Image Guided High Precision Radiotherapy
Group leader: Prof. Dr. Esther Troost
The research group focuses on thorough analysis and subsequent clinical implementation of 3D- and 4D-imaging techniques for high-precision radiotherapy of moving targets, e.g., pancreatic tumors. It furthermore explores suitable markers for reliable tumor localization during the course of fractionated radiation. This applies to both photon and proton beam treatment.
3D- and 4D- imaging / new markers for positioning
Based on the imaging obtained in the diagnostic phase or for radiation planning purposes, the group aims at identifying new prognostic or predictive markers enabling the delivery of tailored treatment, increasing tumor control while maintaining or even reducing the normal tissue complication probability.
Tumors of the head and neck barely move. But many other tumors in the body, i.e. tumors of the lung, liver or pancreas, do move due to the continuous heart beat, breathing and because of the gastrointestinal filling in the abdominal area. To offer accurate radiation in such cases, it is necessary to take into account the movement of the tumor and the surrounding organs. This is called four-dimensional (4D-) radiation treatment planning.
The group focuses on 3D- and 4D- imaging techniques for high precision radiation therapy in (moving) tumors. Innovative combination therapies will be tested in clinical trials.
In addition the researchers explore innovative markers for the radiation with photons and protons. These are needed to precisely define the position of the tumors in consecutive radiation sessions. One example for this are extremely thin gold fibers and gel markers, which are implanted to the tumor margins and which can be detected by X-ray (incl. CT) and MRI.
With (CT-)imaging facilities being available in the treatment room, dose-guided instead of image-guided radiotherapy comes within reach and will be assessed in collaboration with other groups at OncoRay. Finally, the patients’ choices will be taken aboard when designing complex (IMRT/VMAT) treatment plans with numerous degrees of freedom. By doing so, the level of regret experienced through undesired side-effects is likely to decrease, improving the patients’ quality of life.
In spite of the sensitivity of the available imaging techniques finest offshoots of the tumor margins cannot be detected. To be able to apply sufficient doses of radiation also to these areas, generous safety margins are included. To meet the actual challenges of the adaptive photon and proton therapy, we initiated research projects targeting exactly these issues. The research group is working on developing methods to predict the tumor translations precisely and individually for each patient.
Besides the clinical research - in close cooperation between OncoRay and the Department of Radiation Therapy and Radiooncology of the University Hospital Carl Gustav Carus - newest therapies are being developed and tested within clinical studies (DKTK-project PARADIGM, Horizon 2020 project IMMUNOSABR, IIT RadioCoBrim). For this we are part of a strong network with national and international partners: