Radiation Therapy

Practical use of simulators, treatment planning systems and treatment machines is essential for a radiation oncologist.

Treatment Machines

The Linear Accelerator

• 1.1 - Movements Of The Linac
• 1.2 - Linac Energies
• 1.3 - Linac Accessories
• 1.4 - Treatment Machine Schematics

Safety and Radiation Protection

• 2.1 - The Linac Bunker
• 2.2 - Emergency Shut-Off
• 2.3 - ALARA For Linacs
• 2.4 - Testing Of Radiation Protection
• 2.5 - Patient Safety
• 2.6 - Shielding Of The Patient

Quality Assurance

• 3.1 - Quality Assurance For New Treatments
• 3.2 - Regular Quality Assurance Procedures
• 3.3 - Minimisation Of Errors

Patient Setup

• 4.1 - Isocentre Of The Linac
• 4.2 - Patient Positioning
• 4.3 - Immobilisation Devices
• 4.4 - Surface Anatomy And Setup
• 4.5 - Source Surface Distance
• 4.6 - Extended SSD Treatment
• 4.7 - Bolus

Treatment Verification

• 5.1 - Portal Films
• 5.2 - Electronic Portal Imaging
• 5.3 - On Board kV Imaging (OBI)
• 5.4 - Cone Beam CT
• 5.5 - Errors In Radiotherapy Setup
• 5.6 - Action Thresholds
• 5.7 - Image Guidance

The Console

• 6.1 - Record And Verify System
• 6.2 - Monitor Units
• 6.3 - Dose Rate

Orthovoltage / superficial X-ray treatment

• Kilovoltage patient setup
• Kilovoltage shielding techniques
• Kilovoltage energies
• Filtration of kilovoltage beams
• SSD of kilovoltage treatments

Early Tissue Toxicity

• 8.1 - Grading Systems For Early Effects
• 8.2 - Treatment Factors Affecting Toxicity

Waiting Lists, Fractionation & Triage

• 9.1 - Length Of Treatment
• 9.2 - Waiting Times
• 9.3 - Triage Of Radiotherapy Patients
• 9.4 - Altered Fractionation In The Department

Simulation

Introduction

• Radiotherapy Simulators
• Conventional Simulators
• CT Simulators
• Flow of data in radiotherapy

Quality Assurance

• Quality Assurance of Simulators
• Errors in Simulation

Patient Setup

• Immobilisation in the Simulator
• Manufacturing of Immobilisation Devices
• Isocentre of Simulator
• Laser and Tattoo Positions
• Surface Anatomy in the Simulator
• Shift of the Isocentre
• Bolus Materials

Electron Treatments

• Planning of Electron Treatment
• Methods of Electron Planning
• Treatment Planning and Electron Beams
• Uncertainty in Electron Beam Calculations
• Electron / Photon Junctions
• Bolus and Electrons
• Field Size Limits for Electrons
• Shielding and Electrons

Kilovoltage Treatments

• Kilovoltage energy and prescription
• Kilovoltage treatment and SSD
• Stand-off
• Specification of dose for kV treatment
• Shielding for kV treatment

Mould Room

• Mould room devices
• Use of Mould Room creations

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Planning System

Introduction

• 3D planning systems
• Older planning methods
• Computer calculation of dose

Quality Assurance

• Commissioning of TPS
• Transfer of Data from TPS to the RV system
• Errors in Planning

Factors affecting dose

• Photon beam energy and dose distribution
• Photon beam SSD and dose distribution
• Photon beam incidence and dose distribution
• Wedging and Dose Distribution
• Field size and dose distribution
• Inhomogeneity and dose distribution
• Inhomogeneity correction
• Parallel Opposed MV photon beams

Prescription

• Field and volume based prescriptions
• ICRU Volumes and Expansions
• Image Fusion

Plan Generation

• Hot Spots
• Decreasing inhomogeneity
• Beam Weighting
• Field Size and PTV
• Photon Beam Junctions

Plan Assessment

• Beam's Eye View
• Digitally Reconstructed Radiographs
• ICRU Dose Recommendations
• Dose Volume Histograms

IMRT and Inverse Planning

• Forward Planning and Inverse Planning
• Planning Objectives

From Plan to Treatment

• Using planning paramaters on the treatment machine
• Monitor Units per beam

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Links

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