Image guidance for precise conformal radiotherapy

Thomas Rockwell Mackie, Jeff Kapatoes, Ken Ruchala, Weiguo Lu, Chuan Wu, Gustavo Olivera, Lisa Forrest, Wolfgang Tome, Jim Welsh, Robert Jeraj, Paul Harari, Paul Reckwerdt, Bhudatt Paliwal, Mark Ritter, Harry Keller, Jack Fowler, Minesh Mehta

Research output: Contribution to journalArticlepeer-review

421 Scopus citations


Purpose To review the state of the art in image-guided precision conformal radiotherapy and to describe how helical tomotherapy compares with the image-guided practices being developed for conventional radiotherapy. Methods and materials Image guidance is beginning to be the fundamental basis for radiotherapy planning, delivery, and verification. Radiotherapy planning requires more precision in the extension and localization of disease. When greater precision is not possible, conformal avoidance methodology may be indicated whereby the margin of disease extension is generous, except where sensitive normal tissues exist. Radiotherapy delivery requires better precision in the definition of treatment volume, on a daily basis if necessary. Helical tomotherapy has been designed to use CT imaging technology to plan, deliver, and verify that the delivery has been carried out as planned. The image-guided processes of helical tomotherapy that enable this goal are described. Results Examples of the results of helical tomotherapy processes for image-guided intensity-modulated radiotherapy are presented. These processes include megavoltage CT acquisition, automated segmentation of CT images, dose reconstruction using the CT image set, deformable registration of CT images, and reoptimization. Conclusion Image-guided precision conformal radiotherapy can be used as a tool to treat the tumor yet spare critical structures. Helical tomotherapy has been designed from the ground up as an integrated image-guided intensity-modulated radiotherapy system and allows new verification processes based on megavoltage CT images to be implemented.

Original languageEnglish (US)
Pages (from-to)89-105
Number of pages17
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number1
StatePublished - May 1 2003
Externally publishedYes

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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