Linac-based stereotactic radiosurgery or stereotactic body radiotherapy via online dynamic tracking

Area of Science:

• Radiation Oncology
• Medical Physics
• Cancer Treatment

Background:

• Stereotactic body radiotherapy (SBRT) is a key treatment for early-stage non-small cell lung cancer (NSCLC) and spine metastases.
• Advancements in tracking technology have significantly improved dose delivery accuracy in SBRT.
• Real-time motion management is crucial for enhancing treatment efficacy and patient outcomes.

Purpose of the Study:

• To review state-of-the-art respiratory motion tracking techniques in SBRT.
• To discuss the principles and implementation of real-time motion compensation during radiation delivery.
• To highlight the impact of evolving tracking technologies on radiation therapy workflows.

Main Methods:

• Discussion of various tracking methods: multi-leaf collimator (MLC), optical imaging, portal X-ray imaging, radio-frequency markers, and positron emission tomography (PET) imaging.
• Explanation of real-time tracking implementation involving image correlation, predictive modeling, and linear accelerator (Linac) control.
• Analysis of how advanced imaging modalities necessitate workflow revisions.

Main Results:

• Improved dose delivery accuracy achieved through real-time motion management.
• Enhanced tumor control probability due to precise targeting and normal tissue sparing.
• Identification of key components in real-time tracking: imaging, predictive modeling, and Linac compensation.

Conclusions:

• Real-time motion tracking significantly enhances SBRT precision for lung cancer and spine metastases.
• Continuous technological evolution in tracking necessitates adaptive radiation therapy workflows.
• Accurate motion compensation is vital for maximizing therapeutic benefits in SBRT.