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    Conformalterminology

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    This document discusses and compares two types of intensity modulated radiation therapy (IMRT): dynamic IMRT and step-and-shoot IMRT. Dynamic IMRT involves continuously moving MLC leaves while the radiation beam is always on, allowing higher doses to targets while reducing doses to critical structures. Step-and-shoot IMRT involves the radiation beam turning on and off between discrete MLC leaf movements to sequentially deliver dose to different beam shapes using a forward-planning technique. Both techniques aim to better conform radiation dose to targets while sparing nearby organs at risk compared to conventional radiation therapy.

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    Conformalterminology

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    13 views3 pages
    This document discusses and compares two types of intensity modulated radiation therapy (IMRT): dynamic IMRT and step-and-shoot IMRT. Dynamic IMRT involves continuously moving MLC leaves while the radiation beam is always on, allowing higher doses to targets while reducing doses to critical structures. Step-and-shoot IMRT involves the radiation beam turning on and off between discrete MLC leaf movements to sequentially deliver dose to different beam shapes using a forward-planning technique. Both techniques aim to better conform radiation dose to targets while sparing nearby organs at risk compared to conventional radiation therapy.

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    This document discusses and compares two types of intensity modulated radiation therapy (IMRT): dynamic IMRT and step-and-shoot IMRT. Dynamic IMRT involves continuously moving MLC leaves while the radiation beam is always on, allowing higher doses to targets while reducing doses to critical structures. Step-and-shoot IMRT involves the radiation beam turning on and off between discrete MLC leaf movements to sequentially deliver dose to different beam shapes using a forward-planning technique. Both techniques aim to better conform radiation dose to targets while sparing nearby organs at risk compared to conventional radiation therapy.

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    13 views3 pages

    Conformalterminology

    Uploaded by

    api-264047496
    This document discusses and compares two types of intensity modulated radiation therapy (IMRT): dynamic IMRT and step-and-shoot IMRT. Dynamic IMRT involves continuously moving MLC leaves while the radiation beam is always on, allowing higher doses to targets while reducing doses to critical structures. Step-and-shoot IMRT involves the radiation beam turning on and off between discrete MLC leaf movements to sequentially deliver dose to different beam shapes using a forward-planning technique. Both techniques aim to better conform radiation dose to targets while sparing nearby organs at risk compared to conventional radiation therapy.

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    Stephanie Olson

    March 20, 2015


    Conformal Terminology discussion
    Dynamic IMRT vs. Step-and-Shoot IMRT
    Intensity modulated radiation therapy (IMRT) is a treatment planning technique which uses
    beamlets to redistribute radiation dose away from highly critical regions of normal tissues to
    regions which are less critical while delivering high-dose volumes to the target of interest.
    Beamlets of varying intensities are computed from multiple non-coplanar fields to achieve
    desirable target doses while also achieving dose constraints on normal tissues.1 Two types of
    IMRT techniques used to deliver highly conformal radiation treatments include dynamic IMRT
    and step-and-shoot IMRT.
    Dynamic IMRT can otherwise be known as sliding window IMRT. In this type of treatment, the
    radiation beam in always on while the MLC leaves are continuously moving to modulate the
    treatment beam.1 Planning for dynamic IMRT is done using an inverse technique. Target dose is
    specified along with dose constraints to organs at risk (OR) near the target volume. Dose volume
    histogram (DVH) parameters such as total dose, minimum and maximum dose and objective
    priorities are input to the treatment planning system (TPS) and the computer program does the
    hard work of computing how many beamlets and what intensities are needed for a given
    treatment beam angle.2 Advantages to using a dynamic IMRT technique include the ability to
    administer higher doses to the target while reducing the dose to the critical structures. An
    overview of the dynamic IMRT technique can be seen in this YouTube video.3
    Step-and-shoot IMRT or segmented IMRT is another modulation type treatment technique.
    However, with step-and-shoot IMRT the radiation beam turns on and off between MLC leaf
    movements. An initial beam shape is set and then the beam turns on to deliver a portion of the
    dose. Once the necessary dose is delivered for that beam shape, the beam then turns off, the
    MLC leaves move to a new beam shape and the beam once again turns on. This process occurs
    multiple times from many different angles until the desired dose is delivered. Planning step-and-

    shoot IMRT is done using a forward planning technique. In forward planning, beam angles and
    field shapes are specified. The initial dose is calculated for those given fields and the dose
    distribution is evaluated. The beams are then copied and new segments are drawn to block the
    regions of high dose. This technique can also be called field-in-field and is commonly used
    when planning breast cancer treatments.4 Forward planned treatments are often times a trial-anderror to see which segments and beam weights give the best outcome.

    References
    1 Khan F. Treatment Planning in Radiation Oncology. 3rd ed. Philadelphia, PA: Lippincott
    Williams & Wilkins; 2012.
    2 Nedev N. Palmerston North Department of Radiation Oncology. Powershare.com.
    http://www.powershow.com/view1/21b54aZDc1Z/IMRT_for_beginners_powerpoint_ppt_presentation. Accessed March 20, 2015.
    3 The NCI Hospital. What is intensity modulated radiotherapy (IMRT)? YouTube Website.
    https://www.youtube.com/watch?v=eZS6DVGBx0k. Published September 23, 2011. Accessed
    March 20, 2015.
    4 Hilsendager L. Intensity Modulated Radiation Therapy. [SoftChalk]. La Crosse, WI: UW-L
    Medical Dosimetry Program; 2013.

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