بسم الله الرحمن الرحيم
DESCRIPTION
بسم الله الرحمن الرحيم. ﴿ و قل رب زدنى علماً ﴾. صدق الله العظيم. Introduction to Radiotherapy. RAD 461. Dr. Ahmed Al Far, M.D. Professor of Radiation Oncology. What is the Target Volumes?. The Target Volumes. ◘ Before Planning: - PowerPoint PPT PresentationTRANSCRIPT
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بسم الله الرحمن الرحيمبسم الله الرحمن الرحيم
و قل رب زدنى و قل رب زدنى ﴿﴾علمًا�علمًا�
صدق الله العظيمصدق الله العظيم
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Introduction to Radiotherapy
Dr. Ahmed Al Far, M.D.Professor of Radiation Oncology
RAD 461RAD 461
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What is the Target VolumesWhat is the Target Volumes??
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The Target Volumes
◘◘ Before Planning:
1. Gross Tumor Volume (GTV): primary tumor + any detectable metastases in LN
2. Clinical Target Volume (CTV): GTV + sub-clinical micro. disease
◘◘ During Planning:
1. Planned Target Volume (PTV): CTV + safety margin to account for movement of patient or organ during treatment
2. Organs at Risk: dose limiting normal tissue e.g. spinal cord
◘◘ After planning:
1. Treated Volume: enclosed by isodose line (equal or close to PTV)
2. Irradiated Volume: the volume receives 50% of the tumor dose (indicator of the quality of the plan)
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The Target Volumes
Clinical target volume
Gross Tumor volume
Planning target volumeTreated volume
Irradiated volume
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◘◘ Clinical Methods :• Clinical examination: inspection, palpation
• Surgical findings and metal clips at fixed points
◘◘ Radiological Methods:• Diagnostic x-ray unit:
- Comparison with simulator (distance, focus, magnification)?
• Simulator Unit:
• Conventional
• Computed Tomography (CT)
Localization of the Target Volumes
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What is the Simulators?
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Simulator
A diagnostic x-ray machine which:
accurately simulates the geometry, optical systems and mechanical movements of a radiotherapy machine.
Importance:
1. Localization: the target volume and critical normal tissue with respect to skin marks
2. Simulation: the planned treatment fields with respect to tumor and normal tissue
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Simulator
ZX
Y
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Simulator: Main components
• Gantry rotation around a horizontal axis
• Source axis distance (SAD) motion in radial direction
• Collimator rotation
• Image intensifier motion in the vertical, longitudinal and
radial directions
• Table movement ( rotation, vertical, longitudinal and
lateral)
• Movement of X-ray field collimators and the wires (ruler)
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Simulator
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Shielding Block Tray
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Localization by conventional simulator
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Conventional & CT Simulators
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C.T. Simulator : Uses
1.Localization of tumor and normal tissues
2.Direct determination of body contour in different planes (2D, 3D)
3.Dose calculation in different tissues (pixel density)
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C.T. Simulator : Specification
1.Wide gantry opening
2.Flat top table
3.Laser system
4.The couch movement
5.Rapid scanning
6.Slice thickness
7.Measurement of CT number
8.Making cuts in different planes
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Conventional & CT Simulators
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CT simulation
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The CT scans are linked with a specialized treatment planning computer providing detailed information which
will assist with optimum treatment .
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Localization by C.T Simulator
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