A modern review of the uncertainties in volumetric imaging of respiratory‐induced target motion in lung radiotherapy

Radiotherapy has become a critical component for the treatment of all stages and types of lung cancer, often times being the primary gateway to a cure. However, given that radiation can cause harmful side effects depending on how much surrounding healthy tissue is exposed, treatment of the lung can...

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Bibliographic Details
Published in:Medical physics (Lancaster) 2020-10, Vol.47 (10), p.e988-e1008
Main Authors: Vergalasova, Irina, Cai, Jing
Format: Article
Language:English
Subjects:
4D imaging
Diagnostic Imaging
Humans
IGRT
Lung - diagnostic imaging
Lung Neoplasms - diagnostic imaging
Lung Neoplasms - radiotherapy
Lung Neoplasms - surgery
lung radiotherapy
Motion
motion management
Radiosurgery - adverse effects
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
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Summary:Radiotherapy has become a critical component for the treatment of all stages and types of lung cancer, often times being the primary gateway to a cure. However, given that radiation can cause harmful side effects depending on how much surrounding healthy tissue is exposed, treatment of the lung can be particularly challenging due to the presence of moving targets. Careful implementation of every step in the radiotherapy process is absolutely integral for attaining optimal clinical outcomes. With the advent and now widespread use of stereotactic body radiation therapy (SBRT), where extremely large doses are delivered, accurate, and precise dose targeting is especially vital to achieve an optimal risk to benefit ratio. This has largely become possible due to the rapid development of image‐guided technology. Although imaging is critical to the success of radiotherapy, it can often be plagued with uncertainties due to respiratory‐induced target motion. There has and continues to be an immense research effort aimed at acknowledging and addressing these uncertainties to further our abilities to more precisely target radiation treatment. Thus, the goal of this article is to provide a detailed review of the prevailing uncertainties that remain to be investigated across the different imaging modalities, as well as to highlight the more modern solutions to imaging motion and their role in addressing the current challenges.
ISSN:0094-2405
2473-4209
DOI:10.1002/mp.14312