
  • Medical physics
  • Prostate cancer treatment

Background:

  • Intensity-modulated radiotherapy (IMRT) is standard for prostate cancer, offering conformal dose delivery.
  • Image-guided radiotherapy (IGRT) is crucial for IMRT, compensating for daily anatomical and positioning variations.
  • Geometric uncertainties in prostate cancer radiotherapy necessitate precise image guidance.

Purpose of the Study:

  • To review sources of geometric uncertainty in prostate cancer radiotherapy.
  • To explain the rationale for using IGRT with IMRT in prostate cancer treatment.
  • To describe and evaluate common IGRT techniques and their clinical evidence.

Main Methods:

  • Literature review of geometric uncertainties in prostate cancer radiotherapy.
  • Analysis of the role and necessity of IGRT in conjunction with IMRT.
  • Description and comparative review of various IGRT techniques (e.g., kV imaging, cone-beam CT).
  • Examination of clinical studies evaluating the benefits of IGRT.

Main Results:

  • Identified key sources of geometric uncertainty in prostate cancer radiotherapy.
  • Established the critical role of IGRT in mitigating these uncertainties for IMRT.
  • Detailed the advantages and disadvantages of prevalent IGRT methods.
  • Summarized evidence supporting the clinical utility of IGRT in prostate cancer.

Conclusions:

  • IGRT is essential for optimizing IMRT delivery in prostate cancer by managing daily variations.
  • Understanding IGRT techniques and their evidence base is vital for clinicians.
  • IGRT demonstrates potential for improving clinical outcomes in prostate cancer radiotherapy.