4-D Respiratory Gating
As lung cancer patients breath, tumors in the lung can move up and down several inches. In radiation therapy, the size and shape of radiation fields do not change during treatment. Therefore, the size of the treatment field must be enlarged to cover the tumor motion during breathing. This can lead to very large volumes of normal lung treated to an unacceptably high level. By using gating technology, less healthy lung is treated and more radiation can be focused on the cancer site. In August 1999, a respiratory gated radiation treatment program was established at Thompson Cancer Survival Center. Thompson and Memorial Sloan-Kettering Cancer Center were selected as treatment test sites for this FDA approved technique. Researchers at the Thompson Center and Memorial Sloan Kettering are considered the world's experts in this new and exciting treatment technique. Thompson was one of the first in the world to use respiratory gating to treat patients and to use 4-D CT imaging. The facility's researchers are considered experts in this new and exciting treatment technique. In addition, Thompson's lead physicist is a member of the American Association of Physicists in Medicine Task Group on Management of Respiration Motion. This group, which is leading the way in respiratory gating, sets quality assurance standards for the procedure.		Patient respiration is tracked by a computer and the radiation is turned on only when the tumor is inside the treatment field (Click for Larger Image) Illustration of yumor motion during treatment (a) without respiratory gating, and (b) with gating technology. Respiratory Gated CT Images Acquired in 2000.
Also See: Helical TomoTherapy and Image Guided Radiation Therapy (IGRT) Intensity Modulated Radiation Therapy

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