Technical developments in high precision radiotherapy

Abstract

Introduction Modern Radiotherapy techniques demand high spatial accuracy and precision in order to guarantee the necessary quality and safety of high-dose, often hypo-fractionated treatments. This need prompted the development of refined in-room imaging and tracking techniques that allow correction of patient position and even real-time compensation of organ motion to be performed. In this presentation, some examples of technological solutions and related methods are analysed with the aim of providing an overview of the evolving field of image-guided and signal-guided Radiotherapy techniques. Technology and methods High precision techniques in Radiotherapy can be categorized in image-guided methods, non-conventional system architectures, signal-guidance by means of non-imaging techniques used to track a surrogate signal in real time, and combinations of these approaches. The theory and technology underlying these techniques come both from the imaging and therapy realms, with interesting examples that will be presented in this talk. From the standpoint of a Medical Physicist, a strong need of reference guidance is generally felt as specialised systems show peculiarities that make standard protocols often non-applicable. Furthermore, the increasing sensibility to the organized approach to quality and safety in Radiation Oncology asks for more standardization. Final considerations The Medical Physicist has the opportunity to play an important role in the management of safety and quality of precision techniques in Radiotherapy, especially in view of the inherent multi-disciplinarity of Medical Physics that benefits from competences acquired in the diverse fields that embrace our profession. It will be the task of our scientific societies to provide members with sufficient resources – education and scientific support, above all – so that this opportunity is fully understood.