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Fig. 3 | Radiation Oncology

Fig. 3

From: Time-synchronized immune-guided SBRT partial bulky tumor irradiation targeting hypoxic segment while sparing the peritumoral immune microenvironment

Fig. 3

Target definition by segmentation of an unresectable bulky lung cancer (a): Segment 1- representing the contrast-enhanced (vascularized, “normoxic”) peripheral tumor segment, (GTV), Segment 2 - being the contrast-unenhanced (necrotic, “anoxic”) central tumor region, Segment 3- delineating the contrast-hypo-enhanced (hypovascularized, “hypoxic”) junctional tumor region as an up to a maximum of 5 mm junctional zone between the central-necrotic and the remaining peripheral-vascularized tumor segments, Segment 4 - representing peritumoral tissue; (b) Sparing of the peri-tumoral-surrounding immune microenvironment (thick green line) by creating as an organ at risk multiple “immune microenvironmental islands” (thick yellow line) in order to spare from radiation dose a significant volume (for ex. 2/3) of the tumor microenvironment, leaving it intact and functional

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Radiation Oncology

ISSN: 1748-717X

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