In this chapter, we will describe both theoretical and practical considerations for modern image-guided radiotherapy (IGRT) simulation, planning, and treatment delivery. Most of the concepts can be applied to all forms of highly conformal therapy, including 3D conformal radiotherapy (3D…
General Principles Brachytherapy is arguably the most conformal of all the modes of radiotherapy. Accurate placement of sources directly in the target area allows for precise dose delivery to the target with unparalleled sparing of normal adjacent tissue. Although a…
Introduction The Relationship Between Safety and Quality Health care is replete with examples of errors culminating in adverse events that compromise the quality and value of care. It comes as no surprise that optimum oncological outcomes depend on excellent execution…
Introduction and General Considerations Statement of the Problem Incidental irradiation of normal tissues is unavoidable during radiotherapy. The primary determinants of injury are the radiation dose (total dose and dose per fraction) and the volume of normal tissue irradiated. Additional…
It has been estimated that between 40% and 60% of referrals for radiation treatment fall under the rubric of palliative consults. Furthermore, as systemic therapies improve, patients with metastatic disease can live longer, which effectively increases the denominator of patients…
Before discussing the implications of old age on cancer care, a definition of old age or geriatric seems needed. Unfortunately, a chronological definition of older age is difficult to provide. Old is a relative term. How societies define old age…
What Is Health Services Research? Medical research may be considered as a continuum of four overlapping domains: basic or biomedical research, clinical research, health services research (HSR), and population health research. HSR aims to create the knowledge required to improve…
Clinical trials began to emerge in their modern form only in the early 20th century, with the first randomized controlled trials conducted in the 1940s, but are now firmly established as the fundamental basis of modern evidence-based medicine. An evidence-based…
Image-guided ablative techniques have been used by interventional radiologists and some surgeons to treat primary and metastatic tumors across several organ systems, including liver, kidney, lung, and the musculoskeletal system. Most treatments use percutaneous needle devices to deliver thermal or…
Molecular imaging techniques such as nuclear medicine and functional magnetic resonance imaging (MRI) are playing an increasingly important role in oncology. Hybrid functional/anatomic imaging modalities, such as positron emission tomography/computed tomography (PET/CT) and single photon-emission computed tomography/computed tomography (SPECT/CT), can…