A Practical Guide to MR-Linac
Technical Innovation and Clinical Implication
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Open AccessBeam quality and the mystery behind the lower percentage depth dose in grid radiation therapy
Grid therapy recently has been picking momentum due to favorable outcomes in bulky tumors. This is being termed as Spatially Fractionated Radiation Therapy (SFRT) and lattice therapy. SFRT can be performed wit...
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Epilogue and Outlook
This chapter summarizes the length and breadth of this book. Each chapter was written by experts in their own fields. MR-Linac technology is very promising, but it is still nascent, with high but as yet unconf...
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Introduction to MR-Linac
A short history of radiation and its advances in cancer treatment is presented. It provides context to this book and an overview of the chapters.
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Role of MRI in Radiation Oncology
Magnetic resonance (MR) images are used frequently in the diagnosis of disease and also in radiation oncology. In many disease sites, MR has unequivocal superiority over other imaging modalities. This chapter ...
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Clinical Necessity and Patient Selection in MR-Linac
Every new technology may not be best suited for a patient’s treatment, and a selection procedure is needed for the management plan. This is certainly the case with MR-Linac technology, which uses magnetic reso...
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Normal Tissue Radiation Response
Radiation toxicity in normal tissues can be classified as early effects, late effects, and consequential late effects. These effects vary based on the tissue type, radiation dose, fractionation, and the volume...
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Characteristics of Photon Beams
Photon beams are characterized by their intensity and energy. The attenuation coefficient measures the rate at which the beam is attenuated (loses intensity) at depth. A half-value layer is a thickness of mate...
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Cell and Tissue Kinetics
The response of cells to low LET radiation is often dependent upon phase of the cell cycle at the time of irradiation, but the response of tumors and normal tissue is dependent on other additional parameters s...
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Chemotherapy, Chemomodulation, and Immunomodulation of Radiation Therapy
Radiation therapy can be modified by increasing the effectiveness of radiation on tumors (radiosensitizers), protecting normal tissues (radioprotectors), increasing oxygen concentration, or by using systemic t...
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Dosimetry of Photon Beams in a Patient
Simple dose calculations are based on photon dose to water. When treating patients, dose corrections must be introduced to account for anatomic variations in shape and density. These dose correction techniques...
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Time Dose and Fractionation Effects
The linear-quadratic (LQ) model utilizes the terms α (single-hit kill) and β (two-hit kill) which correlate with low-dose killing and high-dose killing, respectively. Fractionation experiments with normal tiss...
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Hyperthermia
Though its use has waned and conventional heat treatments alone are only used to treat some types of cancer at a few clinics in the United States, there is still some interest in the use of hyperthermia as an ...
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Radiation Effects in the Embryo and Fetus
The severity of the effects of ionizing radiation on the pre- and postimplantation embryo/fetus is dependent upon the dose, dose rate, and stage of gestation. In the preimplantation (conceptus) stage, relative...
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Dosimetry of Electron Beams
The electron is a charged particle with a finite range directly proportional to its energy. Electrons are limited to more superficial depths than photons. Surface dose increases with energy, unlike photons. Si...
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Advanced Treatment Planning for EBRT
Treatment planning techniques include patient immobilization, imaging, radiation field design, verification, and evaluation. Modern radiotherapy takes advantage of many different imaging modalities, including ...
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Radiation Protection and Safety
Radiation protection is a necessary process to reduce dose to radiation workers and the general public. There are multiple bodies that regulate various aspects of radiation protection including the Internation...
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Special Topics: Computers
With the advent of computers and especially with 3D conformal radiotherapy, the use of Patient Archiving and Communication System and common Digital Imaging and Communications in Medicine files has become incr...
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Cancer Biology
Cancer results from an accumulation of multiple mutations in cellular genes that regulate cell growth/life span, death, and migration, immune response, telomere length, genomic instability, invasion, and metas...
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Radioactive Decay
When atoms become unstable, they undergo changes called radioactive decay. If the nucleus is very heavy and has too many protons, it may undergo alpha decay (release a helium nucleus). If a nucleus is very lig...
