Virtual simulation in radiation therapy planning. Report of five-year experience

In this paper, a new methodological approach to using PET information in radiotherapy treatment planning has been discussed. Computed tomography (CT) represents the primary modality to plan personalized radiation treatment, because it provides the basic electron density map for correct dose calculation. If PET scanning is also performed it is typically coregistered with the CT study. This operation can be executed automatically by a hybrid PET/CT scanner or, if the PET and CT imaging sets have been acquired through different equipment, by a dedicated module of the radiotherapy treatment planning system. Both approaches have some disadvantages: in the first case, the bore of a PET/CT system generally used in clinical practice often does not allow the use of certain bulky devices for patient immobilization in radiotherapy, whereas in the second case the result could be affected by limitations in window/level visualization of two different image modalities, and the displayed PET volumes can appear not to be related to the actual uptake into the patient. To overcome these problems, at our centre a specific procedure has been studied and tested in 30 patients, allowing good results of precision in the target contouring to be obtained. The process consists of segmentation of the biological target volume by a dedicated PET/CT console and its export to a dedicated radiotherapy system, where an image registration between the CT images acquired by the PET/CT scanner and a large-bore CT is performed. The planning target volume is contoured only on the large-bore CT and is used for virtual simulation, to individuate permanent skin markers on the patient.

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CT simulation for radiotherapy treatment planning

Aird¹,

Conway²

2002

BJR

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The present status of CT simulation (CT sim) hardware, software and practice is reviewed, particularly with regard to the changes that have taken place over the last 5 years. The latest technology is discussed together with some recently developed techniques. The article concludes with a discussion of virtual simulation vs physical (conventional) simulation; in particular there is a review of the changes that have been made to the "Disadvantages table" presented by Conway and Robinson [1], which now make CT sim an attractive system for any radiotherapy department.

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Virtual simulation in radiation therapy planning. Report of five-year experience

Cited by 3 publications

References 38 publications

Virtual simulation and three-dimensional treatment planning and conformal radiation therapy

Virtual simulation and three-dimensional treatment planning and conformal radiation therapy

A new methodological approach for PET implementation in radiotherapy treatment planning

CT simulation for radiotherapy treatment planning

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