Treatment verification and delivery
This chapter focuses on the principles and theories of image-guided radiation therapy (IGRT)-based treatment verification and delivery for lung cancer. It provides an overview of principles and clinical workflow of image guidance, practices of inter- and intrafractional motion management, treatment delivery techniques, and clinical impacts of IGRT on the lung cancer treatment. Interfractional motion localization and the application of setup correction protocols is key for safe and accurate delivery of a curative dose to tumors in the lung. The chapter presents an overview of the clinical flow of IGRT for lung cancer, including considerations of immobilization devices and proper positioning during the simulation, intravenous contrast consideration, computed tomography (CT) / four-dimensional CT (4D-CT) simulation, patient localization and verification, and the basic principles of online image registration. It also focuses on the treatment delivery aspects of respiratory gating and real-time tracking techniques.
