Surface-guided radiation therapy

Surface-guided radiation therapy (SGRT) is a radiation therapy technique that utilizes advanced imaging and tracking technologies to deliver precise radiation doses to cancerous tumors while minimizing exposure to surrounding healthy tissues. SGRT employs real-time, non-invasive surface imaging to monitor the patient's external surface in three dimensions during radiation delivery. This approach enhances the accuracy of patient positioning and motion management throughout the treatment, thereby improving the safety and effectiveness of radiation therapy.

Overview

SGRT technology uses sophisticated camera systems to capture and monitor the shape, position, and motion of the patient's skin surface in real time. By comparing the observed surface to a reference surface obtained from the patient's planning Computed Tomography (CT) scan, SGRT systems can detect even slight movements of the patient. This capability allows for immediate adjustment of the radiation beam or repositioning of the patient to ensure that the radiation is accurately targeted at the tumor site.

Benefits

The primary benefits of SGRT include:

• Increased Accuracy: By continuously monitoring the patient's position, SGRT ensures that radiation is precisely delivered to the tumor, reducing the risk of damaging healthy tissues.
• Improved Safety: The non-invasive nature of surface imaging reduces the need for additional X-rays or markers implanted in the body, thereby minimizing the patient's exposure to extra radiation.
• Enhanced Comfort: SGRT allows for a more comfortable treatment experience for patients, as it requires less restrictive immobilization devices.
• Adaptability: This technology is versatile and can be used in treating various types of cancers, including those in the breast, lung, and prostate.

Applications

SGRT is particularly useful in treatments where the tumor location is prone to movement, such as in the lung or breast, or where high precision is required to avoid critical structures, such as in the brain or near the spinal cord. It is also beneficial in treatments that require the patient to be in a specific posture or position, as it ensures that the patient remains correctly aligned throughout the radiation session.

Challenges

While SGRT offers significant advantages, there are challenges to its implementation, including:

• Technical Complexity: The setup and operation of SGRT systems require specialized training and expertise.
• Cost: The advanced technology used in SGRT can be expensive, potentially limiting its availability in some settings.
• Integration: Integrating SGRT with existing radiation therapy systems and workflows can be complex and time-consuming.

Future Directions

Research and development in SGRT are focused on enhancing the technology's accuracy, reducing its cost, and expanding its applications. Future advancements may include more sophisticated algorithms for surface tracking, integration with other imaging modalities for improved tumor visualization, and automated systems for real-time adaptation of the treatment plan.

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