bull’s eye’ techniques to ensure the accurate delivery of ... · o modern radiotherapy...
TRANSCRIPT
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‘Bull’s eye’
Techniques to ensure the accurate delivery of Radiation Therapy in Clinical practice
Dr Indranil Mallick
Tata Medical Center, Kolkata
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Tata Medical Center, Kolkata
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How does radiotherapy work?
Radiotherapy is one of the 3 standard treatments of cancer
70% of cancer patients require radiotherapy
Gamma Rays or X rays – enter cells and damage the DNA to cause cell death.
Injures cancer cells a lot more than normal tissues.
Usually delivered in multiple small treatments over 4-7 weeks.
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Radiotherapy is the technologically most advanced treatment for cancer….
Rapid advances in the last 2-3 decades using engineering and software breakthroughs
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Modern Radiotherapy Units
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Progress in Radiotherapy Planning
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Why do we need image guidance?
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Target volumes
Tumor
Clinical Target Volume
Planning Target Volume
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Verification ModalitiesHow do we verify that the treatment is being delivered at exactly the right place?
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2D Imaging Uses orthogonal X-rays to match bony anatomy
Fast, simple and relatively inexpensive
Cannot show soft-tissue anatomy
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3D imaging Uses multiple X-rays to generate a CT image
Advances in image reconstruction - fast
Can show soft tissue changes
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Respiratory Motion
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Respiratory Motion Management
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Respiratory Motion Management
Internal Target Volume Gating
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Tumor tracking
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Exploiting respiration to save the heart
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Anatomical Changes
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Tata Medical Center and IGRT
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IGRT at Tata Medical CenterKeen interest in IGRT
Studies/abstracts on IGRT in Prostate – online vs offline
Head & neck – imaging frequency F5 study
Breast – Pioneers in DIBH in India
Lung – response on cone beam
Cervical – 3D variations
Paediatric cancers - shifts and doses
Goal: optimize use if IGRT in clinical settings
Respiratory motion management
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Online learning
Goals: Simple, Easily accessible, Not time or schedule bound, FREE
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Updated figures at 1 year of launch:
903 users from 53 countries in 6 continents
Country n
India 510
USA 95
Brazil 40
UK 39
Spain 24
Germany 21
Peru 20
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Current figures
Users: 1455
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Automation in image guidance - IIT
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Summary
o Modern radiotherapy techniques aim to very precisely target the tumor and areas at risk while sparing surrounding normal tissues.
o It is essential that the planned dose be delivered at the correct location.
o Several techniques of image guidance (IGRT) have been developed for precise delivery
o Tata Medical Center Kolkata is the leader in IGRT implementation in India. Our initiatives in Innovative education and research on IGRT has brought us international recognition
o Further research in IGRT will lead to more precise delivery of treatment.