Four-Dimensional Imaging and Radiation Therapy: A Review of Challenges and Advancements in Clinical Practices

4-Dimensional Radiation therapy (4DRT) has been vastly developed in the past two decades. Motion management has become a vital part of high precision radiotherapy, wherein Stereotactic Body Radiation Therapy (SBRT) turns out to be a great boon for treating thoracic and abdominal tumours with confidence. In this review paper, we have analyzed the development of motion management strategies and the advancement of 4DRT.We have discussed the evolution of Internal target volume (ITV), 4D imaging techniques and the problems of breathing motion. In the second part, we have discussed various methods to tackle breathing motion. We also have reviewed the dosimetric aspects of 4D imaging and its clinical implications. In the last section, we have elaborated the 4D radiation therapy and recent advancements and practices.