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Cancers
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Image-Guided Radiotherapy for Cancers
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Image-Guided Radiotherapy for Cancers

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 8164

Special Issue Editors

Dr. Yi-Jen Chen

E-Mail Website
Guest Editor
City of Hope National Medical Center, Duarte, CA, USA
Interests: radiation treatment for gastrointestinal and gynecologic cancers
Dr. Jason Liu

E-Mail Website
Guest Editor
City of Hope National Medical Center, Duarte, CA, USA
Interests: image guided brachytherapy

Special Issue Information

Dear Colleagues,

Alongside surgery and chemotherapy, radiation treatment is one of the three pillars of cancer treatment. Radiation treatment is constantly being transformed by technological innovation. Image-guided radiation therapy (IGRT) incorporates imaging techniques during each radiation therapy session to improve the precision and accuracy of radiation delivery. IGRT is essential for cancers located close to sensitive structures and is particularly useful for cancers in areas of the body that move, such as the lungs. IGRT has enabled clinicians to use ablative doses of radiation per treatment, which increases the probability of tumor control and decreases the number of treatments. In addition, IGRT is a prerequisite to enable adaptive radiation therapy, which incorporates anatomic changes and re-optimizes the treatment plan during the course of treatment. In fact, IGRT is now considered the standard of care for radiation therapy, and it is used to treat all types of cancer.

The recent development of IGRT includes computer tomography (CT)-based IGRT, magnetic resonance (MR)-based IGRT, image-guided brachytherapy, quantitative imaging and radiomics for response-adaptive radiation treatment, and biology-guided radiotherapy using integrated PET detectors. This Special Issue will provide an overview of the state of the art and current trends in using IGRT. The objectives are to highlight both original and review articles addressing subjects related to novel concepts and emerging technologies of IGRT.

Dr. Yi-Jen Chen
Dr. Jason Liu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • image guidance
  • radiation treatment
  • adaptive radiotherapy
  • image-guided brachytherapy
  • cone-beam CT
  • MR-linac
  • stereotactic radiotherapy
  • molecular imaging
  • biology-guided radiotherapy

Published Papers (4 papers)

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Research

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10 pages, 1669 KiB  
Article
Dosimetric Benefit of Adaptive Magnetic Resonance-Guided Stereotactic Body Radiotherapy of Liver Metastases
by Fabian Weykamp, Efthimios Katsigiannopulos, Lars Piskorski, Sebastian Regnery, Philipp Hoegen, Jonas Ristau, C. Katharina Renkamp, Jakob Liermann, Tobias Forster, Kristin Lang, Laila König, Carolin Rippke, Carolin Buchele, Jürgen Debus, Sebastian Klüter and Juliane Hörner-Rieber
Cancers 2022, 14(24), 6041; https://doi.org/10.3390/cancers14246041 - 8 Dec 2022
Cited by 7 | Viewed by 1506
Abstract
(1) Background: To assess dosimetry benefits of stereotactic magnetic resonance (MR)-guided online adaptive radiotherapy (SMART) of liver metastases. (2) Methods: This is a subgroup analysis of an ongoing prospective registry including patients with liver metastases. Patients were treated at the MRIdian Linac between [...] Read more.
(1) Background: To assess dosimetry benefits of stereotactic magnetic resonance (MR)-guided online adaptive radiotherapy (SMART) of liver metastases. (2) Methods: This is a subgroup analysis of an ongoing prospective registry including patients with liver metastases. Patients were treated at the MRIdian Linac between February 2020 and April 2022. The baseline plan was recalculated based on the updated anatomy of the day to generate the predicted plan. This predicted plan could then be re-optimized to create an adapted plan. (3) Results: Twenty-three patients received 30 SMART treatment series of in total 36 liver metastases. Most common primary tumors were colorectal- and pancreatic carcinoma (26.1% respectively). Most frequent fractionation scheme (46.6%) was 50 Gy in five fractions. The adapted plan was significantly superior compared to the predicted plan in regard to planning-target-volume (PTV) coverage, PTV overdosing, and organs-at-risk (OAR) dose constraints violations (91.5 vs. 38.0%, 6 vs. 19% and 0.6 vs. 10.0%; each p < 0.001). Plan adaptation significantly increased median BEDD95 by 3.2 Gy (p < 0.001). Mean total duration of SMART was 72.4 min. (4) Conclusions: SMART offers individualized ablative irradiation of liver metastases tailored to the daily anatomy with significant superior tumor coverage and improved sparing of OAR. Full article
(This article belongs to the Special Issue Image-Guided Radiotherapy for Cancers)
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Review

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11 pages, 251 KiB  
Review
Current Status and Future Directions of Image-Guided Adaptive Brachytherapy for Locally Advanced Cervical Cancer
by Nicholas Eustace, Jason Liu, Colton Ladbury, Andrew Tam, Scott Glaser, An Liu and Yi-Jen Chen
Cancers 2024, 16(5), 1031; https://doi.org/10.3390/cancers16051031 - 2 Mar 2024
Cited by 1 | Viewed by 1159
Abstract
Purpose: The standard of care for patients with locally advanced cervical cancer is definitive chemoradiation followed by a brachytherapy boost. This review describes the current status and future directions of image-guided adaptive brachytherapy for locally advanced cervical cancer. Methods: A systematic search of [...] Read more.
Purpose: The standard of care for patients with locally advanced cervical cancer is definitive chemoradiation followed by a brachytherapy boost. This review describes the current status and future directions of image-guided adaptive brachytherapy for locally advanced cervical cancer. Methods: A systematic search of the PubMed and Clinicaltrials.gov databases was performed, focusing on studies published within the last 10 years. The search queried “cervical cancer [AND] image-guided brachytherapy [OR] magnetic resonance imaging (MRI) [OR] adaptive brachytherapy”. Discussion: The retroEMBRACE and EMBRACE-I trials have established the use of MRI as the standard imaging modality for brachytherapy application and planning. Quantitative imaging and radiomics have the potential to improve outcomes, with three ongoing prospective studies examining the use of radiomics to further risk-stratify patients and personalize brachytherapy. Another active area of investigation includes utilizing the superior soft tissue contrast provided by MRI to increase the dose per fraction and decrease the number of fractions needed for brachytherapy, with several retrospective studies demonstrating the safety and feasibility of three-fraction courses. For developing countries with limited access to MRI, trans-rectal ultrasound (TRUS) appears to be an effective alternative, with several retrospective studies demonstrating improved target delineation with the use of TRUS in conjunction with CT guidance. Conclusions: Further investigation is needed to continue improving outcomes for patients with locally advanced cervical cancer treated with image-guided brachytherapy. Full article
(This article belongs to the Special Issue Image-Guided Radiotherapy for Cancers)
13 pages, 440 KiB  
Review
Clinical Applications of Magnetic Resonance-Guided Radiotherapy: A Narrative Review
by Colton Ladbury, Arya Amini, Amanda Schwer, An Liu, Terence Williams and Percy Lee
Cancers 2023, 15(11), 2916; https://doi.org/10.3390/cancers15112916 - 26 May 2023
Cited by 3 | Viewed by 2093
Abstract
Magnetic resonance-guided radiotherapy (MRgRT) represents a promising new image guidance technology for radiation treatment delivery combining an onboard MRI scanner with radiation delivery technology. By enabling real-time low-field or high-field MRI acquisition, it facilitates improved soft tissue delineation, adaptive treatment, and motion management. [...] Read more.
Magnetic resonance-guided radiotherapy (MRgRT) represents a promising new image guidance technology for radiation treatment delivery combining an onboard MRI scanner with radiation delivery technology. By enabling real-time low-field or high-field MRI acquisition, it facilitates improved soft tissue delineation, adaptive treatment, and motion management. Now that MRgRT has been available for nearly a decade, research has shown the technology can be used to effectively shrink treatment margins to either decrease toxicity (in breast, prostate cancer, and pancreatic cancer) or facilitate dose-escalation and improved oncologic outcomes (in pancreatic and liver cancer), as well as enabling indications that require clear soft tissue delineation and gating (lung and cardiac ablation). In doing so, the use of MRgRT has the potential to significantly improve the outcomes and quality of life of the patients it treats. The present narrative review aims to describe the rationale for MRgRT, the current and forthcoming state of technology, existing studies, and future directions for the advancement of MRgRT, including associated challenges. Full article
(This article belongs to the Special Issue Image-Guided Radiotherapy for Cancers)
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11 pages, 272 KiB  
Review
Image-Guided Proton Therapy: A Comprehensive Review
by Shelby A. Lane, Jason M. Slater and Gary Y. Yang
Cancers 2023, 15(9), 2555; https://doi.org/10.3390/cancers15092555 - 29 Apr 2023
Cited by 8 | Viewed by 2693
Abstract
Image guidance for radiation therapy can improve the accuracy of the delivery of radiation, leading to an improved therapeutic ratio. Proton radiation is able to deliver a highly conformal dose to a target due to its advantageous dosimetric properties, including the Bragg peak. [...] Read more.
Image guidance for radiation therapy can improve the accuracy of the delivery of radiation, leading to an improved therapeutic ratio. Proton radiation is able to deliver a highly conformal dose to a target due to its advantageous dosimetric properties, including the Bragg peak. Proton therapy established the standard for daily image guidance as a means of minimizing uncertainties associated with proton treatment. With the increasing adoption of the use of proton therapy over time, image guidance systems for this modality have been changing. The unique properties of proton radiation present a number of differences in image guidance from photon therapy. This paper describes CT and MRI-based simulation and methods of daily image guidance. Developments in dose-guided radiation, upright treatment, and FLASH RT are discussed as well. Full article
(This article belongs to the Special Issue Image-Guided Radiotherapy for Cancers)
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