Image Guided and Adaptive Radiation Therapy

Abstract

The capacity to use image data during the delivery of radiation therapy represents a major development in radiation oncology, and along with adaptive radiotherapy, it is the topic of this review on Image Guided Adaptive Radiation Therapy (IGART). The book is edited by Robert Timmerman and Lei Xing, with 22 chapters by 71 authors grouped into three parts. Part I is an overview of image-guided adaptive radiotherapy (IGART), with two informative introductory chapters summarizing its rationale, methods, current status, and future expectations. It explains current image-guided radiotherapy (IGRT) and IGART methods, with the assistance of a table that allows comparisons among different methods. Next are several chapters, each explaining a major topic in IGART, such as errors and margins, management of respiratory motion, IGART in brachytherapy, stereotactic radiosurgery, and stereotactic body RT, and implanted fiducial markers. The justification for IGART is to “reduce the uncertainty and treatment margins,” by addressing three issues—tumor delineation, interfractional, and intrafractional uncertainties, and the chapter on errors and margins is particularly well-written, identifying the gain that is achieved and potentially achievable by addressing each of these three issues.