By Andrew Gaya, Anand Mahadevan

This is a unmarried, complete instruction manual for medical oncology trainees and experts, masking the fundamental elements of stereotactic radiotherapy structures and treatment.

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As the gold standard for visualization of brain neoplasms, MR also found increasing applications in prostate, spinal tumors, and chest and solid abdominal tumors. PET (Positron Emission Tomography) is valuable in staging, planning and evaluating treatment response and might predict long-term outcome [35]. PET-CT is now popular for reduced image registration uncertainties and widely used for lung cancer, head-andneck tumors, colon cancer, etc. Whenever possible, the initial patient setup (along with any immobilization device) during CT simulation should be reproduced during other imaging modalities, which helps to significantly reduce the uncertainty when it is fused with the CT imaging.

53. Fowler JF, Tome WA, Fenwich JD, et al. A challenge to traditional radiation oncology. Int J Radiat Oncol Biol Phys. 2004;60:1241–56. 54. Hall EJ, Wuu C-S. Radiation-induced second cancers: the impact of 3D-CRT and IMRT. Int J Radiat Oncol Biol Phys. 2003;56:83–8. 55. Kutcher GJ, et al. Comprehensive QA for radiation oncology: report of AAPM Radiation Therapy Committee Task Group 40. Med Phys. 1994;21:581–618. 56. Klein EE, Hanley J, Bayouth J, et al. AAPM Task Group 142 report: quality assurance of medical accelerators.

4. Treatment deliveries include static and dynamic conformal arcs, conformal beams, and beam or arc intensity-modulated radiosurgery and radiotherapy. A combination of Varian’s SBRT product with the immobilization and imageguidance system developed by BrainLab AG (Feldkirchen, Germany) is the TrueBeam STx with Novalis Radiosurgery (shown in Fig. 2). ExacTrac® Robotic 6D Couch provides automated patient positioning. Room-based X-ray imaging offers fast and accurate patient setup and intra-fraction verification.

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