MO‐A‐T‐6C‐01: Managing Respiratory Motion in Radiation Oncology

Abstract

Intrafraction motion is an issue that is becoming increasingly important in the era of image‐guided radiotherapy. Intrafraction motion can be caused by the respiratory, skeletal muscular, cardiac and gastrointestinal systems. Of these three systems, much research and development to date has been directed towards accounting for respiratory motion. Respiratory motion causes deleterious effects during the imaging, planning and delivery of radiation therapy. The management of respiratory motion in radiation oncology is the subject of this continuing education class which aims to advise medical physicists involved in the external beam radiation therapy of patients with thoracic and abdominal tumors that move due to respiratory motion. This session will describe the magnitude of respiratory motion, discuss radiotherapy‐specific problems caused by respiratory motion, explain techniques that explicitly manage respiratory motion during radiotherapy and give recommendations in the application of these techniques for patient care, including quality assurance guidelines for these devices. The techniques to be described include respiratory gating, breath‐hold techniques, forced shallow breathing and respiration‐synchronized radiotherapy. This session intends to reflect the current state of the scientific understanding and technical methodology in imaging, treatment planning and radiation delivery for radiation oncology patients with tumors affected by respiratory motion. Issues requiring further study will also be raised. The educational objectives of this course include:1. Appreciate the effects of respiratory motion during the imaging, planning and delivery of radiotherapy.2. Learn the various techniques that have been clinically applied to manage respiratory motion.3. Understand the general and specific quality assurance requirements for different respiratory management techniques.4. Describe the clinical process for managing patients with tumors affected by respiratory motion.