Name of the Procedure:

Guidance for Localization of Target Volume for Delivery of Radiation Treatment (Includes Intrafraction Tracking)

Summary

This procedure involves using advanced imaging techniques to precisely locate the area that needs to receive radiation treatment. The procedure also includes real-time tracking during the therapy to ensure accuracy.

Purpose

Guidance for localization of target volume is used to treat various types of cancers by delivering radiation directly to the tumor with high precision. The goal is to maximize the radiation dose to the malignant cells while minimizing exposure to the surrounding healthy tissues.

Indications

• Cancer diagnosis, particularly tumors that require precise radiation therapy.
• Patients with tumors located near critical organs or structures.
• Recurrent tumors that need targeted radiation.

Preparation

• The patient may need to undergo imaging tests like CT scans, MRIs, or PET scans to identify the tumor location.
• Patients might be asked to fast for a few hours before the procedure.
• Certain medications may need to be adjusted or paused.

Procedure Description

1. The patient is positioned on the treatment table.
2. Advanced imaging techniques like CT, MRI, or PET scans are used to locate the target tumor.
3. Markers or devices may be placed on or in the patient for accurate tracking.
4. The radiation machine is calibrated and aligned based on the imaging data.
5. Intrafraction tracking systems monitor the tumor's position in real-time during radiation delivery to accommodate any movement.
6. Radiation is delivered precisely to the target area.

Tools/Equipment: Imaging devices, radiation delivery systems, intrafraction tracking technology.

Anesthesia: Typically not required, but sedation might be used if the patient has difficulty staying still.

Duration

The entire procedure, including setup, typically takes between 30 minutes to 2 hours.

Setting

This procedure is usually performed in a hospital's radiation oncology department or an outpatient radiation therapy center.

Personnel

• Radiation Oncologist
• Medical Physicist
• Radiation Therapist
• Radiologic Technologist
• Nurse

Risks and Complications

• Skin irritation or redness at the site of radiation.
• Fatigue.
• Rare risks include damage to nearby organs or tissues, depending on the tumor's location.
• Management includes symptomatic treatment and follow-up imaging to ensure the target area is being correctly treated.

Benefits

• Highly precise targeting of the tumor.
• Minimizes damage to surrounding healthy tissue.
• Potential for better treatment outcomes and fewer side effects.
• Benefits may be realized immediately in terms of targeting and gradually as the tumor responds to treatment.

Recovery

• Most patients can resume normal activities shortly after the procedure.
• There may be specific instructions regarding skin care at the radiation site.
• Regular follow-up appointments for monitoring treatment effectiveness and managing any side effects.

Alternatives

• Conventional radiation therapy without advanced localization.
• Surgery to remove the tumor.
• Chemotherapy or other systemic treatments.
• Each alternative has its own pros and cons, such as different risk profiles, recovery times, and effectiveness depending on the type and location of the tumor.

Patient Experience

• Generally, the procedure is painless.
• There might be discomfort from lying still for an extended period and slight skin irritation from the radiation.
• Pain management and comfort measures are provided if necessary, and support staff will be present to ensure the patient's comfort.