TU‐A‐BRA‐01

Planning, QA, and the Role of Imaging of Localization for Head and Neck Treatments

C. Mayo, Yolanda Isabel Garces, L. Dong, R. Howell

Research output: Contribution to journalArticle

Abstract

This educational session is designed to provide practical perspective on head and neck treatment planning and delivery. The panel will draw from their own and the shared experiences of the other panelists to provide a comprehensive discussions of the issues and decisions encountered daily as part of treating patients with head and neck cancer. Contouring, PTV and Organ at Risk Doses: a Physician's perspective ‐ How a physician approaches the question of a practical balance between doses to target and proximal normal tissues will be explored and implications of contouring approaches will be considered. • Use and implications of hand drawn PTV vs CTV + margin = PTV • Organs at risk • Dose trade‐offs • Planning process: When is it good enough? Is the difference between plans clinically observable or art? What dose levels, that can be affected in planning, produce results that are observed in practice? Treatment Planning ‐Strategies in beam selection, contouring of dose sculpting structures and in setting of constraints to enable for driving IMRT opimizers to achieve the balance sought by the physician for targets treated at multiple concurrent dose levels will be discussed. Process flow and time to create plans will be discussed. • Dose Sculpting Structures • Beam selection (IMRT vs VMAT) • Optimization strategies Patient Positioning Options and Imaging Strategies — The ability of the treatment plan to accurately reflect delivered doses, is linked to the ability to reliably set up and verify the same patient position as in the original CT. A range of typical questions and practical approaches will be discussed. • Patient Positioning Options: Head cup + aquaplast,vac‐loc bag, alpha cradle based,bite block, etc. • Imaging ∘ kV vs Conebeam ∘ Image treatment fields or just setup fields? ∘ How frequently should fields be imaged? ∘ Decision tree for use of MV, kV, ConeBeam ∘ Use of blended imaging tools for checking measured vs predicted DRR or ConeBeam? ∘ When it doesn't align, then what? IMRT QA — There area wide array of devices and measurements for QA of IMRT fields. This presentation will address issues encountered in designing practical approaches to demonstrate that the dose planned for a patient can be delivered with acceptable accuracy. The strengths and weaknesses of QA approaches will be discussed. • Measurement devices, strategies and basis for choice • Is gamma analysis alone sufficient? What else is used instead?

Original languageEnglish (US)
Number of pages1
JournalMedical Physics
Volume38
Issue number6
DOIs
StatePublished - Jan 1 2011

Fingerprint

Neck
Head
Organs at Risk
Patient Positioning
Physicians
Equipment and Supplies
Decision Trees
Carboxymethylcellulose Sodium
Bites and Stings
Therapeutics
Art
Head and Neck Neoplasms
Hand

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging

Cite this

TU‐A‐BRA‐01 : Planning, QA, and the Role of Imaging of Localization for Head and Neck Treatments. / Mayo, C.; Garces, Yolanda Isabel; Dong, L.; Howell, R.

In: Medical Physics, Vol. 38, No. 6, 01.01.2011.

Research output: Contribution to journalArticle

@article{8c8098ff967f4a13afd603a269bd1669,
title = "TU‐A‐BRA‐01: Planning, QA, and the Role of Imaging of Localization for Head and Neck Treatments",
abstract = "This educational session is designed to provide practical perspective on head and neck treatment planning and delivery. The panel will draw from their own and the shared experiences of the other panelists to provide a comprehensive discussions of the issues and decisions encountered daily as part of treating patients with head and neck cancer. Contouring, PTV and Organ at Risk Doses: a Physician's perspective ‐ How a physician approaches the question of a practical balance between doses to target and proximal normal tissues will be explored and implications of contouring approaches will be considered. • Use and implications of hand drawn PTV vs CTV + margin = PTV • Organs at risk • Dose trade‐offs • Planning process: When is it good enough? Is the difference between plans clinically observable or art? What dose levels, that can be affected in planning, produce results that are observed in practice? Treatment Planning ‐Strategies in beam selection, contouring of dose sculpting structures and in setting of constraints to enable for driving IMRT opimizers to achieve the balance sought by the physician for targets treated at multiple concurrent dose levels will be discussed. Process flow and time to create plans will be discussed. • Dose Sculpting Structures • Beam selection (IMRT vs VMAT) • Optimization strategies Patient Positioning Options and Imaging Strategies — The ability of the treatment plan to accurately reflect delivered doses, is linked to the ability to reliably set up and verify the same patient position as in the original CT. A range of typical questions and practical approaches will be discussed. • Patient Positioning Options: Head cup + aquaplast,vac‐loc bag, alpha cradle based,bite block, etc. • Imaging ∘ kV vs Conebeam ∘ Image treatment fields or just setup fields? ∘ How frequently should fields be imaged? ∘ Decision tree for use of MV, kV, ConeBeam ∘ Use of blended imaging tools for checking measured vs predicted DRR or ConeBeam? ∘ When it doesn't align, then what? IMRT QA — There area wide array of devices and measurements for QA of IMRT fields. This presentation will address issues encountered in designing practical approaches to demonstrate that the dose planned for a patient can be delivered with acceptable accuracy. The strengths and weaknesses of QA approaches will be discussed. • Measurement devices, strategies and basis for choice • Is gamma analysis alone sufficient? What else is used instead?",
author = "C. Mayo and Garces, {Yolanda Isabel} and L. Dong and R. Howell",
year = "2011",
month = "1",
day = "1",
doi = "10.1118/1.3613065",
language = "English (US)",
volume = "38",
journal = "Medical Physics",
issn = "0094-2405",
publisher = "AAPM - American Association of Physicists in Medicine",
number = "6",

}

TY - JOUR

T1 - TU‐A‐BRA‐01

T2 - Planning, QA, and the Role of Imaging of Localization for Head and Neck Treatments

AU - Mayo, C.

AU - Garces, Yolanda Isabel

AU - Dong, L.

AU - Howell, R.

PY - 2011/1/1

Y1 - 2011/1/1

N2 - This educational session is designed to provide practical perspective on head and neck treatment planning and delivery. The panel will draw from their own and the shared experiences of the other panelists to provide a comprehensive discussions of the issues and decisions encountered daily as part of treating patients with head and neck cancer. Contouring, PTV and Organ at Risk Doses: a Physician's perspective ‐ How a physician approaches the question of a practical balance between doses to target and proximal normal tissues will be explored and implications of contouring approaches will be considered. • Use and implications of hand drawn PTV vs CTV + margin = PTV • Organs at risk • Dose trade‐offs • Planning process: When is it good enough? Is the difference between plans clinically observable or art? What dose levels, that can be affected in planning, produce results that are observed in practice? Treatment Planning ‐Strategies in beam selection, contouring of dose sculpting structures and in setting of constraints to enable for driving IMRT opimizers to achieve the balance sought by the physician for targets treated at multiple concurrent dose levels will be discussed. Process flow and time to create plans will be discussed. • Dose Sculpting Structures • Beam selection (IMRT vs VMAT) • Optimization strategies Patient Positioning Options and Imaging Strategies — The ability of the treatment plan to accurately reflect delivered doses, is linked to the ability to reliably set up and verify the same patient position as in the original CT. A range of typical questions and practical approaches will be discussed. • Patient Positioning Options: Head cup + aquaplast,vac‐loc bag, alpha cradle based,bite block, etc. • Imaging ∘ kV vs Conebeam ∘ Image treatment fields or just setup fields? ∘ How frequently should fields be imaged? ∘ Decision tree for use of MV, kV, ConeBeam ∘ Use of blended imaging tools for checking measured vs predicted DRR or ConeBeam? ∘ When it doesn't align, then what? IMRT QA — There area wide array of devices and measurements for QA of IMRT fields. This presentation will address issues encountered in designing practical approaches to demonstrate that the dose planned for a patient can be delivered with acceptable accuracy. The strengths and weaknesses of QA approaches will be discussed. • Measurement devices, strategies and basis for choice • Is gamma analysis alone sufficient? What else is used instead?

AB - This educational session is designed to provide practical perspective on head and neck treatment planning and delivery. The panel will draw from their own and the shared experiences of the other panelists to provide a comprehensive discussions of the issues and decisions encountered daily as part of treating patients with head and neck cancer. Contouring, PTV and Organ at Risk Doses: a Physician's perspective ‐ How a physician approaches the question of a practical balance between doses to target and proximal normal tissues will be explored and implications of contouring approaches will be considered. • Use and implications of hand drawn PTV vs CTV + margin = PTV • Organs at risk • Dose trade‐offs • Planning process: When is it good enough? Is the difference between plans clinically observable or art? What dose levels, that can be affected in planning, produce results that are observed in practice? Treatment Planning ‐Strategies in beam selection, contouring of dose sculpting structures and in setting of constraints to enable for driving IMRT opimizers to achieve the balance sought by the physician for targets treated at multiple concurrent dose levels will be discussed. Process flow and time to create plans will be discussed. • Dose Sculpting Structures • Beam selection (IMRT vs VMAT) • Optimization strategies Patient Positioning Options and Imaging Strategies — The ability of the treatment plan to accurately reflect delivered doses, is linked to the ability to reliably set up and verify the same patient position as in the original CT. A range of typical questions and practical approaches will be discussed. • Patient Positioning Options: Head cup + aquaplast,vac‐loc bag, alpha cradle based,bite block, etc. • Imaging ∘ kV vs Conebeam ∘ Image treatment fields or just setup fields? ∘ How frequently should fields be imaged? ∘ Decision tree for use of MV, kV, ConeBeam ∘ Use of blended imaging tools for checking measured vs predicted DRR or ConeBeam? ∘ When it doesn't align, then what? IMRT QA — There area wide array of devices and measurements for QA of IMRT fields. This presentation will address issues encountered in designing practical approaches to demonstrate that the dose planned for a patient can be delivered with acceptable accuracy. The strengths and weaknesses of QA approaches will be discussed. • Measurement devices, strategies and basis for choice • Is gamma analysis alone sufficient? What else is used instead?

UR - http://www.scopus.com/inward/record.url?scp=85024812779&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85024812779&partnerID=8YFLogxK

U2 - 10.1118/1.3613065

DO - 10.1118/1.3613065

M3 - Article

VL - 38

JO - Medical Physics

JF - Medical Physics

SN - 0094-2405

IS - 6

ER -