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Synthetic CT in assessment of anatomical and dosimetric variations in radiotherapy - procedure validation

100%

Grządziel A. , Gądek A. , Bekman B. , Wendykier J. , Ślosarek K.

2020

tom Vol. 26, Iss. 4

185--192

Introduction: One of many procedures to control the quality of radiotherapy is daily imaging of the patient's anatomy. The CBCT (Cone Beam Computed Tomography) plays an important role in patient positioning, and dose delivery monitoring. Nowadays, CBCT is a baseline for the calculation of fraction and total dose. Thus, it provides the potential for more comprehensive monitoring of the delivered dose and adaptive radiotherapy. However, due to the poor quality and the presence of numerous artifacts, the replacement of the CBCT image with the corrected one is desired for dose calculation. The aim of the study was to validate a method for generating a synthetic CT image based on deformable image registration. Material and methods: A Head & Torso Freepoint phantom, model 002H9K (Computerized Imaging Reference Systems, Norfolk, USA) with inserts was imaged with CT (Computed Tomography). Then, contouring and treatment plan were created in Eclipse (Varian Medical Systems, Palo Alto, CA, USA) treatment planning system. The phantom was scanned again with the CBCT. The planning CT was registered and deformed to the CBCT, resulting in a synthetic CT in Velocity software (Varian Medical Systems, Palo Alto, CA, USA). The dose distribution was recalculated based on the created CT image. Results: Differences in structure volumes and dose statistics calculated both on CT and synthetic CT were evaluated. Discrepancies between the original and delivered plan from 0.0 to 2.5% were obtained. Dose comparison was performed on the DVH (Dose-Volume Histogram) for all delineated inserts. Conclusions: Our findings suggest the potential utility of deformable registration and synthetic CT for providing dose reconstruction. This study reports on the limitation of the procedure related to the limited length of the CBCT volume and deformable fusion inaccuracies.

Przeciwzapalne napromienianie płuc chorych na COVID-19

86%

Sroka Ł. , Gądek A. , Dolla Ł. , Radwan M. , Rutkowski T. , Ślosarek K.

tom Vol. 10, nr 2

93--96

W pracy przedstawiono metodę napromieniania płuc pacjentów chorych na COVID-19. Wszelkie badania obrazowe, wymagane do zrealizowania radioterapii, są wykonywane na akceleratorze liniowym. Zastosowany plan leczenia jest planem 2D, natomiast rozkład dawki 3D otrzymuje się w oparciu o badanie tomografii stożkowej CBCT (Cone Beam Computed Tomography) wykonywane po napromienieniu pacjenta. Po tym badaniu pacjent może opuścić szpital. Celem takiego sposobu napromienienia jest skrócenie czasu pobytu pacjenta w placówce oraz ograniczenie jego kontaktu z personelem do niezbędnego minimum. W czasie napromienienia pacjenta mierzona jest mapa fluencji. Cały proces jest wykonywany z zachowaniem wszystkich procedur QA oraz zasad ochrony epidemiologicznej. Całość leczenia jest dokumentowana w postaci elektronicznej, jak i papierowej, generowanej na podstawie planu 3D.

The paper presents a method of lung irradiation in COVID-19 patients. All imaging tests required for radiotherapy are performed on a linear accelerator. The treatment plan used is a 2D plan, while the 3D dose distribution is based on the Cone Beam Computed Tomography (CBCT) scan performed after the patient’s irradiation. After this examination, the patient can leave the hospital. The purpose of this method of irradiation is to shorten the patient’s stay in the facility and to limit his contact with the staff to the necessary minimum. During the irradiation of the patient, the fluency map is measured. The entire process is carried out in compliance with all QA procedures and the principles of epidemiological protection. The entire treatment is documented in electronic and paper form, generated on the basis of a 3D plan.