Radiotherapy in Practice: Imaging for Clinical Oncology Radiotherapy in Practice: External Beam Radiotherapy Edited by Peter Hoskin Radiotherapy in Practice: Brachytherapy Edited by Peter Hoskin and Catherine Coyle Radiotherapy in Practice: External Beam Therapy Edited by Peter Hoskin Radiotherapy in Practice: Imaging for Clinical Oncology Edited by Peter Hoskin, Thankamma Ajithkumar, and Vicky Goh Radiotherapy in Practice: Physics for Clinical Oncology Edited by Amen Sibtain, Andrew Morgan, and Niall MacDougall Radiotherapy in Practice: Radioisotope Therapy Edited by Peter Hoskin Radiotherapy in Practice: Radiotherapy and the Cancers of Children, Teenagers, and Young Adults Edited by Tom Boterberg, Karin Dieckmann, and Mark Gaze Radiotherapy in Practice Imaging for Clinical Oncology SECOND EDITION Edited by Peter Hoskin Consultant in Clinical Oncology, Mount Vernon Cancer Centre, Northwood, UK; Professor of Clinical Oncology, University of Manchester, UK Thankamma Ajithkumar Consultant Clinical Oncologist, Cambridge University Hospitals NHS Foundation Trust, UK Vicky Goh Chair of Clinical Cancer Imaging, King’s College London; Honorary Consultant Radiologist, Guy’s & St Thomas’ NHS Foundation Trust, UK 1 1 Great Clarendon Street, Oxford, OX2 6DP, United Kingdom Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries © Oxford University Press 2021 The moral rights of the authors have been asserted First Edition published in 2010 Second Edition published in 2021 Impression: 1 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by licence or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this work in any other form and you must impose this same condition on any acquirer Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016, United States of America British Library Cataloguing in Publication Data Data available Library of Congress Control Number: 2021941848 ISBN 978– 0– 19– 881850– 2 DOI: 10.1093/ med/ 9780198818502.001.0001 Printed in Great Britain by Bell & Bain Ltd., Glasgow Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-t o- date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non- pregnant adult who is not breast- feeding Links to third party websites are provided by Oxford in good faith and for information only. Oxford disclaims any responsibility for the materials contained in any third party website referenced in this work. Contents Contributors vii 1 Introduction 1 Peter Hoskin and Vicky Goh 2 Principles of imaging 4 Connie Yip, N. Jane Taylor, Anthony Chambers, and Vicky Goh 3 MRI and functional imaging in radiotherapy planning, delivery, and treatment 32 Huiqi Yang and Thankamma Ajithkumar 4 Breast 46 Dinos Geropantas and Victoria Ames 5 Lung and thorax 64 Pooja Jain, Katy Clarke, and Michael Darby 6 Lymphoma 82 Heok Cheow, Peter Hoskin, and Thankamma Ajithkumar 7 Oesophageal tumours 98 Kieran Foley, Carys Morgan, and Tom Crosby 8 Gastric tumours 108 Nicholas Carroll and Elizabeth C. Smyth 9 Hepatic and biliary tumours 114 Marika Reinius, Edmund Godfrey, and Bristi Basu 10 Pancreatic tumours 128 David Bowden and Thankamma Ajithkumar 11 Gastrointestinal stromal tumours 137 Haesun Choi 12 Rectal cancer 148 Vivek Misra and Rohit Kochhar 13 Anal cancer 160 Rebecca Muirhead and Vicky Goh 14 Urological cancers 168 Ananya Choudhury and Peter Hoskin 15 Gynaecological cancers 193 Kate Lankester and Lavanya Vitta vi CONTENTS 16 Head and neck cancers 208 Gill Barnett and Tilak Das 17 Central nervous system 222 Sara C. Erridge, Gerard Thompson, and David Summers 18 Soft tissue sarcomas 251 Morag Brothwell, Sarah Prewett, Gail Horan, and Emma-L ouise Gerety 19 Endocrine tumours 265 Luigi Aloj 20 Primary bone sarcomas 275 Gulshad Begum, Sarah Prewett, Gail Horan, and Emma- Louise Gerety 21 Paediatrics 288 Mark Gaze, Monique Shahid, Paul Humphries, and Francesca Peters 22 Imaging for common complications 315 Helen Addley, Katy Hickman, and Thankamma Ajithkumar 23 Imaging for treatment verification 335 June Dean 24 Radiation protection issues when imaging patients for radiotherapy 356 Simon Thomas Index 373 Contributors Helen Addley David Bowden Consultant Radiologist Consultant Radiologist Cambridge University Hospitals NHS Cambridge University Hospitals NHS Foundation Trust Foundation Trust Cambridge, UK Cambridge, UK Thankamma Ajithkumar Morag Brothwell Consultant Clinical Oncologist Specialist Registrar in Clinical Oncology Cambridge University Hospitals NHS Cambridge University Hospitals NHS Foundation Trust Foundation Trust Cambridge, UK Cambridge, UK Luigi Aloj Nicholas Carroll Consultant Nuclear Medicine Physician Consultant Radiologist University of Cambridge School of Cambridge University Hospitals NHS Clinical Medicine Foundation Trust Cambridge, UK Cambridge, UK Victoria Ames Anthony Chambers Consultant Radiologist Consultant Radiologist Norfolk and Norwich University Paul Strickland Scanner Centre Hospitals NHS Foundation Trust Mount Vernon Cancer Centre Norwich, UK Northwood, UK Gill Barnett Heok Cheow Consultant Clinical Oncologist Consultant Radiologist Cambridge University Hospitals NHS Cambridge University Hospitals NHS Foundation Trust Foundation Trust Cambridge, UK Cambridge, UK Bristi Basu Haesun Choi Academic Consultant Medical Professor Oncologist Department of Abdominal Imaging Department of Oncology MD Anderson Cancer Center University of Cambridge Houston, Texas, USA Cambridge, UK Ananya Choudhury Gulshad Begum Chair and Honorary Consultant in Specialist Registrar in Clinical Oncology Clinical Oncology Cambridge University Hospitals NHS The Christie NHS Foundation Trust Foundation Trust Manchester, UK Cambridge, UK viii CONTRIbUTORS Katy Clarke Dinos Geropantas Consultant Clinical Oncologist Consultant Clinical Oncologist St James’ University Hospital Norfolk and Norwich University Leeds, UK Hospitals NHS Foundation Trust Norwich, UK Tom Crosby Clinical Oncologist Edmund Godfrey Velindre Cancer Centre Consultant Radiologist Cardiff, UK Cambridge University Hospitals NHS Foundation Trust Michael Darby Cambridge, UK Consultant Radiologist St James’ University Hospital Vicky Goh Leeds, UK Chair of Clinical Cancer Imaging King’s College London Tilak Das Honorary Consultant Radiologist Consultant Neuroradiologist Guy’s & St Thomas’ NHS Foundation Cambridge University Hospitals NHS Trust Foundation Trust London, UK Cambridge, UK Katy Hickman June Dean Specialist Registrar in Radiology Associate Radiotherapy Manager Cambridge University Hospitals NHS Cambridge University Hospitals NHS Foundation Trust Foundation Trust Cambridge, UK Cambridge, UK Gail Horan Sara C. Erridge Consultant Clinical Oncologist Consultant Clinical Oncologist Cambridge University Hospitals NHS Edinburgh Cancer Centre Foundation Trust Western General Hospital Cambridge, UK Edinburgh, UK Peter Hoskin Kieran Foley Consultant in Clinical Oncology Consultant Radiologist Mount Vernon Cancer Centre Royal Glamorgan Hospital & Velindre Northwood, UK; Cancer Centre Professor of Clinical Oncology Cardiff, UK University of Manchester, UK Mark Gaze Paul Humphries Consultant in Clinical Oncology Consultant Paediatric Radiologist University College London Hospitals University College London Hospitals NHS Foundation Trust NHS Foundation Trust London, UK London, UK Emma- Louise Gerety Pooja Jain Consultant Musculoskeletal Consultant Clinical Oncologist Radiologist St James’ University Hospital Cambridge University Hospitals NHS Leeds, UK Foundation Trust Cambridge, UK CONTRIbUTORS ix N. Jane Taylor Monique Shahid Principal Clinical Scientist Consultant Paediatric Radiologist Paul Strickland Scanner Centre The Leeds Teaching Hospitals NHS Trust Mount Vernon Hospital Leeds, UK Northwood, UK Elizabeth C. Smyth Rohit Kochhar Consultant Oncologist Consultant Radiologist Cambridge University Hospitals NHS The Christie NHS Foundation Trust Foundation Trust Manchester, UK Cambridge, UK Kate Lankester David Summers Honorary Clinical Senior Lecturer Consultant Neuroradiologist Sussex Cancer Centre Western General Hospital Royal Sussex County Hospital Edinburgh, UK Brighton, UK Simon Thomas Vivek Misra Consultant Clinical Scientist Consultant Clinical Oncologist Cambridge University Hospitals NHS The Christie NHS Foundation Trust Foundation Trust Manchester, UK Cambridge, UK Carys Morgan Gerard Thompson Clinical Oncologist Senior Clinical Lecturer in Radiology Velindre Cancer Centre Department of Radiology Cardiff, UK University of Edinburgh Edinburgh, UK Rebecca Muirhead Consultant Clinical Oncologist Lavanya Vitta Oxford University Hospitals Trust Consultant Radiologist Oxford, UK Brighton and Sussex University Hospitals NHS Trust Francesca Peters Brighton, UK Consultant Radiologist East and North Hertfordshire Trust Huiqi Yang Stevenage, UK Consultant Clinical Oncologist Cambridge University Hospitals NHS Sarah Prewett Foundation Trust Cambridge, UK Consultant Clinical Oncologist Cambridge University Hospitals NHS Connie Yip Foundation Trust Senior Consultant Radiation Oncologist Cambridge, UK Department of Radiation Oncology Singapore Marika Reinius Specialist Registrar in Medical Oncology Cambridge University Hospitals NHS Foundation Trust Cambridge, UK