SBRT Treatment Planning: Practical Considerations

SBRT Lung/Liver/Abdominal Cases
• 4DCT simulation must be done first to access tumor
motion range
• Gating will be considered only if motion > 0.5cm, and the
patient has a regular, reproducible breathing pattern;
alternatively, an ITV can be created.
• For gating cases, BlueBAG TM without vacuum suction is
used as immobilization device.
• Abdominal Belt Compression system can be used for
some patients
• Fiducials necessary for Liver/Abdominal Cases: no other
way to visualize tumor. CBCT image quality, FOV
limitation for lateral tumors.
• If no fiducials for Lung cases, Fluoro on the machine
must be done before simulation to verify visualization of
tumor