An automatic CT-guided adaptive radiation therapy technique by online modification of multileaf collimator leaf positions for prostate cancer

Multiadaptive Plan (MAP) IMRT to Accommodate Independent Movement of the Prostate and Pelvic Lymph Nodes

“…Some researchers have worked to develop deformable image registration to improve efficiency of structure delineation [21][22][23] while others have sought to develop fast dose calculation engines and fast computer optimization algorithms [24][25][26]. For prostate only treatment, our clinical experience and other published studies [27,28] support that the iso-center tracking strategy is practical and effective.…”

Adaptive radiotherapy strategies for pelvic tumors – a systematic review of clinical implementations

“…Deformable image registration was more frequently applied in the in silico studies, mostly for online re-planning/re-optimization [59,61,67,71,86,87,94] and offline re-planning/re-optimization strategies [60,63,66,69,75,107] but also applied for online MLC/field adjustments [77,89]. To facilitate adaptations, especially for online execution, modifications of the planning system or automatic activation/selection of plans was applied in 50% of the in silico studies [58][59][60][61][67][68][69]71,72,[74][75][76][77][78][79][80][82][83][84][85][86][87][88][92][93][94]. In view of the increasing speed of optimization algorithms, limited in-room imaging quality together with manual (re-)contouring remains the biggest bottlenecks for clinical implementation of many of the ART strategies and certainly limiting online applications.…”

The contribution of on-line correction for rotational organ motion in image-guided radiotherapy of the bladder and prostate

“…A similar correction strategy was proposed by Wu and colleagues [17] in a study of prostate-only treatment; however they limited the collimator rotations to the lateral beams only. A variety of sophisticated methods for on-line IGRT corrections have also been proposed, with approaches ranging from modification of MLC shapes [18], through deformation of beam intensity fluences [19] to full 6 DoF rigid body corrections [20].…”