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First clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer: technical procedure

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 with intraoperative real time dose calculation based on the indivi...

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Autores principales: Roeder, Falk, Fastner, Gerd, Fussl, Christoph, Sedlmayer, Felix, Stana, Markus, Berchtold, Johannes, Jäger, Tarkan, Presl, Jaroslav, Schredl, Philipp, Emmanuel, Klaus, Colleselli, Daniela, Kotolacsi, Gabriel, Scherer, Philipp, Steininger, Philipp, Gaisberger, Christoph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638784/
https://www.ncbi.nlm.nih.gov/pubmed/37950314
http://dx.doi.org/10.1186/s13014-023-02374-6
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author Roeder, Falk
Fastner, Gerd
Fussl, Christoph
Sedlmayer, Felix
Stana, Markus
Berchtold, Johannes
Jäger, Tarkan
Presl, Jaroslav
Schredl, Philipp
Emmanuel, Klaus
Colleselli, Daniela
Kotolacsi, Gabriel
Scherer, Philipp
Steininger, Philipp
Gaisberger, Christoph
author_facet Roeder, Falk
Fastner, Gerd
Fussl, Christoph
Sedlmayer, Felix
Stana, Markus
Berchtold, Johannes
Jäger, Tarkan
Presl, Jaroslav
Schredl, Philipp
Emmanuel, Klaus
Colleselli, Daniela
Kotolacsi, Gabriel
Scherer, Philipp
Steininger, Philipp
Gaisberger, Christoph
author_sort Roeder, Falk
collection PubMed
description 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 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 intraoperative cone-beam computed tomography 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.
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spelling pubmed-106387842023-11-11 First clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer: technical procedure Roeder, Falk Fastner, Gerd Fussl, Christoph Sedlmayer, Felix Stana, Markus Berchtold, Johannes Jäger, Tarkan Presl, Jaroslav Schredl, Philipp Emmanuel, Klaus Colleselli, Daniela Kotolacsi, Gabriel Scherer, Philipp Steininger, Philipp Gaisberger, Christoph Radiat Oncol Research 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 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 intraoperative cone-beam computed tomography 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. BioMed Central 2023-11-10 /pmc/articles/PMC10638784/ /pubmed/37950314 http://dx.doi.org/10.1186/s13014-023-02374-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Roeder, Falk
Fastner, Gerd
Fussl, Christoph
Sedlmayer, Felix
Stana, Markus
Berchtold, Johannes
Jäger, Tarkan
Presl, Jaroslav
Schredl, Philipp
Emmanuel, Klaus
Colleselli, Daniela
Kotolacsi, Gabriel
Scherer, Philipp
Steininger, Philipp
Gaisberger, Christoph
First clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer: technical procedure
title First clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer: technical procedure
title_full First clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer: technical procedure
title_fullStr First clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer: technical procedure
title_full_unstemmed First clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer: technical procedure
title_short First clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer: technical procedure
title_sort first clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer: technical procedure
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638784/
https://www.ncbi.nlm.nih.gov/pubmed/37950314
http://dx.doi.org/10.1186/s13014-023-02374-6
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