Leading expert physicians and investigators from around the world review the state-of-the-art in the management of squamous cell head and neck cancer, with emphasis on coordinating different treatment modalities. The authors address several surgical issues, including laser-based surgery, larynx preservation approaches, salvage surgery, and neck management after non-operative treatment. They also discuss definitive radiation for larynx cancer, brachytherapy, altered fractionation radiation, intensity modulated radiation therapy, and the importance of tumor hypoxia, as well as the role of chemotherapy in sequential, concurrent, and adjuvant multi-modality treatment schedules. Other topics of special interest include targeted and gene therapies, multimodality management of nasopharyngeal cancer, chemoprevention, toxicity modification, quality of life outcomes, symptom palliation, and epidemiology.

This book explores the physics of CT dosimetry and provides practical guidance on best practice for medical researchers and practitioners. A rigorous description of the basic physics of CT dosimetry is presented and illustrates flaws of the current methodology. It also contains helpful (and rigorous) shortcuts to reduce the measurement workload for medical physicists. The mathematical rigor is accompanied by easily-understood physical explanations and numerous illustrative figures. Features: Authored by a recognised expert in the field and award-winning teacher Includes derivations for tube current modulation and variable pitch as well as stationary table techniques Explores abnormalities present in dose-tracking software based on CTDI and presents methods to correct them

This book concisely reviews important advances in radiation oncology, providing practicing radiation oncologists with a fundamental understanding of each topic and an appreciation of its significance for the future of radiation oncology. It explores in detail the impact of newer imaging modalities, such as multiparametric magnetic resonance imaging (MRI) and positron emission tomography (PET) using fluorodeoxyglucose (FDG) and other novel agents, which deliver improved visualization of the physiologic and phenotypic features of a given cancer, helping oncologists to provide more targeted radiotherapy and assess the response. Due consideration is also given to how advanced technologies for radiation therapy delivery have created new treatment options for patients with localized and metastatic disease, highlighting the increasingly important role of image-guided radiotherapy in treating systemic and oligometastatic disease. Further topics include the potential value of radiotherapy in enhancing immunotherapy thanks to the broader immune-stimulatory effects, how cancer stem cells and the tumor microenvironment influence response, and the application of mathematical and systems biology methods to radiotherapy.

On-treatment verification imaging has developed rapidly in recent years and is now at the heart of image-guided radiation therapy (IGRT) and all aspects of radiotherapy planning and treatment delivery. This is the first book dedicated to just this important topic, which is written in an accessible manner for undergraduate and graduate therapeutic radiography (radiation therapist) students and trainee medical physicists and clinicians. The later sections of the book will also help established medical physicists, therapeutic radiographers, and radiation therapists familiarise themselves with developing and cutting-edge techniques in IGRT. Features: Clinically focused and internationally applicable; covering a wide range of topics related to on-treatment verification imaging for the study of IGRT Accompanied by a library of electronic teaching and assessment resources for further learning and understanding Authored by experts in the field with over 18 years' experience of pioneering the original forms of on-treatment verification imaging in radiotherapy (electronic portal imaging) in clinical practice, as well as substantial experience of teaching the techniques to trainees

Given that treatment with curative intent is possible in only one-half of cancer victims, and that such treatment frequently fails, the majority of patients with cancer will require relief of symptoms and signs caused by their disease. In this book, the specific contribution of radiation therapy to palliation is considered within the context of multidisciplinary management. Individual chapters are devoted to palliative radiation therapy for primary tumours and metastases at different sites. The management of pain is discussed, and chapters are also devoted to end of life care, the management of complications of radiation therapy, and useful medications. This book will prove useful and interesting not only to radiation oncologists but also to medical students of all ages and to doctors from all disciplines who are concerned with the relief or prevention of suffering in patients with cancer.

This issue of Neuroimaging Clinics of North America focuses on Temporal Bone Imaging: Clinicoradiologic and Surgical Considerations, and is edited by Drs. Gul Moonis and Amy Fan-Yee Juliano. Articles will include: Imaging of Temporal Bone Infection Inflammation; Imaging of Meniere's Disease; Treatment of Vestibular Schwannoma; Post Operative Imaging of the Temporal Bone; Otosclerosis and Dysplasias of the Temporal Bone; Imaging of Syndromes with Temporal Bone Abnormalities; Imaging of Third Window Lesions; Imaging of Tinnitus; Imaging of Temporal Bone Tumors; Imaging of Pediatric Hearing Loss; Common Otologic Surgical Procedures: Clinical Decision Making Pearls; Imaging of Temporal Bone Trauma: A Clinicoradiologic Perspective; and more!

This issue of Radiologic Clinics of North America focuses on Imaging of the Pelvis and Lower Extremity, and is edited by Drs. Laura Bancroft and Kurt Scherer. Articles will include: Turf toe injury/Plantar plate pathology; Lisfranc injury; Metatarsalgia; Ankle impingement types; Posterolateral corner injury; Imaging of the post-operative meniscus; Demystifying uncommon sources of pelvic pain; Current concepts of femoro-acetabular impingement; Bone/soft tissue tumors about the foot/ankle; Ultrasound intervention of the lower extremity/pelvis; Lower extremity neuropathies (entrapment); Extreme sport injuries of the pelvis/lower extremity; and more!

The book is divided into two parts: Part I deals with the relevant physics and planning algorithms of protons (H Breuer) and Part II with the radiobiology, radiopathology and clinical outcomes of proton therapy and a comparison of proton therapy versus photon therapy (BJ Smit). Protons can be used for radiosurgery and general radio therapy. Since proton therapy was first proposed in 1946 by Wilson, about sixteen facilities have been built globally. Only a very few of these have isocentric beam delivery systems so that proton therapy is really only now in a position to be compared directly by means of randomised clinical trials, with modern photon radiotherapy therapy sys tems, both for radiosurgery and for general fractionated radiotherapy. Three-dimensional proton planning computer systems with image fusion (image of computerised tomography (CT), magnetic resonance registration) capabilities imaging (MRI), stereotactic angiograms and perhaps positron emission tomography (PET) are essential for accurate proton therapy planning. New planning systems for spot scanning are under development. Many of the older comparisons of the advantageous dose distributions for protons were made with parallel opposing or multiple co-planar field arrangements, which are now largely obsolete. New comparative plans are necessary once more because of the very rapid progress in 3-D conformal planning with photons. New cost-benefit analy ses may be needed. Low energy (about 70 MeV) proton therapy is eminently suitable for the treatment of eye tumours and has firmly established itself as very useful in this regard."

This first dedicated overview for beam's eye view (BEV) covers instrumentation, methods, and clinical use of this exciting technology, which enables real-time anatomical imaging. It highlights how the information collected (e.g., the shape and size of the beam aperture and intensity of the beam) is used in the clinic for treatment verification, adaptive radiotherapy, and in-treatment interventions. The chapters cover detector construction and components, common imaging procedures, and state of the art applications. The reader will also be presented with emerging innovations, including target modifications, real-time tracking, reconstructing delivered dose, and in vivo portal dosimetry. Ross I. Berbeco, PhD, is a board-certified medical physicist and Associate Professor of Radiation Oncology at the Dana-Farber Cancer Institute, Brigham and Women's Hospital and Harvard Medical School.

This volume discusses the background and various clinical applications of radiation therapy in the treatment of non-malignant diseases. It documents the radiobiological and physical principles of treatment and the rationale underlying the use of radiotherapy for various disorders of the CNS, head and neck, eye, skin and soft tissues, bone and joints, and vascular system. In so doing, it draws attention to and elucidates the scope for application of radiotherapy beyond the treatment of malignancies. Both the risks and the benefits of such treatment are fully considered, the former ranging from minor clinical problems to life-threatening diseases.

Spine-related pain is the world's leading disabling condition, affecting every population and a frequent reason for seeking medical consultation and obtaining imaging studies. Numerous spinal phenotypes (observations/traits) and their respective measurements performed on various spine imaging have been shown to directly correlate and predict clinical outcomes. Atlas of Spinal Imaging: Phenotypes, Measurements and Classification Systems is a comprehensive visual resource that highlights various spinal phenotypes on imaging, describes their clinical and pathophysiological relevance, and discusses and illustrates their respective measurement techniques and classifications. Complies the knowledge and expertise of Dr. Dino Samartzis, the preeminent global authority on spinal phenotypes who has discovered and proposed new phenotypes and classification schemes; Dr. Howard S. An, a leading expert in patient management and at the forefront of 3D imaging of various spinal phenotypes; and Dr. Philip Louie, a young surgeon who is involved in one of the largest machine learning initiatives of spinal phenotyping. *Includes a Foreword by renowed spine surgeons Alexander Vaccaro and Max Aebi* Helps readers better understanding spinal phenotypes and their imaging, and how today's knowledge will facilitate new targeted drug discovery, novel diagnostics and biomarker discovery, and outcome predictions. Features step-by-step instructions on performing the radiographic measurements with examples of normal and pathologic images to demonstrate the various presentations. Presents clinical correlation of the phenotypes as well as the radiographic measurements with landmark references. Includes validated classification systems that complement the phenotypes and radiographic measurements. Complies the knowledge and expertise of Dr. Dino Samartzis, the preeminent global authority on spinal phenotypes who has discovered and proposed new phenotypes and classification schemes; Dr. Howard S. An, a leading expert in patient management and at the forefront of 3D imaging of various spinal phenotypes; and Dr. Philip Louie, a prolific surgeon who is involved in one of the largest machine learning initiatives of spinal phenotyping.

Radiation Protection in Medical Imaging and Radiation Oncology focuses on the professional, operational, and regulatory aspects of radiation protection. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This book summarizes evidence supporting changes in consensus recommendations, regulations, and health physics practices associated with these recent advances in radiology, nuclear medicine, and radiation oncology. It supports intelligent and practical methods for protection of personnel, the public, and patients. The book is based on current recommendations by the International Commission on Radiological Protection and is complemented by detailed practical sections and professional discussions by the world's leading medical and health physics professionals. It also includes substantial information on international aspects of radiation protection, with sections covering Africa, Asia and Oceania, the European Union, the Middle East, and North and Latin America.

Understand Quantitative Radiobiology from a Radiation Biophysics Perspective In the field of radiobiology, the linear-quadratic (LQ) equation has become the standard for defining radiation-induced cell killing. Radiotherapy Treatment Planning: Linear-Quadratic Radiobiology describes tumor cell inactivation from a radiation physics perspective and offers appropriate LQ parameters for modeling tumor and normal tissue responses. Explore the Latest Cell Killing Numbers for Defining Iso-Effective Cancer Treatments The book compiles radiation mechanism information from biophysical publications of the past 50 years, addressing how ionizing radiation produces the killing of stem cells in human tumors. It presents several physical and chemical parameters that can modulate the radiation response of clonogenic cells in tumors. The authors describe the use of the LQ model in basic radiation mechanism studies with cells of relatively homogeneous radiation response and then extend the model to the fitting of survival data generated with heterogeneous cell populations (tumors). They briefly discuss how to use the LQ model for predicting tumor (local) control probability (TCP) and normal tissue complication probability (NTCP). The book also examines potential molecular targets related to alpha- and beta-inactivation and gives suggestions for further molecular characterizations of these two independent processes. Develop Efficacious, Patient-Friendly Treatments at Reduced Costs Focusing on quantitative radiobiology in LQ formulation, this book assists medical physicists and radiation oncologists in identifying improved cancer treatments. It also encourages investigators to translate potentially improved radiotherapy schedules based on TCP and NTCP modeling into actual patient benefit.

This study guide will be a reliable support and easy-to-use source of information for students in the fields of dosimetry, physics, radiation oncology, and therapy as they progress through the educational levels in preparation for board examinations. The theoretical and practical knowledge gained by students on previous courses or in clinical settings is reinforced by means of almost 1200 questions and accompanying detailed analytical answers. In order to cater for the needs of all students, the questions are arranged according to three levels of difficulty. The level 1 questions are mainly intended for those hoping to pass the Medical Dosimetrist Certification Board (MDCB) exam but will also be beneficial for Medical Physics candidates taking written exams and for Radiation Oncology residents. The level II questions are in general clinically related and will be relevant for any student, while the level III questions are advanced and are especially suitable for American Board of Radiology candidates or those taking equivalent exams elsewhere in the world. The study guide is broken down into different subject areas, with provision of multiple questions and answers on each subject. In addition, the mathematical and physics questions include brief explanations of how the student can solve each problem. At the end of the guide, three practice tests are included with the same number of questions as are found in the MDCB exam. These tests will help students to test their knowledge and improve their test-taking speed.

Radiofrequency Ablation of Cancer: Current Techniques, Indications and Outcomes discusses the principles and techniques of safe usage of radiofrequency current for the treatment of malignancies. Throughout the text, indications and outcomes data are stressed. Edited and authored by pioneers in the field, the book features extensive discussion of RFA for hepatic tumors, including treatment of liver metastases from colorectal cancer, combined modality therapy for liver metastases, treatment of hepatocellular carcinoma with RFA, laparoscopic RFA, percutaneous RFA, and hepatic metastases from neuroendocrine tumors. In addition, chapters consider the emerging role of RFA in the management of primary breast cancer, primary bone tumors as well as metastatic bone tumors, renal tumors, and lung tumors. The principles and instrumentation as well as the imaging aspects of RFA are presented with comprehensive chapters on ultrasound, MRI, PET and CT by leaders in the field. Complemented by 90 illustrations, this text is the gold standard reference on the use of RFA in treating a wide variety of malignant processes. It will serve as a valuable reference for all physicians engaged in the care of cancer patients.

The second edition of this easy-to-understand pocket guide remains an invaluable tool for students, assistant practitioners and radiographers. Providing an accessible introduction to the subject in a reader-friendly format, it includes diagrams and photographs to support the text. Each chapter provides clear learning objectives and a series of MCQs to test reader assimilation of the material. The book opens with overviews of image production, basic mathematics and imaging physics, followed by detailed chapters on the physics relevant to producing diagnostic images using X-rays and digital technologies. The content has been updated throughout and includes a new chapter on CT imaging and additional material on radioactivity, dosimetry, and imaging display and manipulation. Clark's Essential Physics in Imaging for Radiographers supports students in demonstrating an understanding of the fundamental definitions of physics applied to radiography ... all you need to know to pass your exams!

Proton and Carbon Ion Therapy is an up-to-date guide to using proton and carbon ion therapy in modern cancer treatment. The book covers the physics and radiobiology basics of proton and ion beams, dosimetry methods and radiation measurements, and treatment delivery systems. It gives practical guidance on patient setup, target localization, and treatment planning for clinical proton and carbon ion therapy. The text also offers detailed reports on the treatment of pediatric cancers, lymphomas, and various other cancers. After an overview, the book focuses on the fundamental aspects of proton and carbon ion therapy equipment, including accelerators, gantries, and delivery systems. It then discusses dosimetry, biology, imaging, and treatment planning basics and provides clinical guidelines on the use of proton and carbon ion therapy for the treatment of specific cancers. Suitable for anyone involved with medical physics and radiation therapy, this book offers a balanced and critical assessment of state-of-the-art technologies, major challenges, and the future outlook of proton and carbon ion therapy. It presents a thorough introduction for those new to the field while providing a helpful, up-to-date reference for readers already using the therapy in clinical settings.

External-beam radiotherapy has long been challenged by the simple fact that patients can (and do) move during the delivery of radiation. Recent advances in imaging and beam delivery technologies have made the solution adapting delivery to natural movement a practical reality. Adaptive Motion Compensation in Radiotherapy provides the first detailed treatment of online interventional techniques for motion compensation radiotherapy.

This authoritative book discusses:

• Each of the contributing elements of a motion-adaptive system, including target detection and tracking, beam adaptation, and patient realignment
• Treatment planning issues that arise when the patient and internal target are mobile
• Integrated motion-adaptive systems in clinical use or at advanced stages of development
• System control functions essential to any therapy device operating in a near-autonomous manner with limited human interaction
• Necessary motion-detection methodology, repositioning techniques, and approaches to interpreting and responding to target movement data in real time

Medical therapy with external beams of radiation began as a two-dimensional technology in a three-dimensional world. However, in all but a limited number of scenarios, movement introduces the fourth dimension of time to the treatment problem. Motion-adaptive radiation therapy represents a truly four-dimensional solution to an inherently four-dimensional problem. From these chapters, readers will gain not only an understanding of the technical aspects and capabilities of motion adaptation but also practical clinical insights into planning and carrying out various types of motion-adaptive radiotherapy treatment.

This book provides a state-of-the-art review of the role of radiation therapy in various pelvic malignancies as well as the consequences of the radiation in the pelvic tissues. With sections covering the role of radiation therapy in the various pelvic malignancies, the pathophysiology of radiation related injury and the risk factors that increase the possibility of such an injury, and the latest in medical, endoscopic and surgical therapies for these radiation related complications the text offers a concise yet comprehensive overview of radiation therapy in the human pelvis, its role and the adverse effects on the pelvic organs. Written by experts in the field with readers in mind, Radiation Therapy for Pelvic Malignancy and its Consequences is the first of its kind standalone reference on the subject. Radiation Therapy for Pelvic Malignancy and its Consequences is of great value to urologists, medical radiation and gynecological oncologists, and gastroenterologists.

Sonography has emerged as a substantial diagnostic tool today. This handbook aims to cover ultrasound physics, abdominal and obstetric sonography, color Doppler, high resolution sonography and USG guided interventions with multiple choice questions and case reports for practical orientation.

Common factors that lead to treatment failure in head and neck cancer are the lack of tumour oxygenation, the accelerated division of cancer cells during treatment, and radioresistance. These tumour-related challenges and possible ways to overcome them are covered in this book, authored by three medical physicists and a clinical oncologist who explain how different radiobiological findings have led to the development of various treatment techniques for head and neck cancer. Novel treatment techniques as supported by current scientific evidence are comprehensively explored, as well as the major challenges that arise in the retreatment of patients who have already undergone a form of radiotherapy for primary head and neck cancer. Features: Uses an interdisciplinary approach, encompassing clinical aspects of radiotherapy, radiation biology, and medical physics Applies content by relating all radiobiological characteristics to their respective clinical implications Explains the radiobiological rationale for all previous and current clinical trials for head and neck cancer

The most important radiotherapy modality used today, intensity modulated radiation therapy (IMRT), is the most technologically advanced radiotherapy cancer treatment available, rapidly replacing conformal and three-dimensional techniques. Because of these changes, oncologists and radiotherapists need up-to-date information gathered by physicists and engineers. Focusing on new developments and the preliminary clinical implementation, Contemporary IMRT: Developing Physics and Clinical Implementation discusses the relationship between these advances and applications. Capturing contemporary technological advances, the book reviews modern applications of IMRT and shows how IMRT is used now and how it will be used in the future. The book begins with a historical background of IMRT as well as a discussion of the current state of IMRT. It also covers technical solutions that have been commercialized, such as the sliding window technique, step-and-shoot, tomotherapy, and the Cyberknife. The final chapter explores imaging developments and new planning methods, including gradient-descent and split modulation. Covering recent advancements in IMRT and showing how these techniques and devices have been implemented, Contemporary IMRT: Developing Physics and Clinical Implementation provides state-of-the-art findings for oncologists, radiotherapists, radiographers, physicists, and engineers.

Surgery continues to be the most effective treatment of solid tumors in terms of recovery, while its combination with other treatments improves the survival curves especially in the advanced forms of the disease. The aim of my task first of all has been to provide readers with both the current and constantly evolving pathophysiologic knowledge required for building the foundation of a specific education enabling surgeons to meet the fundamental targets in surgical oncology. Secondly, this volume aims to present an update on the real possibilities offered by the cooperation between surgeon and pathologist and by chemotherapy, radiotherapy and gene therapy in the treatment of tumors in the light of the most recent scientific achievements. Lastly, the report presents the experiences and cases drawn mostly from our School regarding some of the major issues in oncologic surgery. This overview does not pretend to elucidate or to summarize all aspects of oncologic surgery, but rather to be the result of a general consideration on cancer surgery, on its rational bases, on its interaction with other treatment modalities, on its desirable and expected developments and on its probable future evolution.

Clinical conformal radiotherapy is the holy grail of radiation treatment and is now becoming a reality through the combined efforts of physical scientists and engineers, who have improved the physical basis of radiotherapy, and the interest and concern of imaginative radiotherapists and radiographers. Intensity-Modulated Radiation Therapy describes in detail the physics germane to the development of a particular form of clinical conformal radiotherapy called intensity modulated radiation therapy (IMRT). IMRT has become a topic of tremendous importance in recent years and is now being seriously investigated for its potential to improve the outcome of radiation therapy. The book collates the state-of-the-art literature together with the author's personal research experience and that of colleagues in the field to produce a text suitable for new research workers, Ph.D. students, and practicing radiation physicists that require a thorough introduction to IMRT. Fully illustrated, indexed, and referenced, the book has been prepared in a form suitable for supporting a teaching course.

This book, written by leading international experts, describes alternate fractionation strategies in which technology-driven precise targeting and dosing allow for improved conformance and decreased volumes, with concordant lessening of toxicity, reduction in treatment time, and lower overall health care expense. The aim is to provide the advanced clinician with an up-to-date evidence-based reference that will assist in the delivery of enhanced patient care in daily practice. Traditional multi-week fractionation schedules were established at a time when the inclusion of relatively large amounts of normal tissue was unavoidable owing to the lack of accurate target localization during treatment. Such schedules are time and resource consuming, difficult for patients, and expensive. Nevertheless, acceptance of alternate fractionation strategies has been slow in some countries. The paradigm is, however, changing as evidence accumulates to demonstrate improved local control, equivalence of tolerance, or both. In documenting these alternate strategies, this book will be of value for radiation oncologists, medical physicists, and oncologists worldwide.