Target Volume Delineation for Conformal and Intensity-Modulated Radiation Therapy (Medical Radiology)

Description

This textbook is designed to help the busy radiation oncologist to accurately and confidently delineate tumor volumes for conformal radiation therapy (including IMRT). The book provides an atlas of clinical target volumes (CTVs) for commonly encountered cancers, with each chapter illustrating CTV delineation on a slice-by-slice basis, on planning CT images. Common anatomic variants for each tumor are represented in individual illustrations, with annotations highlighting differences in coverage. The anatomy of each site and patterns of lymphatic drainage are discussed, and their influence on the design of CTVs is explained in detail. Utilization of other imaging modalities, including MRI, to delineate volumes is highlighted. Key details of simulation and planning are briefly reviewed. Although the emphasis is on target volume delineation for conformal techniques, information is also provided on conventional radiation field setup and design when IMRT is not suitable. Review: Must have for your library - Nancy Lee's new target volume delineation is a resource that all residents and perhaps all radiation oncologists should have at their disposal. This book is an expansion of the previous edition with extensive updates: Contouring atlases for ALL body sites, chapters by various authors Examples for multiple stages of disease Text explaining contouring and rationale Tables of CTV and PTV expansion definitions Tables of dosimetric constraints for each site The textbook contains instructions for planning based on atlases, protocols, institutional experience, and expert opinion. Multiple examples with different stages are provided. The expert opinion sections are shown for cases such as extensive disease or cranial nerve invasion for head and neck. Quite a bit of resources are quoted and references are included for recommended reading. A strength of the text lies in that it is not over-confident or religious: it is stated in many sections that variations are acceptable. For example, Nancy Lee's head and neck chapters are very courteous in that she provides her choice doses but also goes on to outline other methods of doing things. Advanced techniques such as hypofractionation and SIB are outlined for various body sites. There are a few areas that the text could improve: Some images are too small or poor quality and their contours are difficult to see. Looks like someone's spell check didn't get to the images - they can have the occasional typo. The prostate chapter could use improvement. The author is from MSKCC and outlines only their method, one that few institutions use. Standard dosing and some SIB suggestions for pelvis and node positive would have been nice to see. Nodes in the gastric cancer section are confusing the way they are labeled In a few instances what is done in a picture differs slightly from what is described in the text. This also serves however to show that variations in practice are acceptable. The breast chapter could use some more detailed explanations on how to go about contouring the breast and nodes, as these descriptions differ slightly in different atlases. The breast chapter could also use some more text on planning and some more details on breast reconstruction inflated vs deflated. The breast chapter has some helpful IMRT technique descriptions. Others have mentioned there are some problems with the index. I have never used the index. The table of contents is labeled well enough for me. An index of dosimetric constraints would be a nice addition in future editions The downsides to the text make this book 4.5 stars at the worst, which still rounds up to 5 stars. All in all, this is an excellent text I believe all should have. Review: Five Stars - It is a great reference for contouring. I always use it. It is worth the money.