Trial Information

4D Image-guided Adaptive Radiotherapy for Lung Cancer: Patient Image Acquisition

OBJECTIVES:

- Quantify the magnitude and distribution of inter- and intrafraction anatomic
variations, including the temporal stability of the tumor/respiration signal
correlation.

- Improve the acquisition and reconstruction of 4D CT scan images by advancing the 4D CT
scan data collection process and evaluating 4D CT scan image reconstruction using
different respiratory inputs.

- Quantify the uncertainty of deformable image-registration algorithms.

- Develop and investigate the efficacy of inter- and intrafraction probabilistic
planning-based 4D image-guided adaptive radiotherapy (IGART) strategies for clinical
application.

- Determine the expected geometric, dosimetric, and radiobiological improvements from the
4D IGART system.

OUTLINE: Patients undergo insertion of ≥ 1 small radio-opaque marker into (or in the
vicinity of) the primary lesion or suspect lymph nodes via bronchoscopy. X-rays are
performed to document the position of the markers.

Patients undergo 4D CT scan before each radiotherapy session and once a week after a
radiotherapy session. Patients also undergo x-ray imaging before and during radiotherapy,
optical and internal marker motion recording before and after radiotherapy, and audiovisual
feedback during radiotherapy.

Patients undergo image-guided adapted radiotherapy based on these data.