New brachytherapy: Image Adapted Interventional Radiotherapy (Image AIR)

In the last 20 years we have seen a significant improvement in the field of brachytherapy that touched in particular the “planning”, the “delivery” and surgical techniques with multidisciplinary approach. So, in the time being manyauthors talk about a new kind of brachytherapy that can be modulated by the use of Intensity Modulated Brachytherapy, Image Guided Brachytherapy  dose-volume optimization: simply known as Image Adapted Brachytherapy (IABT) or Image Adapted Interventional Radiotherapy (Image AIR)  Image AIR leads to a better target volume definition with higher implants quality, which results in better normal tissue preservation and decreases acute and late toxicity as wellas improving local control. Today IABT becomes feasible thanks to the impressive progress of three dimensional (3D) imaging, the rapidly increasing speed and capacity of computers, and of the sophisticated techniques developed for the treatment planning. The dose modulation potential paired with biological target imaging informations opened a new era.

Image AIR with imaging compatible applicators, allows, when compared to traditional approaches, a more accurate delineation of GTV and CTV, as well as healthy (critical) organs; has a direct impact on treatment planning, especiallyas, it is possible to optimize and deliver high doses exactly to the target subvolumes. Furthermore, using traditional dosimetry systems the prescription dose is related to the geometry of the implant and not to the individual target volume. In modern Image AIR procedures both treatment planning and plan evaluation have to be based on a real 3D volume of the PTV and of OARs.

 

 The School

The school is a “Gemelli ART” service. The logo means: “Catholic University” by Agostino Gemelli Hospital interacts with physicians and physicist interested in education and research in interventional radiotherapy. The mission is the education of physicians/medical physicists in interventional radiotherapy (brachytherapy) through a multidisciplinary approach with theoretical lessons and practical exercises.