Importance of Planning CT Simulation(3D) in Radiothrapy/Radiation o...

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IMPORTANCE OF
CT- SIMULATION IN
RADIOTHERAPY

WHAT IS SIMULATION ?
• A simulation is an approximate imitation of the operation of a process or system
that represents it...

SIMULATION TYPE IN
RADIOTHERAPY
2D 3D 4D

2D / CONVENTIONAL SIMULATION
 Radiotherapy field determination unit using X-ray machine.
 The Geometrical,Mechanical and...

2D / CONVENTIONAL SIMULATION
ADVANTAGE DISADVANTAGE
 Cheapest among rest
 Less radiation exposure than CT
 Fast and Eff...

3D / CT SIMULATION
The CT scanner is used to acquire a volumetric CT-Scan of a
patients which represents the “virtual” rep...

3D / CT SIMULATION PROCEDURE
SETUP IMMOBILIZATION IMAGING

SETUP PROCEDURE IN
CT SIMULATION
DIAGNOSIS
AREA OF INTEREST
FOR IMAGING
SUITABLE SETUP FOR
TREATMENT

SETUP PROCEDURE IN
CT SIMULATION
THORAX SETUP
HEAD AND NECK
SETUP
BREAST SETUP
PELVIC REGION
SETUP
MOTION MANAGEMENT
SPECI...

IMMOBILIZATION IN
CT SIMULATION
“Immobilization are said to be the most crucial parts
of radiation therapy treatment.”
Why...

IMMOBILIZATION DEVICES
A. Thermoplastic cast ( 3 Pts./5 Pts.)
B. Index Bar.
C. All in One Base plate (AIO)
D. Foam wedge (...

VISUAL OVERVIEW OF SOME
IMMOBILIZATION DEVICE
Thermoplastic cast:
Head – 3 Point Head,Neck and Shoulders – 5 point
Index B...

VISUAL OVERVIEW OF SOME
IMMOBILIZATION DEVICE
All In One Base plate:

VISUAL OVERVIEW OF SOME
IMMOBILIZATION DEVICE
Foam Wedge:
0° Wedge
Thorax and
Abdomen
5° Wedge
Thorax and
Abdomen
10° Wedg...

VISUAL OVERVIEW OF SOME
IMMOBILIZATION DEVICE
Arm Rest:
Low Arm Rest High Arm Rest

VISUAL OVERVIEW OF SOME
IMMOBILIZATION DEVICE
Lateral supports:
Lateral support 0° Lateral support 5° Lateral support 10° ...

VISUAL OVERVIEW OF SOME
IMMOBILIZATION DEVICE

VISUAL OVERVIEW OF SOME
IMMOBILIZATION DEVICE
Head Rest(Supine) Low Density With Lateral Neck Support :
Head Rest(Supine) ...

VISUAL OVERVIEW OF SOME
IMMOBILIZATION DEVICE
Head Rest(Prone)

VISUAL OVERVIEW OF SOME
IMMOBILIZATION DEVICE
Low Density Positioning Blocks:
20 mm 40 mm
Low Density Positioning Wedge:
9...

VISUAL OVERVIEW OF SOME
IMMOBILIZATION DEVICE
Knee rest:
Base Plate Extension:

VISUAL OVERVIEW OF SOME
IMMOBILIZATION DEVICE
Vac Lock:

IMAGING IN CT-SIMULATION
Why we use CT image for Radiotherapy Planning?
a. The CT images excellent soft tissue contrast al...

IMAGING IN CT-SIMULATION
Important Parameters for simulation Imaging via CT scan
a) Scan type.
b) Scan Length.
c) Number o...

IMAGING IN CT-SIMULATION

PRACTICAL OVERVIEW OF
SETUP,IMMOBILIZATION AN IMAGING
TECHNIQUE IN DIFFERENT DIAGNOSIS.
All parameters are as per my depar...

BRAIN,HEAD AND
NECK SETUP
SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
SETUP MODALITY(FOR SUPINE ...

BRAIN,HEAD AND
NECK SETUP
SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
IMMOBILIZATION MODALITY
 ...

BRAIN,HEAD AND
NECK SETUP
SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
IV CONTRAST MODALITY (If D...

SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
SETUP MODALITY(FOR SUPINE POSITION):
SETUP SHEET
PEL...

PELVIC REGION
SETUP
SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
IMMOBILIZATION MODALITY
Index b...

PELVIC REGION
SETUP
SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
IV CONTRAST MODALITY (If Doctor ...

SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
SETUP MODALITY(FOR SUPINE POSITION):
SETUP SHEET
THO...

THOEAX SETUP
SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
IMMOBILIZATION MODALITY
Index bar.
 A...

THORAX SETUP
SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
IV CONTRAST MODALITY (If Doctor Prescri...

SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
SETUP MODALITY(FOR SUPINE POSITION):
SETUP SHEET
BRE...

BREAST SETUP
SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
IMMOBILIZATION MODALITY
Index bar.
 A...

BREAST SETUP
SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
IV CONTRAST MODALITY (If Doctor Prescri...

DIBH FOR LEFT
BREAST
DIBH- Deep Inspiration Breath Hold Technique.
Mostly used in Left Breast Irradiation.
1. Using Deep I...

DIBH FOR LEFT
BREAST
WITHOUT DIBH WITH DIBH

SUITABLE SETUP,IMMOBILIZATION AND
IMAGINE ACCRODING TO DIAGNOSIS SITE
SETUP MODALITY(FOR SUPINE POSITION):
MODIFIED/CUSTOM...

IMPORTANT POINTS FOR CT-SIM OPARATOR
A. Patient consent confirmation before procedure.
B. Verify Patient Identity.
C. Alwa...

THANK YOU
Saikat Roy
Intern – DRT
Department of Radiation Oncology.
Tata Medical Center.

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