SBRT&StereoscopicIGRT_2012 [Compatibility Mode]

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Patient Immobilization With arms over the head. Flat lung board with T-bar holder for the arms. Vacuum Bag Maximum Intensity Projection (MIP) CT data is acquired using a Bellows or RPM device that records a breathing wave. Maximum intensity values are assigned to pixels at locations where a tumor moves to over time. Are a derived dataset of images that show a “composite” of the tumor volume over the time period that the CT data was acquired. 4D CT Simulation for LUNG SBRT CT Scanning procedure for moving target One free breathing scan – 3 mm slices, entire chest. One shorter, time-correlated scan – 3 mm slices, to include the tumor area. Breathing Waveform is acquired along with CT data using a Bellows or RPM device. The CT data acquired in one breath can be binned into 10 equally spaced intervals along the waveform and reconstructed. The 10 intervals are called Phases. Moving Target virtual simulation - Fusion GTV MIP dataset Volume propagation from MIP dataset to free breathing dataset ITV Free Breathing dataset 6
Treatment planning DMPO - optimization SBRT - LUNG Patient setup verification prior to treatment IMAGE GUIDANCE Multiple non-coplanar beams PTV=ITV + 5mm margin www.charlestonradiation.com WE HAVE NOTICED: 2-3 segments allow for dose compensation due to lack of resolution of the 10mm leaf width. Mihailidis, et al., AAPM 2009, Med. Phys. 36, (2009) 2660 Allow for low low-level level Intensity Modulation Treatment Isocenter DVH results Step-and-shoot mode: • 2-3 segments per beam. • 50Gy in 5 fxs. • Optimization objectives -heart -ribs -normal tissues Mihailidis, et al., AAPM 2009, Med. Phys. 36, (2009) 2660 Ipsilateral lung ExacTrac setup for lung SBRT Virtual isocenter for IG ITV PTV 50Gy www.charlestonradiation.com ET reconstructed views 7
Page 1 and 2: IGRT and SBRT Programs with Siemens
Page 3 and 4: Scan direction MLC picket fence tes
Page 5: CI Comparison: Conformity Index 2.5
Page 9 and 10: SBRT brain positioning and planning
Page 11: THANK YOU ! NRAO Green Bank Observa

SBRT&StereoscopicIGRT_2012 [Compatibility Mode]

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