Advances in imaging simulation for lung cancer IGRT

This chapter focuses on advances in computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and other imaging methods in lung cancer applications, and discuss their potentials and limitations for use in clinical practice. Imaging simulations including CT, MRI, PET with 2-fluorine-18 fluoro-2-deoxy-D-glucose (FDG-PET) and FDG-PET combined with CT are being used for clinical assessment of lung cancer. CT is an essential imaging technology in radiation therapy for patient simulation and treatment planning. Four-dimensional CT (4D-CT) is used to account for respiratory motion in radiation treatment planning, but artifacts resulting from the acquisition and post-processing limit its accuracy. Artifacts of 4D-CT are mainly due to breathing irregularities or incorrect breathing phase identification. MRI is often used in areas of poor tissue discrimination with CT scans, such as the brain, abdomen and pelvis, but not historically in the lungs.