2011 Joint AAPM/COMP Meeting
Arno Mundt
For more information about the American Association of Physicists in Medicine, visit aapm.org/

Image guided radiation therapy (IGRT) today is focused on the use of in-room imaging
technologies to improve patient setup and target localization. IGRT in the future,
however, will also include the use of imaging to adapt treatment to changes in the tumor
(and patient) during treatment. One of the most important changes which can be adapted
to is in morphology of both the tumor and surrounding normal tissues. Newer in-room
volumetric imaging opens the door to adapting to such changes. Discussion of adaptive
IGRT quickly turn to the technical issues involved including automated segmentation and
deformable registration. However, a fundamental understanding of the variety and
frequency of morphologic changes which occur is crucial to the development of adaptive
IGRT strategies. This lecture reviews the morphologic changes which occur during
treatment of patients with CNS, Head and Neck, lung, gastrointestinal, breast,
gynecologic, genitourinary and pediatric tumors. Published data on adaptive IGRT
approaches in a variety of tumor sites will also be presented.

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