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UK Clinicians Pass 200th Patient Milestone for Advanced Treatment Methods for Lung Cancer
Date:11/22/2011

verify that the 4D planning CT scan truly represents the tumor's motion and to assess whether 4D CBCT is superior for matches for any patient," he says. "In addition, for patients whose planning 4DCT was sub-optimal we use 4D CBCT to clarify tumor motion earlier in the planning process and adjust the ITV margins if required."

For many patients, after the Day 0 scan, no further Symmetry scans are required if doctors determine that the extent of tumor motion is minimal, the use of Symmetry for every treatment session is unnecessary. However, for patients with mobile tumors, typically smaller tumors and/or those close to the diaphragm, Symmetry scans are repeated up to three times for each of the five SBRT treatment sessions. The first scan is to localize the tumor, the second to verify needed patient position corrections and a third to ensure proper patient immobilization. Notably, the treatments are delivered while the patient is breathing freely.

"For tumors with significant motion, particularly small tumors, it had been very difficult to match up with the 4D planning CT using 3D CBCT on the treatment system," Dr. Franks recalls. "Symmetry has been invaluable for this group of patients."

Advanced registration tool further protects critical structures

St. James's clinicians also have been using Intuity™, suite of advanced image guidance tools. Intuity provides the capability to ensure that not only is the tumor's position accurately accounted for, but also the position of nearby critical structures.

"The dual registration capability of Intuity enables us to set tolerances for organs-at-risk to avoid putting critical structures in the radiation beam's path," Dr. Franks says. "We had been using it in an offline way, but next month we will incorporate Intuity dual registration in a prospective, online way with Symmetry. In this way, we can work out tolerances so that when we go to the treatment it will be quicker and mor
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SOURCE Elekta
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