Professional Documents
Culture Documents
IAEA
International Atomic Energy Agency
7.1 Introduction
7.2 Volume Definition
7.3 Dose Specification
7.4 Patient Data Acquisition and Simulation
7.5 Clinical Considerations for Photon Beams
7.6 Treatment Plan Evaluation
7.7 Treatment Time and Monitor Unit Calculations
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.Slide 1
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7.1 INTRODUCTION
7.1 INTRODUCTION
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.1 Slide 2
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7.1 INTRODUCTION
beam energies
and
field sizes
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.1 Slide 3
7.1 INTRODUCTION
• superficial
(30 kV to 80 kV)
• orthovoltage
(100 kV to 300 kV)
• megavoltage or
supervoltage energies
(Co-60 to 25 MV)
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.1 Slide 4
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7.1 INTRODUCTION
7.1 INTRODUCTION
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7.1 INTRODUCTION
SSD technique
The distance from the source to the surface of the patient
is kept constant for all beams.
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.1 Slide 7
7.1 INTRODUCTION
SAD technique
The center of the target volume is placed at the machine
isocenter, i.e. the distance to the target point is kept
constant for all beams.
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.1 Slide 8
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7.1 INTRODUCTION
Note:
In contrast to SSD technique,
the SAD technique requires
no adjustment of
the patient setup when
turning the gantry to the
next field.
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.1 Slide 9
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.2 Slide 1
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7.2 VOLUME DEFINITION
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7.2 VOLUME DEFINITION
7.2.1 Gross Tumor Volume (GTV)
GTV
CTV
GTV
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7.2 VOLUME DEFINITION
7.2.2 Clinical Target Volume (CTV)
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.2.2 Slide 2
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7.2 VOLUME DEFINITION
7.2.3 Internal Target Volume (ITV)
ITV
CTV
CTV
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7.2 VOLUME DEFINITION
7.2.4 Planning Target Volume (PTV)
PTV
ITV
CTV
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7.2 VOLUME DEFINITION
7.2.4 Planning Target Volume (PTV)
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7.2 VOLUME DEFINITION
7.2.5 Organ at Risk (OAR)
PTV
ITV
CTV
OAR
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7.3 DOSE SPECIFICATION
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.3 Slide 1
frequency dose-area
histogram for the PTV
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7.3 DOSE SPECIFICATION
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7.3 DOSE SPECIFICATION
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7.3 DOSE SPECIFICATION
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.3 Slide 7
Example:
CTV: mediastinum (violette)
OAR:
• both lungs (yellow)
• spinal cord (green)
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.1 Need for patient data
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.2 Nature of patient data
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.2 Nature of patient data
2D treatment planning
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.2 Slide 3
3D treatment planning
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.2 Nature of patient data
• GTV
• CTV
• PTV
• organs at risk
(bladder and rectum).
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.2 Nature of patient data
A digitally reconstructed
radiograph with super-
imposed beam’s eye view
for an irregular field
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.3 Treatment simulation
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.3 Treatment simulation
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.3 Treatment simulation
Therefore, dedicated
equipment – fluoroscopic
simulator - has been
developed and was widely
used for radiotherapy
simulation.
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.3 Slide 6
Modern simulation
systems are based on
computed tomography
(CT) or magnetic
resonance (MR) imagers
and are referred to as CT-
simulators or MR-
simulators.
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.4 Patient treatment position and immobilization devices
Example:
The precision
required in
radiosurgery
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.4 Slide 1
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.4 Patient treatment position and immobilization devices
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.4 Patient treatment position and immobilization devices
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.4 Patient treatment position and immobilization devices
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.4 Slide 7
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.4 Patient treatment position and immobilization devices
In radiosurgery, a stereotactic
frame is attached to the patient’s
skull by means of screws and
is used for target localization,
patient setup, and patient
immobilization during the entire
treatment procedure.
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.4 Slide 9
Examples:
• treatment with a direct field;
• parallel and opposed fields.
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.5 Patient data requirements
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.5 Patient data requirements
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.6 Conventional treatment simulation
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.6 Conventional treatment simulation
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.6 Conventional treatment simulation
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.6 Conventional treatment simulation
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.6 Slide 7
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.6 Conventional treatment simulation
Use of a special
drawing instrument
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.6 Slide 9
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.7 Computed tomography-based conventional simulation
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.7 Computed tomography-based conventional simulation
Scout films
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.7 Slide 4
Scout films
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.7 Computed tomography-based conventional simulation
Scout films
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.7 Slide 6
Virtual Simulation
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.8 Computed tomography-based virtual simulation
CT-Simulator
Dedicated CT scanners for use in radiotherapy treatment
simulation and planning have been developed.
Example of a modern
CT-simulator
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.8 Computed tomography-based virtual simulation
Virtual Simulation
Example of a DRR
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.8 Computed tomography-based virtual simulation
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.8 Slide 6
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.8 Computed tomography-based virtual simulation
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.8 Slide 8
Conventional simulator
Advantage Disadvantage
useful to perform a limited soft tissue contrast
fluoroscopic simulation tumor mostly not visible
in order to verify requires knowledge of
isocenter position and tumor position with respect
field limits as well as to to visible landmarks
mark the patient for
treatment restricted to setting field
limits with respect to bony
landmarks or anatomical
structures visible with the
aid of contrast
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.9 Slide 1
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.9 Conventional simulator vs. CT simulator
CT simulator
Advantage Disadvantage
increased soft tissue limitation in use for some
contrast treatment setups where
axial anatomical patient motion effects are
information available involved
delineation of target and require additional training
OARs directly on and qualification in 3D
CT slices planning
allows DRRs
allows BEV
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.9 Conventional simulator vs. CT simulator
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.10 Magnetic resonance imaging for treatment planning
Disadvantage of MRI
It cannot be used for radiotherapy simulation and
planning for several reasons:
The physical dimensions of the MRI and its accessories limit the use
of immobilization devices and compromise treatment positions.
Bone signal is absent and therefore digitally reconstructed
radiographs cannot be generated for comparison to portal films.
There is no electron density information available for heterogeneity
corrections on the dose calculations.
MRI is prone to geometrical artifacts and distortions that may affect
the accuracy of the treatment.
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.10 Magnetic resonance imaging for treatment planning
MR CT
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.10 Slide 4
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7.4 PATIENT DATA ACQUISITION AND SIMULATION
7.4.11 Summary of simulation procedures
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
Isodose curves
Wedge filters
Bolus
Compensating filters
Corrections for contour irregularities
Corrections for tissue inhomogeneities
Beam combinations and clinical application
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5 Slide 1
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.1 Isodose curves
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.1 Isodose curves
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.2 Wedge filters
Physical wedge:
A set of wedges (15°, 30°, 45°, and 60°) is usually
provided with the treatment machine.
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.2 Wedge filters
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.2 Wedge filters
Example 1:
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.2 Slide 6
Example 2:
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.2 Wedge filters
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.2 Slide 8
Example:
A wedge pair of 6 MV beams
incident on a patient.
The hinge angle is 90°
(orthogonal beams) for which
the optimal wedge angle
would be 45°.
However, in this case the
additional obliquity of the
surface requires the use of a
higher wedge angle of 60°.
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.2 Slide 9
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.2 Wedge filters
Wedge factor
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.2 Slide 10
depth
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.3 Slide 1
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.3 Bolus
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.3 Slide 2
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.3 Bolus
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.4 Compensating filters
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.4 Slide 1
I I0 = e −μx
where μ is the linear attenuation coefficient for the
radiation beam and material used to construct the
compensator.
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.4 Compensating filters
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.4.9 Slide 3
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.5 Corrections for contour irregularities
Grid lines are drawn parallel (1) Manual isodose shift method
to the central beam axis all
across the field.
The tissue deficit (or excess) h is
the difference between the SSD
along a gridline and the SSD on the
central axis.
k is an energy dependent
parameter given in the next slide.
The isodose distribution for a flat
phantom is aligned with the SSD
central axis on the patient contour.
For each gridline, the overlaid
isodose distribution is shifted up (or
down) such that the overlaid SSD is
at a point k×h above (or below) the
central axis SSD.
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.5 Slide 2
<1 0.8
60Co -5 0.7
5 – 15 0.6
15 – 30 0.5
> 30 0.4
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.5 Corrections for contour irregularities
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.6 Corrections for tissue inhomogeneities
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.6 Slide 1
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.6 Corrections for tissue inhomogeneities
Top:
Assuming that all tissues
(including the lung) have
water-equivalent density
Bottom:
Taking into account the
real tissue density
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.6 Slide 3
• TAR method
• Batho power law method
• equivalent TAR method
• isodose shift method
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.6 Corrections for tissue inhomogeneities
z1 ρ1 = 1
z2 ρ2 = ρe
z3 ρ3 = 1
Point P
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.6 Slide 5
TAR method
TAR(z ', rd )
CF =
TAR(z, rd )
where
z’ = z1 + ρez2 + z3 and z1 ρ1 = 1
z = z1 + z2 +z3 z2 ρ2 = ρe
z3 ρ3 = 1
Point P
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.6 Corrections for tissue inhomogeneities
z = z1 + z2 +z3 z2 ρ2 = ρe
z3 ρ3 = 1
Point P
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.6 Slide 7
z = z1 + z2 +z3 z3 ρ3 = 1
Point P
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.6 Corrections for tissue inhomogeneities
The isodose shift method for the dose correction due to the
presence of inhomogeneities is essentially identical to the isodose
shift method outlined in the previous section for contour
irregularities.
Isodose shift factors for several types of tissue have been
determined for isodose points beyond the inhomogeneity.
The factors are energy dependent but do not vary significantly with
field size.
The factors for the most common tissue types in a 4 MV photon
beam are: air cavity: -0.6; lung: -0.4; and hard bone: 0.5. The total
isodose shift is the thickness of inhomogeneity multiplied by the
factor for a given tissue. Isodose curves are shifted away from the
surface when the factor is negative.
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.7 Beam combinations and clinical application
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.7 Beam combinations and clinical application
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.7 Beam combinations and clinical application
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7.5 Clinical considerations for photon beams
7.5.7 Beam combinations and clinical application
Example:
A parallel-opposed beam
pair is incident on a patient.
Note the large rectangular
area of relatively uniform
dose (<15% variation).
The isodoses have been
normalized to 100% at the
isocenter.
This beam combination is well suited to a large variety of
treatment sites (e.g., lung, brain, head and neck).
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.7 Slide 8
Two examples:
4-field box 3-field technique using wedges
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.7 Beam combinations and clinical application
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.7 Beam combinations and clinical application
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.7 Slide 12
Wedge pair:
Two beams with wedges (often orthogonal) are used to achieve a
trapezoid shaped high dose region. This technique is useful in
relatively low-lying lesions (e.g., maxillary sinus and thyroid lesions).
4-field box:
A technique of four beams (two opposing pairs at right angles)
producing a relatively high dose box shaped region. The region of
highest dose now occurs in the volume portion that is irradiated by all
four fields. This arrangement is used most often for treatments in the
pelvis, where most lesions are central (e.g., prostate, bladder, uterus).
Opposing pairs at angles other than 90°:
also result in the highest dose around the intersection of the four
beams, however, the high dose area here has a rhombic shape.
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.7 Beam combinations and clinical application
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.7 Slide 14
Rotational techniques
Note:
The isodoses are
tighter along the
angles avoided by
the arcs
(anterior and
posterior).
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.7 Beam combinations and clinical application
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.7 Beam combinations and clinical application
Non-coplanar beams
arise from non-standard
couch angles coupled
with gantry angulations.
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.7 Beam combinations and clinical application
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.7 Beam combinations and clinical application
Field matching
Field matching
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7.5 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS
7.5.7 Beam combinations and clinical application
Field matching
⎛ z ⎞
g = 0.5 ⋅ L1 ⋅ ⎜ ⎟
⎝ SSD ⎠
⎛ z ⎞
+ 0.5 ⋅ L2 ⋅ ⎜ ⎟
⎝ SSD ⎠
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.5.7 Slide 24
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7.6 TREATMENT PLAN EVALUATION
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6 Slide 2
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7.6 TREATMENT PLAN EVALUATION
Isodose curves
Orthogonal planes and isodose surfaces
Dose distribution statistics
Differential Dose Volume Histogram
Cumulative Dose Volume Histogram
Example:
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.1 Slide 1
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7.6 TREATMENT PLAN EVALUATION
7.6.1 Isodose curves
Same example:
The isodose line [%]
through the ICRU -150
reference point
is 152%. -140
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.1 Slide 3
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7.6 TREATMENT PLAN EVALUATION
7.6.2 Orthogonal planes and isodose surfaces
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.2 Slide 1
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7.6 TREATMENT PLAN EVALUATION
7.6.2 Orthogonal planes and isodose surfaces
Target
volume: blue
Prescription
isodose:
white
wireframe
Bladder and
rectum are
also shown.
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.2 Slide 3
Disadvantage:
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7.6 TREATMENT PLAN EVALUATION
7.6.3 Dose statistics
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.3 Slide 1
These include:
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7.6 TREATMENT PLAN EVALUATION
7.6.3 Dose statistics
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.3 Slide 3
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7.6 TREATMENT PLAN EVALUATION
7.6.4 Dose-volume histograms
frequency
• a specific organ
in the vicinity of
the PTV.
dose value
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.4 Slide 2
dose value in Gy
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.4 Slide 3
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7.6 TREATMENT PLAN EVALUATION
7.6.4 Dose-volume histograms
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7.6 TREATMENT PLAN EVALUATION
7.6.4 Dose-volume histograms
Differential DVHs
Example: Prostate cancer
target
rectum
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7.6 TREATMENT PLAN EVALUATION
7.6.4 Dose-volume histograms
Integral DVHs
Example: Prostate cancer
Target
Critical
structure: rectum
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7.6 TREATMENT PLAN EVALUATION
7.6.4 Dose-volume histograms
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7.6 TREATMENT PLAN EVALUATION
7.6.5 Treatment evaluation
Port films
A port film is usually an
emulsion-type film, often
still in its light-tight paper
envelope, that is placed
in the radiation beam
beyond the patient.
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.5 Slide 1
Port films
Two port films are available.
Depending on their sensitivity (or speed) port films can be
used for:
• Localization:
A fast film is placed in each beam at the beginning or
end of the treatment to verify that the patient
installation is correct for the given beam.
• Verification:
A slow film is placed in each beam and left there for
the duration of the treatment.
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.5 Slide 2
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7.6 TREATMENT PLAN EVALUATION
7.6.5 Treatment evaluation
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7.6 TREATMENT PLAN EVALUATION
7.6.5 Treatment evaluation
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.5 Slide 5
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7.6 TREATMENT PLAN EVALUATION
7.6.5 Treatment evaluation
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7.6 TREATMENT PLAN EVALUATION
7.6.5 Treatment evaluation
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7.6 TREATMENT PLAN EVALUATION
7.6.5 Treatment evaluation
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.6.5 Slide 11
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
Introductional remark
The process of treatment planning and optimization may
be considered as completed if the calculated relative
dose distribution shows an acceptable agreement with the
PTV.
As an example, the 80% isodose curve may well
encompasses the PTV.
It remains to determine the most important final parameter
which controls the absolute dose delivery, that is:
the treatment time (for radiation sources)
or the
the monitor units (for linacs)
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
An example is shown
in the DVH left:
median dose
The median dose is
the dose at the
50% volume level.
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
Note:
This method deviates slightly from that given in the
Handbook.
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.7 Slide 13
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.7 Slide 15
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
7.7.1 Calculations for fixed SSD set-up
Note: [%]
The prescribed
-150
-140
ICRU
weights refer -130 point
-120
to the point of -100
maximum - 70
- 50
dose in each
field:
PA W = 1.0
PRPO W = 0.8
PRPO W = 0.8
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.7.1 Slide 3
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
7.7.1 Calculations for fixed SSD set-up
Method of normalization:
A normalization
was firstly
[%]
performed for each
-150 ICRU point is at
field individually: -140 isocenter: 152%
-130
anterior field: -120
Dmax refers to 100% -100
right posterior field: - 70
Dmax refers to 80% - 50
left posterior field:
Dmax refers to 80%
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.7.1 Slide 4
Step 2: For each field i, the dose at the ICRU point, Di(IP), is
calculated by (using 100 MU):
. PDD( z, A, f , E )
Di (IP ) = D( zmax , Aref , f , E ) ⋅ ⋅ RDF ( A, E ) ⋅ WF ⋅ 100
100
where
.
D(zmax , Aref ,f ,E ) is the calibrated output of the machine
PDD( z, A, f , E ) is the percentage depth dose value
WF is the wedge factor
RDF(A,E) is the relative dose factor (see next slide)
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
7.7.1 Calculations for fixed SSD set-up
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
7.7.1 Calculations for fixed SSD set-up
Σ(dose) = 148.96
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
7.7.1 Calculations for fixed SSD set-up
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.7.1 Slide 10
ICRU point
In this example, the 240%
normalization was
performed for each
beam individually
such that Disocenter
is 100% times the
beam weight.
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
7.7.2 Calculations for isocentric set-ups
Step 2: For each field i, the dose at the ICRU point, Di(IC), is
calculated by (using 100 MU):
.
Di (IC ) = D( zmax , Aref , f , E ) ⋅ TMR( A, z ) ⋅ ISF ⋅ RDF ( A, E ) ⋅ WF ⋅ 100
where:
.
D(zmax, Aref ,f ,E ) is the calibrated output of the machine
TMR( A, z ) is the tissue-maximum-ratio at depth z
WF is the wedge factor
RDF(A,E) is the relative dose factor
ISF is the inverse-square factor (see next slide)
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
7.7.2 Calculations for isocentric set-ups
.
When the calibrated output factor D( zmax , Aref , f , E ) is used in
isocentric calculations, it must be corrected by the inverse-
square factor ISF unless the machine is actually calibrated
at the isocenter:
2
⎡ SSD + zmax ⎤
ISF = ⎢ SSD ⎥
⎣ ⎦
IAEA Review of Radiation Oncology Physics: A Handbook for Teachers and Students - 7.7.2 Slide 4
Step 3: Rescale the MUs such that the dose contributions at the
IP are proportional to the pre-defined weights and sum
up the total resultant dose using the rescaled MUs.
Σ(dose) = 175.44
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
7.7.2 Calculations for isocentric set-ups
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7.7 TREATMENT TIME AND MONITOR UNIT CALCULATIONS
7.7.3 Normalization of dose distributions
Important:
Dose distributions can be normalized in different ways:
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7.7.4 Inclusion of output parameters in dose distribution
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