Medphysics Planning
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Treatment planning involves defining target volumes and organs at risk on imaging scans. Virtual simulation uses CT scans to delineate structures and localize the treatment isocenter. This allows improved volume definition compared to conventional simulation. Treatment planning optimization selects parameters like beam number, weighting, and modifiers to best conform the dose distribution to planning objectives while minimizing dose to organs at risk. Beam modifiers like wedges and compensators can be used to modify the dose distribution for target coverage and organ sparing.
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Beam Direction
Beam direction techniques are used to accurately direct radiation beams towards the tumor while sparing surrounding healthy tissues. Key steps include patient localization using imaging like CT/MRI to delineate the tumor and organs, patient positioning and immobilization, field selection using beam directing devices like lasers, collimators and pointers, and dose distribution analysis to calculate and verify the prescribed dose. Proper beam direction allows obtaining conformal dose distributions and reproducible treatments for better therapeutic outcomes.
Beam Directed Radiotherapy - methods and principles
Beam directed radiotherapy aims to deliver a homogenous tumor dose while minimizing radiation to normal tissues. It involves careful patient positioning, immobilization, tumor localization, field selection, dose calculations, and verification. Key steps include using positioning aids and molds to reproducibly position the patient, imaging such as CT to delineate the tumor volume, contouring to define external body outlines, and dose calculations and verification to ensure accurate delivery.
Stereotactic Radio-Surgery/Therapy (SRS/SRT)
Stereotactic radiotherapy uses a rigid coordinate system attached to the patient to precisely target tumors for radiation treatment. Imaging such as CT and MRI are used to delineate the tumor target and nearby organs at risk. Treatment planning software then designs radiation beams that converge on the target from multiple angles, creating a steep dose gradient to spare surrounding tissue. This allows high-dose radiation to be focused within millimeters to eradicate the tumor while avoiding side effects in normal tissue.
Stereotactic Radiosurgery/ Radiotherapy
This document discusses stereotactic radiotherapy and radiosurgery. It begins by explaining that stereotactic radiotherapy precisely delivers radiation doses to defined tumor volumes, sparing surrounding normal tissues, using an external coordinate system attached to the patient. Stereotactic radiotherapy involves fractionated doses while radiosurgery delivers a high single dose. Imaging is used to delineate the target and organs at risk. Treatment planning software is then used to plan radiation techniques delivering a steep dose gradient. Quality assurance protocols ensure precise dose delivery. Indications, advantages, and limitations of stereotactic radiotherapy and radiosurgery are provided. The document concludes by discussing advances and other modalities like proton radiosurgery.
Imrt&vmat
1. The document discusses various aspects of intensity-modulated radiation therapy (IMRT) planning and delivery, including the use of inverse planning, optimization objectives and constraints, and different delivery methods like static field, dynamic field, tomotherapy, and VMAT.
2. It also discusses treatment volumes defined in ICRU 83 like gross tumor volume, clinical target volume, planning target volume, and organ-at-risk volumes. The document emphasizes using dose-volume histograms to specify dose rather than a single point.
3. Challenges with overlapping treatment volumes and the importance of evaluating the remaining volume at risk are also covered.
Total body irradiation
This document provides information about total body irradiation (TBI). It discusses that TBI uses megavoltage photon beams to destroy the recipient's bone marrow and tumor cells prior to bone marrow transplantation. It is used to treat various diseases like leukemia, lymphoma, and multiple myeloma. TBI can be delivered at high or low doses, to half the body, or total nodes. Techniques include parallel opposed beams from linear accelerators or cobalt-60 machines. Dosimetry and in vivo dosimetry are important due to the large fields and difficulty achieving uniform dose. Complications can include sterility, secondary cancers, and growth issues.
Patient data acquisition and treatment verification.pptx
1) Patient data acquisition involves obtaining 3D models from CT, MRI, or ultrasound scans to represent patient anatomy and tumours for treatment planning. CT numbers provide information on tissue density.
2) Treatment verification is important to ensure accurate radiation dose delivery and can involve portal films, electronic portal imaging, or cone-beam CT to check patient positioning.
3) Cone-beam CT acquires multidirectional x-ray images using on-board imaging systems to reconstruct 3D volumetric images for treatment guidance and avoiding critical structures.
Modern Radiotherapy
This document discusses modern radiotherapy techniques including conformal radiotherapy and intensity-modulated radiation therapy (IMRT). It describes the planning steps which involve CT scanning of the patient, delineating the tumor and organ-at-risk volumes, dose analysis, and treatment delivery with quality assurance and patient positioning. IMRT allows for improved target conformality and reduced radiation exposure to surrounding healthy tissues compared to traditional radiotherapy through inverse planning optimization of multiple modulated radiation beams. Image-guided radiotherapy (IGRT) further improves treatment accuracy by accounting for organ motion and setup variations using frequent imaging.
Clinical Radiotherapy Planning basics for beginners
1) External beam radiotherapy involves delivering high-energy x-ray beams from outside the patient's body to treat tumors. The ICRU recommends doses be within ±7-5% of the prescribed dose to the target.
2) Treatment planning involves acquiring patient images like CT scans, outlining the tumor and organs at risk, determining beam geometry, and calculating dose distributions.
3) Virtual simulation uses digitally reconstructed radiographs from CT images to plan beam placement, replacing conventional simulation using x-rays. This allows direct use of patient anatomy in planning.
IMRT by Musaib Mushtaq.ppt
The document discusses intensity-modulated radiation therapy (IMRT), including its advantages over conventional radiation therapy in delivering higher and more uniform radiation doses to tumor volumes while minimizing doses to surrounding healthy tissues. It explains that IMRT uses computer-optimized inverse planning to calculate non-uniform radiation beam intensities that target the tumor from several angles. This allows complex tumor shapes to be more conformally treated with lower toxicity risks compared to conventional techniques.
IMRT and 3D CRT in cervical Cancers
IMRT and 3 DCRT in cervical Cancers - Principles, Uses, Methods and Planning. A short summary of results of contemporary series are also provided.
Principles of beam direction and use of simulators
Beam direction devices such as collimators, lasers, and immobilization techniques are used during radiation therapy treatment planning to accurately direct the radiation beam toward the tumor target. This ensures better tumor control with minimal damage to surrounding healthy tissues. Treatment planning using radiation therapy simulators, including CT and MRI simulators, allows visualization of internal anatomy and precise delineation of targets and organs at risk to develop optimized 3D conformal or intensity-modulated radiation therapy plans. Accurate patient positioning and immobilization during both simulation and treatment are critical for reproducible and precise radiation delivery.
Total body irradiation
Total body irradiation (TBI) is a form of radiotherapy used prior to bone marrow transplants to reduce the risk of transplant rejection and destroy any remaining cancer cells. TBI techniques use large photon fields, usually from cobalt-60 machines or LINACs, to irradiate the entire body. Common techniques include opposing anterior-posterior beams or lateral beams. Precise dosimetry is required due to the large fields and total body exposure, with dose uniformity targets of within ±10% across the body. In vivo dosimetry using TLD or diodes is also employed to verify accurate dose delivery. Early side effects from TBI include fatigue, nausea, hair loss and skin irritation due to the whole body irradiation
Intensity Modulated Radiotherapy (IMRT) - Dr. S. Sachin
This document discusses intensity modulated radiotherapy (IMRT). It begins by outlining some limitations of conventional radiotherapy and 3D conformal radiotherapy, such as inaccurate target delineation and large safety margins. IMRT allows for more conformal dose distributions, tumor dose escalation, and reduced dose to normal tissues. The document then describes various aspects of IMRT planning and delivery, including inverse planning, beam angle and energy selection, dose calculation algorithms, quality assurance procedures, and treatment delivery.
IMRT_Planning_MRM.pdf
This document summarizes key concepts from ICRU report 83 regarding intensity modulated radiation therapy (IMRT) planning and dose reporting recommendations. Some of the main points include:
1) IMRT uses mathematical objective functions and dose-volume constraints in optimization, compared to traditional planning which iteratively modifies beam parameters.
2) ICRU 83 provides guidelines for standardizing IMRT techniques and procedures such as defining treatment volumes, dose prescription, and reporting levels.
3) It recommends dose-volume histogram reporting for target volumes and organs at risk, using metrics like D98%, D2%, Dmean rather than a single point dose. A homogeneity index is also defined.
Helical Tomotherapy
The document discusses helical tomotherapy, a form of radiation therapy that uses a rotating x-ray beam. It summarizes a study of 150 patients treated with tomotherapy between 2006-2007 for reasons such as complex tumor geometry or need for image guidance. Setup corrections were often needed based on pretreatment MV CT scans. Treatment times were typically under 25 minutes with minimal increases over time. Tomotherapy allows conformal dose distributions and image-guided radiation for difficult cases near critical organs.
multiple filed arrangement in Radiotherapy, Medical College Kolkata
The document discusses various radiation therapy techniques for dose distribution in matter using multiple fields and wedge fields. It covers:
1) Using multiple fields allows more uniform dose distribution in the tumor compared to a single field, while limiting dose to normal tissues.
2) Parallel opposed fields provide simplicity but can excessively dose normal tissues above and below the tumor. Larger field sizes are needed for adequate coverage.
3) Patient thickness, beam energy, and field size must be considered to minimize lateral tissue effects and ensure uniform dose distribution.
4) Multiple techniques like wedges, isocentric beams, and field matching seek to further optimize dose distribution while sparing critical structures. Proper planning and verification is important.
Magna field irradiation
The document discusses various considerations for magna field irradiation (TBI) including:
1) Biological factors like repair, repopulation and fractionation that are important for TBI. Fractionation increases lung tolerance up to 175%.
2) Physical factors that must be addressed like dose calibration, scatter corrections, and ensuring dose uniformity throughout the body.
3) Methods for calculating and prescribing dose including using average or single point doses. Most protocols prescribe to the umbilicus midpoint.
4) Techniques used to achieve homogeneity like bolus, compensators and beam energies. Homogeneity of ±10% is typically achieved.
5) Determining lung dose accurately through methods like CT-based calculations or
Yecco c.c
This chapter discusses total body irradiation (TBI) techniques and equipment. TBI uses megavoltage photon beams to destroy a patient's bone marrow and tumor cells prior to a bone marrow transplant. Two common TBI techniques are described: bilateral TBI where the patient is seated and treated from the left and right sides, and anteroposterior/posterioanterior TBI where the patient stands upright. Compensators and beam spoilers are used to improve dose uniformity. Dosimetry considerations and equations for calculating dose are also provided.
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Beam Directed Radiotherapy - methods and principles
Beam Directed Radiotherapy - methods and principles
Patient data acquisition and treatment verification.pptx
Patient data acquisition and treatment verification.pptx
Clinical Radiotherapy Planning basics for beginners
Clinical Radiotherapy Planning basics for beginners
Principles of beam direction and use of simulators
Principles of beam direction and use of simulators
Intensity Modulated Radiotherapy (IMRT) - Dr. S. Sachin
Intensity Modulated Radiotherapy (IMRT) - Dr. S. Sachin
multiple filed arrangement in Radiotherapy, Medical College Kolkata
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Medphysics Planning
- 1. Treatment Planning: Volume Definition: Beam Selection References: Radiation Therapy Planning, Bentel Treatment Planning in Radiation Oncology, Khan and Potish ICRU 50, 62
- 24. Lateral Field Nodes outlined With solder
- 36. Wedges: modify primary beam profile so as to produce isodose lines at angle wrt to surface Open beam 45 degree wedge
- 37. 15 degree 30 degree 45 degree 60 degree Different wedges available for Varian 600C
- 39. Use of wedges I: To correct for patient contour
- 40. Variation at level of isocentre: 40% 5%
- 41. Use of wedges II: To correct for beam attenuation when using multiple fields Example: 3 field plan, variation in treated volume: 30% 5%
- 42. Example: wedged pair, dose variation in treated volume: 50% 5%
- 50. Example: neck: compensate to give uniform dose along midplane throughout treatment field
- 51. Uncompensated Compensated 15-20% <5%