First clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer: technical procedure.
Image-guided radiation therapy
Intraoperative radiation therapy
Recurrent rectal cancer
Journal
Radiation oncology (London, England)
ISSN: 1748-717X
Titre abrégé: Radiat Oncol
Pays: England
ID NLM: 101265111
Informations de publication
Date de publication:
10 Nov 2023
10 Nov 2023
Historique:
received:
06
12
2022
accepted:
04
11
2023
medline:
13
11
2023
pubmed:
11
11
2023
entrez:
11
11
2023
Statut:
epublish
Résumé
Intraoperative radiation therapy (IORT) is a radiation technique applying a single fraction with a high dose during surgery. We report the first abdomino-pelvic application of an image-guided intraoperative electron radiation therapy with intraoperative real time dose calculation based on the individual intraoperative patient anatomy. A patient suffering from locoregionally recurrent rectal cancer after treatment with neoadjuvant re-chemoradiation was chosen for this approach. After surgical removal of the recurrence, an adequate IORT applicator was placed as usual. A novel mobile imaging device (ImagingRing, MedPhoton) was positioned around the patient covering the region to be treated with the IORT-applicator in place. It allowed the acquisition of three-dimensional intraoperative cone-beam computed tomography images suitable for dose calculation using an automated scaling (heuristic object and head scatter as well as hardening corrections) of Hounsfield units. After image acquisition confirmed the correct applicator position, the images were transferred to our treatment planning system for intraoperative dose calculation. Treatment could be accomplished using the calculated dose distribution. We herein describe the details of the procedure including necessary adjustments in the typically used IORT equipment and work flow. We further discuss the pros and cons of this new approach generally overcoming a decade long limitation of IORT procedures as well as future perspectives regarding IORT treatments.
Identifiants
pubmed: 37950314
doi: 10.1186/s13014-023-02374-6
pii: 10.1186/s13014-023-02374-6
pmc: PMC10638784
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
186Informations de copyright
© 2023. The Author(s).
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