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An isocentric technique is where all beams used in a radiation treatment have a common focus point, a.k.a. the isocenter. Isocentric techniques require less patient repositioning as multiple field arrangements can be delivered with gantry and collimator movements, reducing treatment times. [1]
The idealized intersection point of the gantry axis of rotation with that of the collimator and treatment table is known as the mechanical isocenter [2]
In practice, due to the heavy weight and mechanical imperfections of the system, the isocenter is not a single point and its location changes with the rotation of the gantry, collimator or couch. This causes small uncertainties in the determination of isocenter position, typically less than 2 millimetres [3]
The movements of the linear particle accelerator (or linac) are threefold:
All of these movements in the modern linac occur around an axis that runs through the isocenter. In this way, if the centre of the target area in the patient's body is moved to coincide with the isocenter, then all motions of the machine will remain centred on the target. This way, non-target areas will only receive short durations of radiation, reducing damage to them, while the target area receives constant radiation.
Radiation therapy or radiotherapy is a treatment using ionizing radiation, generally provided as part of cancer therapy to either kill or control the growth of malignant cells. It is normally delivered by a linear particle accelerator. Radiation therapy may be curative in a number of types of cancer if they are localized to one area of the body, and have not spread to other parts. It may also be used as part of adjuvant therapy, to prevent tumor recurrence after surgery to remove a primary malignant tumor. Radiation therapy is synergistic with chemotherapy, and has been used before, during, and after chemotherapy in susceptible cancers. The subspecialty of oncology concerned with radiotherapy is called radiation oncology. A physician who practices in this subspecialty is a radiation oncologist.
Medical physics deals with the application of the concepts and methods of physics to the prevention, diagnosis and treatment of human diseases with a specific goal of improving human health and well-being. Since 2008, medical physics has been included as a health profession according to International Standard Classification of Occupation of the International Labour Organization.
External beam radiation therapy (EBRT) is a form of radiotherapy that utilizes a high-energy collimated beam of ionizing radiation, from a source outside the body, to target and kill cancer cells. A radiotherapy beam is composed of particles which travel in a consistent direction; each radiotherapy beam consists of one type of particle intended for use in treatment, though most beams contain some contamination by other particle types.
A linear particle accelerator is a type of particle accelerator that accelerates charged subatomic particles or ions to a high speed by subjecting them to a series of oscillating electric potentials along a linear beamline. The principles for such machines were proposed by Gustav Ising in 1924, while the first machine that worked was constructed by Rolf Widerøe in 1928 at the RWTH Aachen University. Linacs have many applications: they generate X-rays and high energy electrons for medicinal purposes in radiation therapy, serve as particle injectors for higher-energy accelerators, and are used directly to achieve the highest kinetic energy for light particles for particle physics.
Megavoltage X-rays are produced by linear accelerators ("linacs") operating at voltages in excess of 1000 kV (1 MV) range, and therefore have an energy in the MeV range. The voltage in this case refers to the voltage used to accelerate electrons in the linear accelerator and indicates the maximum possible energy of the photons which are subsequently produced. They are used in medicine in external beam radiotherapy to treat neoplasms, cancer and tumors. Beams with a voltage range of 4-25 MV are used to treat deeply buried cancers because radiation oncologists find that they penetrate well to deep sites within the body. Lower energy x-rays, called orthovoltage X-rays, are used to treat cancers closer to the surface.
In medicine, proton therapy, or proton radiotherapy, is a type of particle therapy that uses a beam of protons to irradiate diseased tissue, most often to treat cancer. The chief advantage of proton therapy over other types of external beam radiotherapy is that the dose of protons is deposited over a narrow range of depth; hence in minimal entry, exit, or scattered radiation dose to healthy nearby tissues.
A collimator is a device which narrows a beam of particles or waves. To narrow can mean either to cause the directions of motion to become more aligned in a specific direction, or to cause the spatial cross section of the beam to become smaller.
Radiosurgery is surgery using radiation, that is, the destruction of precisely selected areas of tissue using ionizing radiation rather than excision with a blade. Like other forms of radiation therapy, it is usually used to treat cancer. Radiosurgery was originally defined by the Swedish neurosurgeon Lars Leksell as "a single high dose fraction of radiation, stereotactically directed to an intracranial region of interest".
A monitor unit (MU) is a measure of machine output from a clinical accelerator for radiation therapy such as a linear accelerator or an orthovoltage unit. Monitor units are measured by monitor chambers, which are ionization chambers that measure the dose delivered by a beam and are built into the treatment head of radiotherapy linear accelerators.
Varian Medical Systems is an American radiation oncology treatments and software maker based in Palo Alto, California. Their medical devices include linear accelerators (LINACs) and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, proton therapy, and brachytherapy. The company supplies software for managing cancer clinics, radiotherapy centers, and medical oncology practices. Varian Medical Systems employs more than 7,100 people at manufacturing sites in North America, Europe, and China and approximately 70 sites globally.
Fast neutron therapy utilizes high energy neutrons typically between 50 and 70 MeV to treat cancer. Most fast neutron therapy beams are produced by reactors, cyclotrons (d+Be) and linear accelerators. Neutron therapy is currently available in Germany, Russia, South Africa and the United States. In the United States, one treatment center is operational, in Seattle, Washington. The Seattle center uses a cyclotron which produces a proton beam impinging upon a beryllium target.
In radiotherapy, radiation treatment planning (RTP) is the process in which a team consisting of radiation oncologists, radiation therapist, medical physicists and medical dosimetrists plan the appropriate external beam radiotherapy or internal brachytherapy treatment technique for a patient with cancer.
Isocenter in aerial photography: it is a point where a line cuts an angle of 90 degree of tier/2. It is the point on the aerial photo platform that directly falls on a line half-way between the Principal point and the Nadir point. In imaging physics and radiation oncology, the isocenter is termed as the point in space through which the central rays of the radiation beams pass.
Tomotherapy is a type of radiation therapy treatment machine. In tomotherapy a thin radiation beam is modulated as it rotates around the patient, while they are moved through the bore of the machine. The name comes from the use of a strip-shaped beam, so that only one “slice” of the target is exposed at any one time by the radiation. The external appearance of the system and movement of the radiation source and patient can be considered analogous to a CT scanner, which uses lower doses of radiation for imaging. Like a conventional machine used for X-ray external beam radiotherapy, a linear accelerator generates the radiation beam, but the external appearance of the machine, the patient positioning, and treatment delivery is different. Conventional linacs do not work on a slice-by-slice basis but typically have a large area beam which can also be resized and modulated.
Intraoperative radiation therapy (IORT) is radiation therapy that is administered during surgery directly in the operating room.
Image-guided radiation therapy is the process of frequent imaging, during a course of radiation treatment, used to direct the treatment, position the patient, and compare to the pre-therapy imaging from the treatment plan. Immediately prior to, or during, a treatment fraction, the patient is localized in the treatment room in the same position as planned from the reference imaging dataset. An example of IGRT would include comparison of a cone beam computed tomography (CBCT) dataset, acquired on the treatment machine, with the computed tomography (CT) dataset from planning. IGRT would also include matching planar kilovoltage (kV) radiographs or megavoltage (MV) images with digital reconstructed radiographs (DRRs) from the planning CT.
Intraoperative electron radiation therapy is the application of electron radiation directly to the residual tumor or tumor bed during cancer surgery. Electron beams are useful for intraoperative radiation treatment because, depending on the electron energy, the dose falls off rapidly behind the target site, therefore sparing underlying healthy tissue.
Four-dimensional computed tomography (4DCT) is a type of CT scanning which records multiple images over time. It allows playback of the scan as a video, so that physiological processes can be observed and internal movement can be tracked. The name is derived from the addition of time to traditional 3D computed tomography. Alternatively, the phase of a particular process, such as respiration, may be considered the fourth dimension.
In a medical facility, such as a hospital or clinic, a gantry holds radiation detectors and/or a radiation source used to diagnose or treat a patient's illness. Radiation sources may produce gamma radiation, x-rays, electromagnetic radiation, or magnetic fields depending on the purpose of the device.
Surface-guided radiation therapy (SGRT) is the process of using 3D imaging to position and track movement of radiation therapy patients during treatment.
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