Page 46 - ARNM-2-3

Advances in Radiotherapy &

Nuclear Medicine

PERSPECTIVE ARTICLE
Interventional radiotherapy: CT-sim guided

modern minimally invasive technique

Qiman Han † , Yi Chen , Bin Qiu , Zhe Ji , Ping Jiang* , and Junjie Wang*
†
Department of Radiation Oncology, Peking University Third Hospital, Beijing, China

Abstract

The concept of interventional radiology was introduced in 1976 as a new diagnostic
and therapeutic method, relying on image guidance, such as X-ray, ultrasound,
computed tomography (CT), and magnetic resonance imaging. Its indications mainly
include obstructive diseases, and to a lesser extent, malignant tumors. Radiotherapy
(RT) plays a pivotal role in the comprehensive treatment of cancer. The advent of
the CT simulator has significantly enhanced the precision of RT and improvement
outcomes and accelerated the development of a series of diagnostic and RT
modalities, including puncture biopsy, fiducial marker implantation, high-dose rate
after-loading after-loading brachytherapy, and radioactive seed implantation. The
innovative concept of image-guidance interventional RT, inspired by interventional
radiology, extends the benefits to not only cancer diagnosis but also RT. The image-
† These authors contributed equally guidance interventional RT advances the field of RT by expanding its indications and
to this work.
connotation.
*Corresponding authors:
Junjie Wang
(junjiewang@pku.edu.cn) Keywords: Intervention; Radiology; Radiotherapy; Carcinoma; Brachytherapy
Ping Jiang
(jiangping@bjmu.edu.cn)
Citation: Han Q, Chen Y, Qiu B,
Ji Z, Jiang P, Wang J. Interventional
radiotherapy: CT-sim guided 1. Introduction
modern minimally invasive According to the statistics of the World Health Organization, radiotherapy (RT)
technique. Adv Radiother Nucl Med.
2024;2(3):3781. plays a notable role in the treatment of cancer, providing options for radical cure,
doi: 10.36922/arnm.3781 palliation, or as an adjuvant or neoadjuvant modality before or after surgery in 70%
Received: May 28, 2024 of cancer patients. A primary procedure in RT is the simulation of tumor positioning,
which precisely identifies the tumor location using computed tomography (CT),
Accepted: August 15, 2024
magnetic resonance imaging (MRI), or positron emission tomography-CT, and then
Published Online: September 11, transfers these images into a treatment planning system (TPS) for designing the RT.
2024 The commonly utilized simulation positioning is the CT simulator (CT-sim), which
Copyright: © 2024 Author(s). primarily features: (i) X, Y, Z-axis three-dimensional (3D) laser positioning; (ii) patient
This is an Open-Access article immobilization using stabilization devices combined with CT couch; (iii) large-
distributed under the terms of the
Creative Commons Attribution aperture diameter in the range of 80 – 85 cm; and (iv) CT-sim couch resembling that
License, permitting distribution, of linear accelerator, which minimizes errors in tumor positioning between CT-sim
and reproduction in any medium,
provided the original work is and RT.
properly cited. With the rapid advancements of CT-sim, a novel percutaneous puncture biopsy
Publisher’s Note: AccScience has emerged, characterized by enhanced efficiency and accuracy. Regarding these
Publishing remains neutral with developments, a pioneering concept, image-guidance interventional RT, was proposed.
regard to jurisdictional claims in
published maps and institutional This concept encompasses various applications, including puncture biopsy, fiducial
affiliations mark implantation, high-dose rate (HDR) after-loading brachytherapy, and radioactive

Volume 2 Issue 3 (2024) 1 doi: 10.36922/arnm.3781