Copenhagen, Denmark
Onsite/Online

ESTRO 2022

Session Item

Monday
May 09
14:15 - 15:30
Auditorium 11
Adapting to changes on different time scales
Jasper Nijkamp, Denmark;
Ye Zhang, Switzerland
In this session we will start with Martin Fast, who will be discussion various real-time motion mitigation techniques to deal with periodic cardiorespiratory motion, including tracking, trailing, gating, and intra-fractional re-planning. Subsequently, Pierluigi Bonomo will discuss how do deal with unpredictable non-periodic target motion and deformation. He will discuss intrafraction GTV changes in rectal and prostate cancer, and how MR-guidance can be used to deal with these. In the third lecture Simon Skouboe will provide his insights into how real-time dose accumulation can be used to detect potential under- or over-dosing, and how act on these. In the last lecture, Stephen Bowen will give an overview of imaging biomarkers that can be used to predict or measure biological response to treatment, and how they can be used to adapt radiation therapy.
Symposium
Physics
14:15 - 14:33
Tracking, trailing and gating: How fast should "real-time" adaptation be?
Martin Fast, The Netherlands
SP-0858

Abstract

Tracking, trailing and gating: How fast should "real-time" adaptation be?
Authors:

Martin Fast1

1University Medical Center Utrecht, Radiotherapy, Utrecht, The Netherlands

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Abstract Text

Cardiorespiratory motion is an important source of uncertainty during thoracic and abdominal radiotherapy. Real-time motion mitigation techniques have the potential to minimize or eliminate the dosimetric effects of (residual) target motion during irradiation.  This talk will discuss the pros and cons of several real-time radiotherapy adaptation techniques such as tracking, trailing, gating and intra-fractional replanning. Practical examples will emphasize MRI-guided radiotherapy. The discussion will differentiate between the real-time requirements for respiratory adaptation and cardiac adaptation. Increasingly, treatment targets within or near the heart are considered for radioablation. Cardiac frequencies are typically four times higher compared to breathing frequencies and thus present a unique challenge for real-time imaging and treatment adaptation techniques.