TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

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Presentation transcript:

TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007

Regions of Radiation Field Considered in Dose Calculations

DOSE TO A POINT IN TISSUE Major Processes that Effect Dose in Tissue from Photon Beams Inverse Square Law Photon Attenuation Photon Scatter

Dose Calculation Methods Used to Determine Dose at a Point in a Patient Correction Based Methods % Depth Dose Calculations Tissue Maximum/Phantom Ratios Tissue-Air Ratios Model Based Methods Pencil Beam Methods Convolution Superposition Monte Carlo Calculations

The General Form of Equation Used to Calculate Dose at Depth in the Patient TPR (d, r, h ) = Dose at Depth / Dose at Reference/Max

10 Mv X-ray Beam

Isodose Curves High Energy

Variation in Dose for Various Energy Beams

COMPARE MONTE CARLO DOSES IN LUNG

Comparison Dose Distribution 6 MV X-Rays

Conformal Planning Process PATIENT DATA SET/S CT, MRI, PET DEFINATION OF TARGET AND NORMAL TISSUES PRESCRIPTION DOSE and FRACTIONATION TOTAL DOSE TO VOLUMES DOSE TO NORMAL TISSUES

EXAMPLE OF A CONFORMAL PLAN The prescription should include the total dose to the target volumes, the fractionation, a statement of the expansion of the GTV to the CTV and PTV. The dose limits to the normal tissues that are near the site of treatment need to be defined.

ICRU 62

EXAMPLE OF TREATMENT VOLUMES

TREATMENT VOLUMES GTVCTVITVPTV

NORMAN TISSUES NEAR TREATMENT SITE SPINAL CORD< ~45 Gy LIVER <~25Gy/100%, 30Gy/35%, 35Gy/25% KIDNEYS<~23Gy/66% LUNG<~30Gy/40%, 60Gy/20% HEART<~30Gy/100% LV, 45Gy/100% (atrium)

AP/PA OPPOSED FIELDS

DVH FOR TISSUES AP/PA CTV PTV Liver Lung RT Kidney RT Heart

FOUR FIELD PLAN AP/PA/RLAT/LLAT

DVH 4 FIELD PLAN CTV PTV Liver Heart Kidney RT Lung RT

5 FIELD PLANE AP/RA/RP/LP/LA

DVH 5 FIELD PLAN CTV PTV Liver Lung RT Heart Kidney RT

CTV Lung RT Kidney RT

Stereotactic Radiosurgery 1905: Introduction of stereotactic equipment 1908: Mapping of brain in 3 planes 1918: First stereotactic frame for humans in London 1940: Greatest strides in intracranial applications began

Stereotactic Radiosurgery 1982: Modified Linear Accelerator

Stereotactic Radiosurgery SRS Frame Placement

STEROTACTIC RADIATION THERAPY SRT

Fractionated Stereotactic Radiation Therapy Fractionated Stereotactic Radiation Therapy(SRT) combines the target and dose localization characteristics of SRS with the biologic advantages of dose fractionization

STEROTACTIC RADIATION SURGERY SRS

Fractionated Stereotactic Radiation Therapy