Image guidance is a terrific technology to help improve safety by ensuring our radiation oncologists are extremely precise during the radiation delivery process. At the Cancer Center of Hawaii, we use image guidance/localization as a way to ensure we are zeroing in on a patient’s tumor with a high degree of accuracy and avoiding healthy tissue. By taking frequent two- and three-dimensional images over the course of a radiation session, we can evaluate the image coordinates to direct the treatment plan. Image guidance technologies utilized at the Cancer Center of Hawaii include Cone Beam Computed Tomography and Respiratory Gating.

Cone Beam Computed Tomography (CBCT)
Cone Beam Computed Tomography Image

Cone Beam Computed Tomography, or CBCT, is the chief imaging technique used to correctly diagnose a variety of cancer types. CBCT employs X-ray computer tomography to form a cone image that our radiation oncologists can use to achieve a diagnosis. This advanced imaging method is highly effective in not only identifying tumors, but also accurately mapping their locations, size and movement in the body. In addition to diagnoses, CBCT’s ability to deliver clear bone, muscle and blood vessel pictures is also utilized in the process of planning radiation treatments, biopsies and other minimally invasive procedures.

Respiratory Gating
Respiratory Gating Image

Respiratory Gating is a technique that is used to monitor and analyze a cancer patient’s tumor movement during normal breathing, so that effective radiation doses may be given. To integrate respiratory gating into a radiation session, radiologists use advanced software to designate a specific “target field” treatment area. During inhale or exhale, if the tumor moves outside of that window, the radiation treatment is automatically halted. Respiratory gating works to not only ensure precise radiation delivery, but also to keep healthy tissue from being affected. In many cases, this technology benefits the patient by allowing for higher doses of radiation over fewer visits.