IMAGE GUIDED RADIATION THERAPY

External Beam Radiation Therapy (EBRT) is a very common type of cancer treatment that is used either together with surgery and chemotherapy or sometimes on its own.  Over 60% of people who are diagnosed with cancer will receive radiation as part of their treatment course and usually it is done with a machine similar to the ones on this page.  Depending on the location and size of the tumor, different technologies may be used to help the radiation oncologist more accurately target the tumor and nearby lymph nodes.  Whether you need radiation for a brain tumor, breast cancer, or prostate cancer, Coastal Radiation Oncology has some of the most capable and precise external beam radiation machines available in California.  There are many forms of EBRT, read the descriptions below for more information about the types of radiation available through your Coastal Radiation Oncology physician.

Intensity Modulated Radiation Therapy (IMRT)


Intensity Modulated Radiation Therapy (IMRT) is an advanced form of noninvasive radiation therapy that utilizes computer-guided x-rays to precisely target and destroy cancer cells while avoiding healthy tissue. The use of high-speed computers and special imaging devices ensures our team is able to control the intensity and size of a radiation beam and adjust it hundreds of times throughout a single treatment. This results in a beam of radiation that can be shaped around a cancerous tumor to avoid healthy tissue. Additionally, the intensity of the beam can be blocked, filtered, and adjusted to most effectively radiate a tumor and destroy a cancer cell’s DNA—preventing a tumor from growing and spreading. To learn the exact location of a cancerous tumor and to precisely target a tumor using IMRT, a variety of diagnostic three-dimensional computer tomographic (3DCT) scans and/or magnetic resonance images (MRI) are collected. Depending on a tumor’s location and the sensitivity of surrounding tissue, a positioning device may be used to help a patient stay perfectly still while undergoing treatment. Sometimes, tiny gold seeds are implanted in or near a tumor to help our treatment team identify it clearly on imaging devices and to ensure the most effective treatment. IMRT is commonly used to treat prostate cancer, head and neck cancer, and cancers of the central nervous system. These sensitive areas require the utmost precision so IMRT is often an optimal treatment option. IMRT may also be used in treating some cases of breast, thyroid, lung, gastrointestinal, and gynecologic cancers.

Image-Guided Radiation Therapy (IGRT)


Image-Guided Radiation Therapy (IGRT) is an advanced form of radiation therapy that uses 2D, 3D and 4D imaging technology to pinpoint the precise shape and location of a cancerous tumor and accurately deliver radiation beams to its location.  Using special imaging technology, IGRT allows our physicians and treatment specialists to view or “image” a tumor before, during, and after treatment.  By imaging the tumor prior to the delivery of every radiation treatment, miniscule adjustments can be made to the radiation beams to precisely target the tumor, which may move or change shape and size during the course of treatment which helps to avoid the surrounding healthy tissue. IGRT is most commonly used in conjunction with IMRT to treat tumors in areas of the body that move regularly (i.e. lungs).

Volumetric Arc Therapy (VMAT)


Volumetric Arc Therapy (VMAT) is an advanced form of intensity modulated radiation therapy (IMRT).  With a 360° rotation of the gantry on the linear accelerator (or multi-arc treatment), a precisely-sculpted 3-D dose is distributed. VMAT is generally able to deliver the dose to the entire tumor in a single 360° rotation around the patient, which can take as little as just two minutes. Conventional IMRT without VMAT usually requires the machine to rotate around the patient several times or to make repeated stops and starts to treat the tumor from different angles.

TomoTherapy


TomoTherapy® system is an all-in-one system that lets your treatment team scan and treat with a single piece of equipment that physically revolves around you. TomoTherapy® is the only radiation therapy system designed on a CT scanner foundation.  Daily imaging before each treatment allows your clinician to adjust treatment for even the smallest changes in the size, shape, and location of tumors. TomoTherapy® provides highly precise targeting and attacking of cancer cells. Advanced image-guided, Intensity Modulated Radiation Therapy (IMRT) delivered from 360 degrees around you. Radiation is delivered via thousands of little “beamlets” coming from all angles. The flexibility and function of TomoTherapy increases control in delivering radiation where it needs to be while minimizing damage to surrounding healthy tissues and organs. It can be adapted at any point to best deliver treatment, ensuring the right dosage in the right place at the right time. Thus ensuring your doctor is able to effectively treat hard-to-reach and complex tumors.

Superficial Radiation Treatment


Superficial Radiation Treatment (SRT) is a non-invasive treatment option for skin cancer. SRT is a logical choice for primary lesions that otherwise require difficult or extensive surgery of sensitive structures in the head and neck regions such as the fold in the nose, eyelids, lips, corner of mouth, and the lining of the ear, where surgery would result in a poor cosmetic outcome. SRT does not require anesthetics or skin grafting, and the cosmetic results are excellent compared to other treatments. The SRT systems used at Coastal Radiation Oncology deliver fast and accurate treatments, which maximize therapeutic benefit while minimizing effects to the surrounding area.

Deep Inspiration Breath Hold (DIBH)


Deep inspiration breath hold (DIBH) is a specialized technique that delivers radiotherapy as patients hold their breath. DIBH is designed to help reduce any incidental radiation to the heart. For patients with cancer of the left breast, one of the main concerns during the radiotherapy treatment is the proximity of the heart to the treatment area. Our internal anatomy and the position of the breast tissue that requires treatment means heart tissue may potentially receive some of the radiation dose. Years after treatment, incidental doses of radiation may cause some heart related problems. The DIBH technique is helpful ensuring that the breast/chest wall area receives the full prescribed dose of radiation while reducing exposure of the heart.

Coastal Radiation Oncology Medical Center

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