IMRT. 3DCRT vs IMRT Treated Volume Tumor Target Volume Intensity Modulation Treated Volume Critical structure Target Volume Collimator "Classical" Conformation.

IMRT

3DCRT vs IMRT3DCRT vs IMRT

TreatedVolume

Tumor Tumor

TargetVolume

Intensity Modulation

TreatedVolume

Criticalstructure

Target Volume

Collimator

"Classical" Conformation IMRT

Criticalstructure

Great for treating donuts and bananas

PTV

RO

IMRT

IMRT VS PROTONS

Ethmoid

Upper Abdomen

Brain

Expanding the Horizon

Phase 1Phase 1 Physical ConformalityPhysical Conformality

Phase 2 Phase 2 Biological Conformality Biological Conformality

Phase 3Phase 3 Multi-Dimensional Multi-Dimensional Conformal Conformal

Radiotherapy Radiotherapy

1990

2000

2005-….

PET CT

PET/CT

IMAGE FUSION FOR IMRT

CT GTV (red contour)PET GTV (yellow contour)

PET/CT GTV(red contour)

HYPOXIA: [18F]FAZA (Nitroimodazole) PET/CT

60 y male Hypopharyngeal SCC

T/B ratio 3.2

PET/CTFusion

4 h after inj.

sagcoraxial

Piert et al., TUM

CT