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

Dec 19, 2015

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Page 1: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

TREATMENT PLANNING PHOTONS & ELECTRONS

Karen P. Doppke 3/20/2007

Page 2: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

Regions of Radiation Field Considered in Dose Calculations

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

DOSE TO A POINT IN TISSUE

Major Processes that Effect Dose in Tissue from Photon Beams

Inverse Square Law

Photon Attenuation

Photon Scatter

Page 4: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

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

Page 5: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

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

Page 6: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.
Page 7: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.
Page 8: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

10 Mv X-ray Beam

Page 9: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

Isodose Curves High Energy

Page 10: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.
Page 11: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

Variation in Dose for Various Energy Beams

Page 12: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

COMPARE MONTE CARLO DOSES IN LUNG

Page 13: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

Comparison Dose Distribution 6 MV X-Rays

Page 14: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.
Page 15: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

Conformal Planning Process

PATIENT DATA SET/SCT, MRI, PET

DEFINATION OF TARGET AND NORMAL TISSUES

PRESCRIPTION DOSE and FRACTIONATIONTOTAL DOSE TO VOLUMES DOSE TO NORMAL TISSUES

Page 16: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

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.

Page 17: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

ICRU 62

Page 18: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

EXAMPLE OF TREATMENT VOLUMES

Page 19: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

TREATMENT VOLUMES

GTVGTV

CTVCTV

ITVITV

PTVPTV

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

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)

Page 21: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

AP/PA OPPOSED FIELDS

Page 22: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

DVH FOR TISSUES AP/PA

CTVPTVLiver

Lung RT Kidney RTHeart

Page 23: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

FOUR FIELD PLAN AP/PA/RLAT/LLAT

Page 24: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

DVH 4 FIELD PLAN

CTVPTVLiver

HeartKidney RTLung RT

Page 25: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

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

Page 26: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

DVH 5 FIELD PLAN

CTVPTVLiverLung RTHeart Kidney RT

Page 27: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.
Page 28: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.
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Page 31: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

CTVLung RTKidney RT

Page 32: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

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

Page 33: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

Stereotactic Radiosurgery1982: Modified Linear Accelerator

Page 34: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

Stereotactic RadiosurgerySRS Frame Placement

Page 35: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

STEROTACTIC RADIATION THERAPY SRT

Page 36: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

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

Page 37: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

STEROTACTIC RADIATION SURGERY SRS

Page 38: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

Fractionated Stereotactic Radiation Therapy

Page 39: TREATMENT PLANNING PHOTONS & ELECTRONS Karen P. Doppke 3/20/2007.

Fractionated Stereotactic Radiation Therapy