The document discusses various immobilization devices used in radiotherapy such as thermoplastic masks, breast boards, belly boards, Vac-Lok systems, and treatment chairs. Proper immobilization is crucial for accurate radiation treatment by reducing setup errors and patient movement. The advantages of each device are described in terms of patient comfort, reproducibility of positioning, and reduction of radiation exposure to surrounding healthy tissues.
1.Stereotactic Radiosurgery (SRS)
SRS is a precise and focused delivery of a single, high dose of irradiation to a small and critically located intracranial volume while sparing normal structure
2.Stereotactic Body Radiation Therapy (SBRT)
SBRT is a treatment procedure similar to SRS, except that it deals extra-cranial radiosurgery
3.Flattening Filter Free (FFF) mode
FFF beam is produced without the use of flattening Filter
In the 1990s, several groups studied about FFF high-energy photon beams. The main interest for that, is to increase the dose rate for radiosurgery or the "physics interest”.
Need of increase in dose rate from traditional 300-600 to 1400-2400MU/min to overcome time-inefficiency and to improve patients comfort specially in SRS/SBRT
Flattening Filter Free (FFF) mode
FFF beam is produced without the use of flattening Filter
In the 1990s, several groups studied about FFF high-energy photon beams. The main interest for that, is to increase the dose rate for radiosurgery or the "physics interest”.
Need of increase in dose rate from traditional 300-600 to 1400-2400MU/min to overcome time-inefficiency and to improve patients comfort specially in SRS/SBRT
Conventional radiotherapy treatments are delivered with radiation beams that are of uniform intensity across the field (within the flatness specification limits). Wedges or compensators are used to modify the intensity profile to offset contour in irregularities and produce more uniform composite dose distributions such as in techniques using wedges. This process of changing beam intensity profile to meet the goals of a composite plan is called intensity modulation
IMRT refers to a radiation therapy technique in which nonuniform fluence is delivered to the patient from any given position of the treatment beam to optimize the composite dose distribution. The optimal fluence profiles for a given set of beam directions are determined through inverse planning. The fluence files thus generated are electronically transmitted to the linear accelerator, which is computer controlled, to deliver intensity modulated beams (IMBs) as calculated.
1.Stereotactic Radiosurgery (SRS)
SRS is a precise and focused delivery of a single, high dose of irradiation to a small and critically located intracranial volume while sparing normal structure
2.Stereotactic Body Radiation Therapy (SBRT)
SBRT is a treatment procedure similar to SRS, except that it deals extra-cranial radiosurgery
3.Flattening Filter Free (FFF) mode
FFF beam is produced without the use of flattening Filter
In the 1990s, several groups studied about FFF high-energy photon beams. The main interest for that, is to increase the dose rate for radiosurgery or the "physics interest”.
Need of increase in dose rate from traditional 300-600 to 1400-2400MU/min to overcome time-inefficiency and to improve patients comfort specially in SRS/SBRT
Flattening Filter Free (FFF) mode
FFF beam is produced without the use of flattening Filter
In the 1990s, several groups studied about FFF high-energy photon beams. The main interest for that, is to increase the dose rate for radiosurgery or the "physics interest”.
Need of increase in dose rate from traditional 300-600 to 1400-2400MU/min to overcome time-inefficiency and to improve patients comfort specially in SRS/SBRT
Conventional radiotherapy treatments are delivered with radiation beams that are of uniform intensity across the field (within the flatness specification limits). Wedges or compensators are used to modify the intensity profile to offset contour in irregularities and produce more uniform composite dose distributions such as in techniques using wedges. This process of changing beam intensity profile to meet the goals of a composite plan is called intensity modulation
IMRT refers to a radiation therapy technique in which nonuniform fluence is delivered to the patient from any given position of the treatment beam to optimize the composite dose distribution. The optimal fluence profiles for a given set of beam directions are determined through inverse planning. The fluence files thus generated are electronically transmitted to the linear accelerator, which is computer controlled, to deliver intensity modulated beams (IMBs) as calculated.
Particle beam – proton,neutron & heavy ion therapyAswathi c p
particle therapy is advanced external beam therapy used to treat cancer , which uses beams of protons or other charged particles such as helium, carbon or other ions instead of photons. charged particles have different depth-dose distributions compared to photons. They deposit most of their energy in the last final millimeters of their trajectory (when their speed slows). This results in a sharp and localized peak of dose, known as the Bragg peak.
1.Aim of Radiotherapy
The goal of radiotherapy is to deliver a prescribed dose of radiation to the Target while sparing surrounding Healthy tissues to the largest extent possible
2.Organ Motion
Intra-fraction motion
during the fraction
Heartbeat
Swallowing
Coughing
Eye movement
Inter-fraction motion
- in between the fractions
Tumour change
Weight gain/loss
Positioning deviation
Breathing
Bowel and rectal filling
Bladder filling
Muscle relaxation/tension
3. Respiratory motion affects:
Respiratory motion affects all tumour sites in the thorax, abdomen and Pelvis. Tumours in the Lung, Liver, Pancreas, Oesophagus, Breast, Kidneys, prostate
Tumour displacement varies depending on the site and organ Location
Lung tumours can move several cm in any direction during irradiation
It is most prevalent and prominent in Lung cancers
4. Problems associated with respiratory motion during RT
Image acquisition limitations
Treatment planning limitations
Radiation delivery limitations
5. Methods to Account for Respiratory Motion
1. Motion encompassing methods
2. Respiratory gating methods
3. Breath hold methods
4. Forced shallow breathing with abdominal compression
5. Real-time tumor tracking methods
Summary:
The management of respiratory motion in radiation oncology is an evolving field
IGRT provides a solution for combating organ motion in radiotherapy
Delivering higher dose to tumor and less dose to normal tissue.
Limited clinical studies, needs to be studied further
IGRT – the future of radiotherapy
A summary of recent innovations in radiation oncology focussing on the priniciples of different techniques and their application. An overview of clinical results has also been given
Particle beam – proton,neutron & heavy ion therapyAswathi c p
particle therapy is advanced external beam therapy used to treat cancer , which uses beams of protons or other charged particles such as helium, carbon or other ions instead of photons. charged particles have different depth-dose distributions compared to photons. They deposit most of their energy in the last final millimeters of their trajectory (when their speed slows). This results in a sharp and localized peak of dose, known as the Bragg peak.
1.Aim of Radiotherapy
The goal of radiotherapy is to deliver a prescribed dose of radiation to the Target while sparing surrounding Healthy tissues to the largest extent possible
2.Organ Motion
Intra-fraction motion
during the fraction
Heartbeat
Swallowing
Coughing
Eye movement
Inter-fraction motion
- in between the fractions
Tumour change
Weight gain/loss
Positioning deviation
Breathing
Bowel and rectal filling
Bladder filling
Muscle relaxation/tension
3. Respiratory motion affects:
Respiratory motion affects all tumour sites in the thorax, abdomen and Pelvis. Tumours in the Lung, Liver, Pancreas, Oesophagus, Breast, Kidneys, prostate
Tumour displacement varies depending on the site and organ Location
Lung tumours can move several cm in any direction during irradiation
It is most prevalent and prominent in Lung cancers
4. Problems associated with respiratory motion during RT
Image acquisition limitations
Treatment planning limitations
Radiation delivery limitations
5. Methods to Account for Respiratory Motion
1. Motion encompassing methods
2. Respiratory gating methods
3. Breath hold methods
4. Forced shallow breathing with abdominal compression
5. Real-time tumor tracking methods
Summary:
The management of respiratory motion in radiation oncology is an evolving field
IGRT provides a solution for combating organ motion in radiotherapy
Delivering higher dose to tumor and less dose to normal tissue.
Limited clinical studies, needs to be studied further
IGRT – the future of radiotherapy
A summary of recent innovations in radiation oncology focussing on the priniciples of different techniques and their application. An overview of clinical results has also been given
Patient Positioning and Immobilization Devices In Radiotherapy PlanningSubhash Thakur
This is a overview of the devices used in the radiotherapy planning. These are specifically designed for patient proper positioning, reproducibility and immobilization of patient during radiotherapy treatment.
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The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
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Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
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1. GONO BISHWABIDYALAY
Dept. of Medical Physics and Biomedical engineering
Radiation treatment planning (MPBME-322)
Assignment on immobilizing device used in radiotherapy
Submittedby: Submittedto:
Mohammad Ullah Shemanto Abu kawser
Roll: 328 Teaching assistant
Semester: 6th Dept. of MPBME
Batch: 16th Gono biswabidyalay
2. IMMOBILIZATION: Any device that helps to establish and maintain the
patient in a fixed, well defined position from treatment to treatment
over a course of radiotherapy or prevent the patient from moving
during a single treatment session.
ROLE OF IMMOBILIZATION:
• Patient positioning and immobilization are said to be the most
crucial parts of radiation therapy treatment.
• For accurate delivery of a prescribed radiation dose to a target
volume, while sparing sourrounding normal and critical tissues.
• Without proper immobilization ,the patient nwanted side effects
• Immobilization such as molds, casts, headrests, and other devices
are constructed to reduce setup error and patient movement
during treatment.
• Although the primary goal of immobilization system is to limit
patient motion and reduce the probability of major positioning
errors, there are other benefits as well..
• A well constructed immobilizing system can reduce the time for
daily patient set up.
• It can make the patient feel more secure and less apprehensive.
3. • It can reduce the reliance on patient co-operation and alertness,
and it can help to stabilize the relationship between external skin
marks and internal structures
Frameless immobilization devices:
• Orfit cast
• Vac lok
• Velcro Straps
• Alfa cradle
• Pituitary board
• Breast board
• Customized foam pads
4. Current methods for positioning and immobilization
Thermoplastic mask of the head Treatment chair
7. VAC-LOk
Thermoplastic mask of the head:
This device is made from a rigid plastic that becomes pliable when placed
in warm water. When it is placed over the patient body and conforms to
the contour of the treatment area.
Advantage of Thermoplastic mask of the head:
Low-temperature orthopedic plastics.
Polycaprolactone
Softens at 60 C (working temp)
Melts at 150 C (melting point)
Solid sheets or a flat plastic mesh of diff thicknesses.
Breast board:
Breast board is used specifically for the treatment of breast cancer.
It has several adjustable features to allow for the manipulation of
patients arms, wrists, head and shoulders. Breast boards are
generally constructed of carbon fibre allowing the device to be
lightweight and durable.
8. Advantage of breast board:
Provides arm support to bring the arm above the shoulders
and out of the way of the lateral field.
Allows the patient to be positioned with the chest wall
horizontal avoiding angulation of the collimator.
Takes advantage of gravity to pull the large breast down into a
better treatment position.
Belly board:
Belly boards are used when the patient is treated prone. Belly boards
allow the small bowel to drop below the lateral field to avoid severe side
effects of irradiation. Use of the belly board significantly decreases the
average volume of small bowel that would otherwise be within the
lateral field during standard box technique treatment.
Advantage of belly board:
Thick mattress for supporting the patient prone with a window
cutout for the patient's belly.
Provide more comfort and stability in the prone position (obese
patient).
Reduces the amount of intestine in the lateral radiation fields.
Vac lok:
A complete vacuum is drawn through the quick-release valve,
cushion becomes a rigid and comfortable mold, offering accurate
reproducibility throughout the course of simulation and treatment.
Made up of Nylon-urethane material, can be cleaned and reused.
9. Benefits of VAC-LOK:
• cost-effective
• re-usable
• quick to set up
• full range of sizes
Treatment chair:
Not popular.
Made of carbon fiber grids.
Chair can be mounted on the treatment couch.
Contain head and neck supports as well as arm rests.
Patients with troubled breathing and cannot be placed in a
recumbent position.
Advantageous for treatment of mediastinal disease.
Reduces the amount of irradiated normal tissue.
Head Fixation Devices:
Stereotactic radio surgery (SRS) immobilization requires greater
precision and accuracy.
Stereotactic frame bolted to the patient's skull before the target
localization procedure and attached until treatment is complete.
Single-fraction technique.
Impractical for fractionated radiotherapy