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Medical Imaging/Radiology B o u Image-Guided r l a n d Radiation Therapy Edited by I J. Daniel Bourland m a g Image-Guided Radiation Therapy presents key image-guided radiation treatment (IGRT) e technologies for external beam radiotherapy. The book explores the decades-long technological - developments that have occurred in the realm of image-guided conformal, customized radiation G treatment. u i Expert authors, all of whom have actively participated in the development or implementation of IGRT, d imaging, and enabling technologies, share their first-hand experiences on the science, clinical uses, e and impact of these technologies. They describe kilovoltage and megavoltage imaging as well as d radiological, ultrasound, and optical technologies for determining and validating target and patient R positioning. The book examines how anatomical and biological imaging using CT and PET has a contributed to the understanding of target volume boundaries and biological behavior. It also explores d such innovations as 4D PET/CT and digital tomosynthesis. i a Features t i o • Explains the clinical uses and impact of IGRT technologies on radiation treatment n • Offers the research and clinical expertise of the inventors of IGRT technologies and early T users of imaging technologies h e • Describes conventional gantry, ring gantry, and robotic linac systems as well as imaging r technologies that use ultrasound, fan-beam CT, cone-beam CT, x-ray, and PET/CT a p • Surveys the technology behind real-time monitoring/tracking y • Presents clinical applications of head–neck, prostate, lung, brain, and breast cancer treatments • Discusses future research and development Advancing patient care, this book focuses on a wealth of hybrid IGRT technologies and devices for coupled imaging and treatment inside the radiation treatment room. It thoroughly covers the modalities, software tools, and imaging treatment geometries that constitute IGRT. K10143 ISBN 978-1-4398-0273-1 90000 9 781439 802731 K10143_COVER_final.indd 1 1/18/12 2:13 PM Image-Guided Radiation Therapy ImagIng In medIcal dIagnosIs and Therapy William R. Hendee, Series Editor Quality and safety in radiotherapy Informatics in medical Imaging Todd Pawlicki, Peter B. Dunscombe, Arno J. Mundt, and George C. Kagadis and Steve G. Langer, Editors Pierre Scalliet, Editors ISBN: 978-1-4398-3124-3 ISBN: 978-1-4398-0436-0 adaptive motion compensation in radiotherapy adaptive radiation Therapy Martin J. Murphy, Editor X. Allen Li, Editor ISBN: 978-1-4398-2193-0 ISBN: 978-1-4398-1634-9 Image-guided radiation Therapy Quantitative mrI in cancer Daniel J. Bourland, Editor Thomas E. Yankeelov, David R. Pickens, and ISBN: 978-1-4398-0273-1 Ronald R. Price, Editors ISBN: 978-1-4398-2057-5 Forthcoming titles in the series cone Beam computed Tomography Informatics in radiation oncology Chris C. Shaw, Editor Bruce H. Curran and George Starkschall, Editors ISBN: 978-1-4398-4626-1 ISBN: 978-1-4398-2582-2 handbook of Brachytherapy Image processing in radiation Therapy Jack Venselaar, Dimos Baltas, Peter J. Hoskin, and Kristy Kay Brock, Editor Ali Soleimani-Meigooni, Editors ISBN: 978-1-4398-3017-8 ISBN: 978-1-4398-4498-4 proton and carbon Ion Therapy Targeted molecular Imaging Charlie C.-M. Ma and Tony Lomax, Editors Michael J. Welch and William C. Eckelman, Editors ISBN: 978-1-4398-1607-3 ISBN: 978-1-4398-4195-0 monte carlo Techniques in radiation Therapy Joao Seco and Frank Verhaegen, Editors ISBN: 978-1-4398-1875-6 stereotactic radiosurgery and radiotherapy Stanley H. Benedict, Brian D. Kavanagh, and David J. Schlesinger, Editors ISBN: 978-1-4398-4197-6 ImaGInG In medIcal dIaGnosIs and TheRapy William R. Hendee, Series Editor Image-Guided Radiation Therapy Edited by J. daniel Bourland Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business A TAYLOR & FRANCIS BOOK CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2012 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20111208 International Standard Book Number-13: 978-1-4398-0274-8 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. 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TThhiiss ppaaggee iinntteennttiioonnaallllyy lleefftt bbllaannkk Contents Series Preface ....................................................................................................................................................................... ix Preface .................................................................................................................................................................................... xi Acknowledgment ..............................................................................................................................................................xiii Editor .....................................................................................................................................................................................xv Contributors ......................................................................................................................................................................xvii 1 Optical and Remote Monitoring IGRT ..................................................................................................1 Sanford L. Meeks, Twyla R. Willoughby, Katja M. Langen, and Patrick A. Kupelian 2 Ultrasound-Guided Radiation Therapy ..............................................................................................13 Janelle A. Molloy 3 In-Room CT System for IGRT .............................................................................................................27 James R. Wong, Minoru Uematsu, and Zhanrong Gao 4 Megavoltage Fan Beam CT IGRT .........................................................................................................43 Gustavo Hugo Olivera and Thomas Rockwell Mackie 5 Kilovoltage Cone-Beam CT Guidance of Radiation Therapy .............................................................71 Jeffrey H. Siewerdsen and Jan-Jakob Sonke 6 Megavoltage Cone-Beam IGRT ..........................................................................................................111 Olivier Morin and Jean Pouliot 7 Kilovoltage X-Ray IMRT and IGRT ...................................................................................................131 Hiroki Shirato, Masayori Ishikawa, Shinichi Shimizu, Gerard Bengua, Ken Sutherland, Rikiya Onimaru, and Hidefumi Aoyama 8 Kilovoltage Radiography for Robotic Linac IGRT ............................................................................147 Martin J. Murphy 9 Respiratory-Correlated CT ................................................................................................................157 Carnell J. Hampton 10 4D PET/CT in Radiotherapy ..............................................................................................................175 Sadek A. Nehmeh and Yusuf E. Erdi 11 On-Board Digital Tomosynthesis: An Emerging New Technology for Image-Guided Radiation Therapy ..............................................................................................................................187 Q. Jackie Wu, Devon Godfrey, Lei Ren, Sua Yoo, and Fang-Fang Yin 12 Image Registration and Segmentation in Radiation Therapy ..........................................................203 Michael B. Sharpe, Michael Velec, and Kristy K. Brock Index .......................................................................................................................................................................................223 vii TThhiiss ppaaggee iinntteennttiioonnaallllyy lleefftt bbllaannkk Series Preface Advances in the science and technology of medical imaging and topic of conversation during a lunch hosted by Taylor & Francis radiation therapy are more profound and rapid than ever before, Publishers and involving a group of senior medical physicists since their inception over a century ago. Further, the disciplines (Arthur L. Boyer, Joseph O. Deasy, C.-M. Charlie Ma, Todd are increasingly cross-linked as imaging methods become more A. Pawlicki, Ervin B. Podgorsak, Elke Reitzel, Anthony B. widely used to plan, guide, monitor, and assess treatments in Wolbarst, and Ellen D. Yorke). The conclusion of this discussion radiation therapy. Today, the technologies of medical imaging was that a book series should be launched under the Taylor & and radiation therapy are so complex and so computer driven Francis banner, with each volume in the series addressing a rap- that it is difficult for the persons (physicians and technologists) idly advancing area of medical imaging or radiation therapy of responsible for their clinical use to know exactly what is hap- importance to medical physicists. The aim would be for each vol- pening at the point of care, when a patient is being examined ume to provide medical physicists with the information needed or treated. The person best equipped to understand the tech- to understand technologies driving a rapid advance and their nologies and their applications are medical physicists, and these applications to safe and effective delivery of patient care. individuals are assuming greater responsibilities in the clinical Each volume in the series is edited by one or more individuals arena to ensure that what is intended for the patient is actually with recognized expertise in the technological area encompassed delivered in a safe and effective manner. by the book. The editors were responsible for selecting the authors The growing responsibilities of medical physicists in the of individual chapters and ensuring that the chapters were com- clinical arenas of medical imaging and radiation therapy are prehensive and intelligible to someone without such expertise. not without their challenges, however. Most medical physicists The enthusiasm of volume editors and chapter authors has been are knowledgeable in either radiation therapy or medical imag- gratifying and reinforces the conclusion of the Minneapolis lun- ing, and expert in one or a small number of areas within their cheon that this series of books addresses a major need of medical discipline. They sustain their expertise in these areas by read- physicists. ing scientific articles and attending scientific talks at meetings. Imaging in Medical Diagnosis and Therapy would not have In contrast, their responsibilities increasingly extend beyond been possible without the encouragement and support of the their specific areas of expertise. To meet these responsibilities, series manager, Luna Han of Taylor & Francis Publishers. The medical physicists periodically must refresh their knowledge editors and authors, and most of all I, are indebted to her steady of advances in medical imaging or radiation therapy, and they guidance of the entire project. must be prepared to function at the intersection of these two fields. How to accomplish these objectives is a challenge. William Hendee At the 2007 annual meeting of the American Association of Series Editor Physicists in Medicine in Minneapolis, this challenge was the Rochester, MN ix