Forschung & Innovation
Publikationen
First clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer
PMU Autor*innen
Falk Roeder, Gerd Fastner, Christoph Fussl, Felix Sedlmayer, Markus Stana, Tarkan Jäger, Jaroslav Presl, Philipp Schredl, Klaus Emmanuel, Daniela Colleselli, Philipp Scherer, Philipp Steininger, Christoph Gaisberger
Alle Autor*innen
Falk Roeder, Gerd Fastner, Christoph Fussl, Felix Sedlmayer, Markus Stana, Johannes Berchtold, Tarkan Jäger, Jaroslav Presl, Philipp Schredl, Klaus Emmanuel, Daniela Colleselli, Gabriel Kotolacsi, Philipp Scherer, Philipp Steininger, Christoph Gaisberger
Fachzeitschrift
RADIATION ONCOLOGY
Kurzfassung
Intraoperative Radiation Therapy (IORT) is a radiation technique applying a single fraction with a high dose during surgery. We report the first abdomino-pelvic application of an image-guided intraoperative electron radiation therapy (IG-IOERT) with intraoperative real time dose calculation based on the individual intraoperative patient anatomy. A patient suffering from locoregionally recurrent rectal cancer after treatment with neoadjuvant re-chemoradiation was chosen for this approach. After surgical removal of the recurrence, an adequate IORT applicator was placed as usual. A novel mobile imaging device (ImagingRing, MedPhoton) was positioned around the patient covering the region to be treated with the IORT-applicator in place. It allowed the acquisition of three-dimensional (3D) intraoperative cone-beam computed tomography (CBCT) images suitable for dose calculation using an automated scaling (heuristic object and head scatter as well as hardening corrections) of Hounsfield units. After image acquisition confirmed the correct applicator position, the images were transferred to our treatment planning system for intraoperative dose calculation. Treatment could be accomplished using the calculated dose distribution. We herein describe the details of the procedure including necessary adjustments in the typically used IORT equipment and work flow. We further discuss the pros and cons of this new approach generally overcoming a decade long limitation of IORT procedures as well as future perspectives regarding IORT treatments.
Keywords
Humans, ELECTRONS, Radiotherapy, Image-Guided/methods, Rectal Neoplasms/diagnostic imaging, Combined Modality Therapy, Cone-Beam Computed Tomography, Intraoperative Period, Intraoperative Care