ESTRO course on Image Guided Radiotherapy in Clinical Practice 2018

Can there be a good external surrogate for the position of a lung/liver tumour?

• No surrogate is good enough

• Solution 1: use large margins ( approx equal to free breathing)

• Solution 2: image the tumour position daily with respiration- correlated (4D) IGRT ➢ 4D-CBCT for gated treatment

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Breath hold CBCT

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2D + markers in the tumour