Imaging opportunities for treatment planning in intraoperative electron beam radiotherapy (IOERT): Developments in the context of RADIANCE system

Abstract Aim The purpose of this report is to store the information of the pre-planning and compare this data with the actual data of the procedure. Background Currently, intraoperative electron beam radiotherapy clinical practice lacks a treatment planning system. Materials and methods The RADIANCE concept approaches treatment planning by providing the user with a navigation platform based on a three-dimensional imaging system in which the radiation oncologist can target the tumor and risk areas in different sections (axial, coronal, sagittal), while a volume rendering engine displays a 3D image that is automatically updated as we make any changes of the space. Finally, the user may select the parameters of the applicator, energy and dose of treatment to optimize the procedure. Six cases are clinically described and illustrated. Results RADIANCE is a useful tool in planning IOERT. Tumor segmentation and risk areas with minimal guide in the selection of parameters for the applicator. Complex locations are challenging, where the experience and skill of the radiation oncologist is necessary to optimize the process. New developments include imaging innovated uses. Intraoperative imaging will approach reality and allow real time, dosimetry estimations, stereotactic recognition of patient and tumor bed position, will guide automatization of radiation beam recognition and pre-robotic arrangements with linear accelerator movements. Conclusions RADIANCE offers a new imaging expansion for IOERT, in the context of a multidisciplinary approach to optimize and define the treatment parameters to approximate the actual treatment radiotherapy procedure.