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Adaptive Radiation Therapy (Online, Offline, Real Time)

K Brock1*, C Glide-Hurst2*, J Booth3*, C Fuller4*, (1) UT MD Anderson Cancer Center, Houston, TX, (2) Henry Ford Health System, Detroit, MI, (3) Royal North Shore Hospital, St Leonards, NSW, Australia (4) MD Anderson Cancer Center, Houston, TX


(Thursday, 7/18/2019) 1:00 PM - 3:00 PM

Room: Stars at Night Ballroom 1

Adaptive radiation therapy (ART) consists of a radiation treatment workflow where the treatment plan can be modified using a systematic feedback of measurements to improve radiation treatment by monitoring treatment variations and incorporating them to re-optimize the treatment plan during the treatment course. ART may be implemented to address patient-specific treatment variations including systematic changes in weight, tumor and organ geometric and biological response, and stochastic variations such as organ deformation, filling change, and respiration and peristaltic motion. These variations may occur at different time scales ranging from seconds to entire days. As a result, the current implementations of ART are often binned into three major classes: (1) offline between treatment fractions, (2) online immediately prior to a treatment fraction, (3) real-time during a treatment fraction. However, the additional complexities that ART introduces in the treatment process require careful study to characterize and aggregate the cumulative uncertainties, including those arising from re-imaging the patient, implementing deformable image registration, offline or online replanning, dose accumulation, and subsequent plan delivery. In this scientific session, the key components for each of these ART approaches will be presented, including clinical evidence, workflow, technical benchmarking, and implementation. Details regarding physics components such as benchmarking and resource allocation will be presented.

Learning objectives:
1) To understand the necessary benchmarking steps in different ART workflows.
2) To learn about the differing roles of physicists in ART.
3) To learn about the steps required for safe clinical ART integration.

Funding Support, Disclosures, and Conflict of Interest: Research agreements with Philips Healthcare, ViewRay, Inc., and Modus Medical. Research partially supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA204189.



Radiation Therapy, Treatment Techniques


IM/TH- Image registration : Multi-modality registration

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