Adaptive radiotherapy (ART) using re-optimised treatment plans calculated on the patient's daily treatment anatomy becomes possible with on-treatment CT imaging. However, practical implementation of such ART techniques is time consuming. This paper proposes a fast and novel method of verifying dosimetric coverage and adapting treatment geometry online, where necessary, without the requirement for a full dose calculation.
An integrated CT-linac system (Primatom, Siemens, CA) has been used for on-treatment imaging at the Northern Centre for Cancer Treatment (NCCT) since 2004. Using a commercial virtual simulation software package (Prosoma, Medcom, Germany) it is possible to register the on-treatment CT study with the original planning anatomy and its associated calculated dose. The coverage of the on-treatment clinical target volume (CTV) can be assessed using the original dose distribution, assuming changes in treatment anatomy do not significantly alter the dose distribution. The work performed to validate this concept will be presented.
The results of an off-line clinical pilot study will also be reported, including the effects of soft tissue guided intervention. Practical issues relating to the full clinical implementation of the technique in a busy clinical radiotherapy department will be discussed.
Smyth G, McCallum HM, Lawrence GP, Lambert EL, Wilson, NJ, Dickson SE. Implementation of 3D verification of dose coverage in prostate radiotherapy. Siemens User Meeting (UK & Ireland), Heidelberg, Germany. 14-15th May 2007.
Greg Smyth, NGH Unit, Newcastle upon Tyne. Tel: +44 (0)191-233-6161.
Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.
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