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Volume 7
OMICS Journal of Radiology
Radiology and Oncology 2018
July 16-17, 2018
July 16-17, 2018 Dubai, UAE
Radiology and Oncology
2
nd
World Congress on
Focus where it matters, optimizing 4D and 5D imaging tools for extracranial radiosurgery
Shankar Vangipuram
HCG Cancer Center, India
Introduction:
Extracranial radiosurgery involves shooting surgical doses of radiation for the management of moving targets
cancer/oligomets and is characterized by accurate target delineation, robust motion management and fast dose delivery (3-8
fractions).
Method:
Basic 3D medical imaging acquisition and reconstruction principles are based on the assumption that the object being
imaged is static over the course of the acquisition. Patient motion and organ distortion, whether the result of voluntary patient
movement or natural functions such as respiration, can impact target design due to artifacts and thus delivered doses will be less
accurate and precise. Instead, a common strategy employed was to expand the target volume by a safety margin to accommodate
the estimated motion of the target volume and then to irradiate larger fields under the expectation that this would compensate for
the unknown motion which would lead to higher toxicity when we are treating stereotactic targets (measuring less than 5 cms).
Results:
In the past two decades, imaging, planning and delivery technologies have progressed to the point that it is now possible
to deal with a 4D model of the patient (consisting of three spatial dimensions plus time as the fourth dimension) which is simply
called 4D radiotherapy. The introduction of 4DCT into radiation therapy was quickly followed by 4DMRI, 4D cone beam CT and
4D PET. All these tools have enabled us to capture the motion information accurately and can be utilized in the delivery of the
treatment.
Conclusion:
5D imaging, are dynamic 3D images (4D) that are acquired at multiple time points and patterns of deformations are
analyzed. The correlations in 5th dimension using deformable image registration softwares (e.g. the pattern of deformation for
dynamic CT imaging) can be extracted for recognition, tracking and diagnosis of the complications of radiosurgery. Techniques
to optimize 4D imaging and 5D imaging and incorporating into the workflow for radiosurgery will be the key into the future of
safe radiosurgery practice.
atree.kundu@hcgoncology.comOMICS J Radiol 2018, Volume 7
DOI: 10.4172/2167-7964-C1-022