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Sri Lanka WS
Patient data acquisition
(36:34)
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by tcc, 2011-04-19 12:20, 人氣(4984)
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標題
1.
Patient Image Acquisition and Simulation
2.
Objectives
3.
Radiation Oncology Clinical Workflow
4.
CT Simulation Work Flow
5.
CT scanner with the table top which patient scanning position can be accurately reproduced on LINAC treatmentCT simulation acquires “Virtual” 3D datasets for planning with virtual representation of patient anatomical and geometrical parametersA CT virtual simulator is a set of software which recreates the treatment machine and allows import, manipulation, display, and storage of images from CT and/or other imaging modalities.
6.
Technical Reference
7.
Complete CT Simulation Process
8.
The CT Simulator
9.
CT Simulator – Large Bore (FOV)
10.
Isocenter Marking Test
11.
Gantry lasers should accurately identify scan planewithin the gantry opening;Gantry lasers should be parallel and orthogonal with the scan plane and should intersect in the center of scan plane;Vertical side-wall lasers should be accurately spacedfrom imaging plane;Wall lasers should be parallel and orthogonal with the scan plane, and should intersect at a point which is coincident with the center of the scan plane;The overhead sagittal laser should be orthogonal to theImaging plane;The overhead sagittal laser movement should be accurate, linear, and reproducible.
12.
CT Sim Isocenter QA
13.
Isocenter Marking Difference
14.
Isocenter Management Tool
15.
Marking Lasers
16.
CT Simulation - Geometry
17.
Tabletops used for patient support during imaging or treatment should be reproducible to improve accurate patient setup Repositioning of a patient from CT sim to treatment table is critical for accurate treatment deliveryKey design factor should have allow indexing of patient immobilization devices to the tabletop for patient reproducibility
18.
Provide a platform for target and OAR contouring and localizationVirtual Simulation (VS) software should allow fast user-friendly contouring process with semi-automatic or automatic contouring tools (contouring and segmentation) An ability to add margins in three dimensions and to automatically draw treatment portals around target volumes with isocenter validation Target deformation or auto-registration are advanced development for CT VS package
19.
Scanning slice thickness creates different quality of DRR, thinner slices produce better images, but need more processing powerNeed balance between large amounts of data and image quality (scanning protocols need to be established)
20.
Image Rendering
21.
Small Bore vs. Large BorePatient population with different setup techniqueConventional simulator availabilityLarger bore creates more scattering doseSingle Slice vs. Multi SliceDRR quality (rendering technique and speed)Image quality (Scanning slice thickness)4D CT (respiratory gating)Sim-CT (conventional sim with cone beam CT option) – Current LINAC with CBCT option competes with Sim-CT in the future?
22.
CT Sim Head Immobilization
23.
Contrast can be used to help differentiate between tumors and surrounding healthy tissue, and better define the target marginContrast always presents clinical nursing difficulty and should be used carefullyFor heterogeneity-based CT planning, contrast presents dose distribution errors due to large CT numbers to the corresponding tissue densities For implementation of contrast in radiotherapy scanning, diagnostic radiological procedures should be followedContrast density override should be carefully examined
24.
PET-CT image fusion head phantom to assess accuracy of image registration/fusion process
25.
Target and Normal Tissue Delineation
26.
ICRU50/62 Target Volume Definition
27.
Unfortunately, in many sites anatomic imaging techniques (i.e., CT or MRI) do not always distinguish malignant from normal tissues.
28.
29.
30.
31.
Safety Specification of CT Sim
32.
Performance Evaluation
33.
Performance Evaluation
34.
Performance Evaluation
35.
Image Performance Evaluation
36.
CT Commissioning Report
37.
CT Sim Annual Test
38.
CT QA/QC – Annual Dosimetry Tests
39.
A Comprehensive QA Process
40.
An imaging technique for providing a set of CT images for a specific breathing phase.A multi-slice CT scanner is used and the couch speed is reduced to accommodate breathing cycleDuring the scanning the patient’s breathing phase is monitored using a device such as Philips Bellows, Varian’s Real-time Position Management System (RPM) or Elekta’s Active Breathing Coordinator (ABC).The data acquired data is then sorted by breathing phase, and phase specific images can be reconstructed.
41.
ToolPrincipleAdvantages Limitations
42.
mid exhale
43.
4D CT - Process for Sorting/Binning
44.
GTV – 4D CT
45.
CT Simulation has gradually replaced the current simulation process and can improve the quality for target definition if properly operatedTG-66 report provides a very thorough QA process for CT sim implementationValidation of CT sim geometrical information validation is the key for successful CT simulation processCT sim changes the conventional simulation procedures and still evolving with new modalities introduced into the routine clinical protocolsCT improved accuracy of target localization and provides flexibility of simulation processQA of CT sim includes QA of CT simulator, virtual simulation process, testing of the patient marking accuracy for patient setup reproducibility.
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