By Ben J. Slotman, Timothy D. Solberg, Dirk Verellen
For radiation oncologists and physicists who wish an authoritative evaluation of rising advancements within the box, in addition to transparent path at the usage of this new expertise in scientific perform, this reference offers in-depth descriptions of latest and promising stereotactic tools for the appliance of stereotactic radiotherapy for the remedy of extracranial tumors.
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Extra resources for Extracranial Stereotactic Radiotherapy and Radiosurgery
The study included 12 patients (122 treatment fractions analyzed), again treated in the supine position with conventional head-and-knee support. A comparison was made between conventional IR positioning, DRRfusion, and implanted marker matching. An objective veriﬁcation (residual error after automated positioning) of the patient positioning was performed on orthogonal megavoltage ﬁlms taken at gantry 0 and 90 . 0 mm3) (Fig. 5). These measurements were repeated on the megavoltage ﬁlm by a radiation oncologist using a standard ruler (1 mm scaling).
The machine-related QA can be seen as a pyramid-shaped approach in that the upper level is build on the quality of 42 Medin and Verellen the level underneath. The base level comprises basic QA of the linac and MLC; level 2 covers small ﬁeld dosimetry, small amounts of MUs, and leaf-control properties; level 3, dosimetry of IM beams; and level 4, 3D IMRT veriﬁcation. In this chapter, treatment veriﬁcation will be limited to veriﬁcation of dose delivery as target localization has been extensively covered in elsewhere in this book.
For CT veriﬁcation the patient is repositioned in the SBF. The accuracy of repositioning is eased by matching the laser of the trunk and leg to the tattoos on the patient’s skin at the determined positions. The diaphragm control device is also positioned and adjusted as determined at the CT for treatment planning. The SBF is aligned to the CT at the planned longitudinal stereotactic isocenter coordinate. Beginning from this position, one or multiple CT slices are generated to ﬁnd the slice with the target shape that best matches 16 Wulf the shape of the isocenter slice from treatment planning.