CT Anatomy for Radiotherapy

P Bridge

Description

CT Anatomy for Radiotherapy is a new radiotherapy-specific text that is intended to prepare the reader for CT interpretation for both IGRT and treatment planning. It is suitable for undergraduate students, qualified therapy radiographers, dosimetrists and may be of interest to oncologists and registrars engaged in treatment planning.

Sujets

• Radiotherapy
• Médecine
• Radiation therapy

Informations

• Publié par: M&K Update Ltd
• Date de parution: 30 août 2011
• Nombre de lectures: 0
• EAN13: 9781907830549
• Langue: English
• Poids de l'ouvrage: 13 Mo

Extrait

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CT Anatomy for Radiotherapy
Pete Bridge
David J. Tipper
CT Anatomy for Radiotherapy
Pete Bridge
David J. Tipper
ISBN: 978-1-907830-54-9
First published 2011
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London, W1T 4LP. Permissions may be sought directly from M&K Publishing, phone: [phone], fax: [phone] or email: [e-mail]
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Original format and layout and all images © the authors.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Notice
Clinical practice and medical knowledge constantly evolve. Standard safety precautions must be followed, but, as knowledge is broadened by research, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers must check the most current product information provided by the manufacturer of each drug to be administered and verify the dosages and correct administration, as well as contraindications. It is the responsibility of the practitioner, utilising the experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Any brands mentioned in this book are as examples only and are not endorsed by the publisher. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from this publication.
To contact M&K Publishing write to:
M&K Update Ltd · The Old Bakery · St. John’s Street
Keswick · Cumbria CA12 5AS
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Designed and typeset in 11pt Helvetica Neue by Mary Blood
Printed in England by H&H Reeds Printers, Penrith
To my ever-supportive parents, my inspirational Jacqui and my wonderful kids, Connor and Rhiannon. (PB)
‘We ought to write a book’, we said; it seemed like a great idea at the time, but the practicalities were a little more complicated than first anticipated, combining a busy work schedule and family life. My heartfelt thanks go to all who have supported me over the last 12 months. Judith, Alex, Amy and Izzy, we can take that holiday in Disneyland now – you’ve earned it! Thank you. (DJT)
Contents
About the authors
Acknowledgements
Foreword by Dr David Bottomley
Preface
Chapter 1 Introduction
1.1 Purpose of the book
1.2 CT Principles and Equipment
1.3 CT Interpretation
1.4 Common CT Artefacts
1.5 MRI Principles and Equipment: A brief introduction
Chapter 2 Pelvis and Abdomen
2.1 Musculoskeletal System
2.2 Urinary System
2.3 Digestive System
2.4 Male Reproductive System
2.5 Female Reproductive System
2.6 Circulatory System
2.7 Lymphatic System
2.8 Male Pelvis and Abdomen Fully Labelled CT Scans
2.9 Female Pelvis and Abdomen Fully Labelled CT Scans
2.10 Common Pelvis and Abdomen Tumour Pathology CT Appearance
2.11 Self-Test Questions
Chapter 3 Thorax
3.1 Musculoskeletal System
3.2 Digestive System
3.3 Respiratory System
3.4 Cardiovascular System
3.5 Lymphatic System
3.6 Full Thoracic CT
3.7 Common Thoracic Tumour Pathology CT Appearance
3.8 Self-Test Questions
Chapter 4 Head and Neck (Extracranial)
4.1 Musculoskeletal System
4.2 Digestive System
4.3 Respiratory System
4.4 Circulatory System
4.5 Lymphatic System
4.6 Deep Spaces
4.7 Full Head and Neck CT Anatomy
4.8 Common Head and Neck Tumour Pathology CT Appearance
4.9 Self-Test Questions
Chapter 5 Intracranial
5.1 Cerebrospinal Fluid Spaces
5.2 Circulatory System
5.3 Central Nervous System
5.4 Full Intracranial CT and MR Anatomy
5.5 Common Intracranial Tumour Pathology CT Appearance
5.6 Self-Test Questions
Chapter 6 CT in Radiotherapy
6.1 Kilovoltage Cone Beam CT
6.2 Megavoltage Cone Beam CT

Answers to Self-Test Questions
Structure Key
References and Further Reading
Index
About the authors
Pete Bridge BSc MSc Senior Lecturer, Faculty of Health, Queensland University of Technology, Brisbane, Australia
Pete is the Course Coordinator for the Bachelor of Radiation Therapy course at Queensland University of Technology where his teaching specialities include Radiotherapy planning and CT anatomy for Radiotherapy. Previously he has been heavily involved in the development and facilitation of CPD short courses on CT Anatomy and structure outlining (prostate, brain and breast). Pete has worked clinically as a therapy radiographer in Manchester, Auckland, Dundee and Derby. He is particularly interested in structure outlining for radiotherapy planning.
David J. Tipper DCR(R) PgCert (MRI) PgCert (CT)
David is the Cross-Sectional Imaging Manager for Sheffield Teaching Hospitals NHS Trust, Northern General Hospital, Sheffield, UK. He has worked clinically as a diagnostic radiographer for 18 years and now has what he describes as his dream job. He chose to specialise in cross-sectional imaging early on in his career, and has worked clinically in CT and MRI for nearly 15 years in Derby and now in Sheffield. David has an almost obsessive interest in cross-sectional anatomy and also lectures regularly on the subject.
Acknowledgements
The grateful thanks of the authors are extended to:
David Bottomley, Consultant Clinical Oncologist, for the foreword; Chris Bragg, Medical Physicist for tracking down elusive tumour images; Hazel McCallum, Medical Physicist, for MVCT images; Sue Warren at TomoTherapy Inc for tomotherapy images; David Scott at Varian Medical Systems Inc for kVCT images; Angela Duxbury for support and advice.
All CT images in the book were acquired using a 64 slice GE ™ VCT Lightspeed scanner. The MR images were acquired on a Siemens Avanto 1.5T MRI scanner. Structure outlining and 3-dimensional reconstruction were performed using Varian Medical Systems’ ECLIPSE™ planning system contouring tools.
Foreword
The CT scanner is an indispensable component in the armoury of the modern radiotherapy consultant. It permeates most aspects of the patient journey: diagnosis and staging, tumour localisation, radiotherapy planning and increasingly on-treatment verification. Although CT interpretation has long been the preserve of medical and selected radiotherapy planning staff, recent developments in image-guided radiotherapy (IGRT) have made these skills essential for a much wider range of staff. This book addresses this new training need at both pre- and post-registration levels. From the clinical oncologist’s perspective, this book offers the potential for radiotherapy staff to unlock these skills and extend their roles to structure outlining and routine CT verification.
The use of radiotherapy-dedicated positioning and slice orientation for image interpretation makes this book much more user-friendly than existing texts. Structures identified are all relevant to radiotherapy practice as potential tumour sites, critical organs or useful indicators of lymph node positions. The reader is guided through the principles of CT in a detailed but accessible manner. I am sure that readers will particularly appreciate the inclusion of dedicated lymph node sections and details of the ‘Deep Spaces’ of the head and neck. The importance of these in the understanding of tumour progression cannot be overemphasised. The intracranial chapter also features some highly relevant CT-MR fused images as well as some useful tips on interpretation of this potentially daunting modality. Combining the authors’ knowledge of both radiotherapy requirements and CT image interpretation has produced a text that provides the detail required, but in a highly focused manner. Thus it remains relevant to radiotherapy while providing a high enough level of detail to satisfy the most inquisitive of students.
This book should become one of the essential texts for those training or working in radiotherapy at any level. I have no hesitation in commending it to you.
Dr David Bottomley MB BS MRCP FRCR
Consultant in Clinical Oncology, St. James’s Institute of Oncology, Leeds, UK
2010
Preface
This book is essentially a celebration of the wedding of two revolutionary (no pun intended) technologies. The first linear accelerators were used clinically in the 1950s. Combined with localisation from plain radiographs, the art of accurate tumour treatment was relatively crude, and knowledge of bony and surface anatomy was an essential skill for a therapy radiographer. Twenty years later the first CT scanners were peering into patients to reveal the position of soft tissue structures. It did not take long for the obvious application to tumour localisation to enrich radiotherapy planning. Since then, the two technologies have steadily evolved and converged until modern times where they have combined to form the Image-Guided radiotherapy machines that are increasingly essential for verification of accurate conformal radiotherapy. This convergence perhaps finds its ultimate expression in the ‘h