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An Introduction to Intensity Modulated Radiotherapy PHY778 Lecture April 1, 2009

Outline ,[object Object],[object Object],[object Object],[object Object],[object Object]

Introduction ,[object Object],[object Object],[object Object],[object Object],Beamlet Field Width Field Length

Introduction ,[object Object],[object Object],[object Object],[object Object]

Introduction ,[object Object],[object Object]

Process Patient Selection ↓ Simulation ↓ Target and Tissue Delineation ↓ Treatment Planning/Optimization ↓ Plan Evaluation ↓ Quality Assurance ↓ Treatment Delivery ↓ Followup

Patient Selection ,[object Object],[object Object],[object Object]

Patient Selection ,[object Object],[object Object],[object Object],Rx to 76 Gy  95%  50%

Patient Selection ,[object Object],[object Object],[object Object],[object Object]

Patient Selection ,[object Object],[object Object],[object Object],[object Object],[object Object]

Simulation ,[object Object],[object Object],[object Object]

Simulation ,[object Object],[object Object],[object Object],[object Object]

Simulation ,[object Object],[object Object],[object Object],[object Object],[object Object]

Contouring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Target Delineation ICRU 50, 62 ,[object Object],[object Object],[object Object],[object Object],[object Object]

PTV versus OAR ,[object Object]

Planning ,[object Object],[object Object],[object Object],[object Object]

Number and Placement of beams ,[object Object],[object Object],[object Object]

Planning ,[object Object],1 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7

Beam number and placement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Parallel Opposed Fields ,[object Object],[object Object],[object Object],[object Object],[object Object]

Beam number and placement ,[object Object]

Collimator Rotation ,[object Object],[object Object]

Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Objectives ,[object Object],[object Object],[object Object],[object Object]

Objectives- Max and Min dose Maximum = 50 Gy Minimum = 70 Gy

Objectives – Uniform dose Maximum Dose Maximum = 70 Gy Minimum = 70 Gy

Objectives – Dose volume objectives Maximum Dose > 70 Gy to 90% Target < 60 Gy to 10% OAR

Objectives – Equivalent Uniform Dose 43 49 30 71 EUD 7.4 Cord 4.6 Brainstem 5.0 Parotid -8.0 Target a Region

Physics ,[object Object],[object Object],[object Object],[object Object]

Physics – optimization algorithms ,[object Object],[object Object],[object Object],[object Object],[object Object]

Physics – optimization algorithms ,[object Object],[object Object],[object Object]

Physics – Optimization in Eclipse ,[object Object]

Physics - optimization in Eclipse ,[object Object],[object Object]

Physics - optimization in Eclipse ,[object Object],[object Object],[object Object],[object Object]

Physics - optimization in Eclipse ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Physics - optimization in Pinnacle ,[object Object]

IMRT - optimization in practice ,[object Object],[object Object],[object Object]

IMRT - optimization in practice ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

IMRT - optimization in practice ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

IMRT – radiation protection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

IMRT – MLC technical details ,[object Object],[object Object],[object Object],[object Object]

IMRT – MLC technical details ,[object Object]

IMRT – MLC transmission ,[object Object],[object Object],[object Object],[object Object]

IMRT – MLC dosimetric leaf gap ,[object Object],[object Object]

IMRT – MLC minimum dose dynamic leaf gap ,[object Object]

IMRT – MLC leaf speed ,[object Object],[object Object],[object Object],[object Object]

IMRT – Dose/Arc dynamic leaf tolerance ,[object Object]

IMRT – Jaw over travel ,[object Object]

IMRT – Leaf over travel ,[object Object]

IMRT – Leaf Positions ,[object Object],[object Object]

IMRT – Leaf Span ,[object Object],[object Object]

IMRT – Multiple carriage delivery ,[object Object],[object Object],[object Object]

Electronic compensation ,[object Object],[object Object],[object Object],[object Object]

Complete Irradiated Area Outline (CIAO) ,[object Object],[object Object]

IMRT QA – Ion chamber array ,[object Object],[object Object],[object Object]

IMRT QA – Day 0 Pinnacle Fluence Map EPID image

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