A simple technique for an accurate shielding of the lungs during total body irradiation
| Autor: | Bassem Youssef, B. Shahine, Wassim Jalbout, Chirine Chehab, Helena Abdel Khalek, Hana Mekdash |
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| Rok vydání: | 2017 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
lcsh:R895-920 ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION CT simulation Computed tomography lcsh:RC254-282 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Total body irradiation Research article medicine Radiology Nuclear Medicine and imaging Radiation treatment planning Care Planning Conventional technique medicine.diagnostic_test Oncology (nursing) business.industry Health Policy Radiation dose Shielding blocks lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Past treatments 030220 oncology & carcinogenesis Electromagnetic shielding Treatment time business Biomedical engineering |
| Zdroj: | Technical Innovations & Patient Support in Radiation Oncology Technical Innovations & Patient Support in Radiation Oncology, Vol 3, Iss C, Pp 13-18 (2017) |
| ISSN: | 2405-6324 |
| DOI: | 10.1016/j.tipsro.2017.07.001 |
| Popis: | Highlights • A total body irradiation technique based on CT simulation was newly introduced. • This technique succeeded in reducing the length of the overall treatment session. • This new technique reduced patient discomfort while ensuring accurate shielding of the lungs. Purpose During total body irradiation (TBI), customized shielding blocks are positioned in front of the lungs to reduce radiation dose. The difficulty is to accurately position the blocks to cover the entire lungs. A new technique based on Computed Tomography (CT) simulation was developed to determine the exact position of lung blocks prior to treatment in order to decrease overall treatment time and reduce patient discomfort. Material/Methods Patients were CT simulated and lungs were contoured using a treatment planning system. Anteroposterior/posteroanterior (AP/PA) fields were designed with MLC aperture conforming to lung contours. The fields were used to represent the extent of the lungs, which was subsequently marked on the patient’s skin. The lung blocks were positioned with their shadow matching the lungs’ marks. Their position was radiographically verified prior to the delivery of each beam. To evaluate the efficiency of this technique, the treatment session time and the number of repeated attempts to correctly position the shielding blocks was recorded for each beam. Exact treatment times for patients treated with the old technique were not available and were hence approximated based on previous experience. Results We succeeded in positioning the shielding blocks from the first attempt in 10/12 beams. The position of the shielding blocks was adjusted only one time prior to treatment in 2/12 beams. These results are compared to an average of 3 attempts per beam for each patient using the conventional technique of trial and error. The average time of a treatment session was 29 min with a maximum of 41 min versus approximately 60 min in past treatments and a maximum of 120 min. Conclusion This new technique succeeded in reducing the length of the overall treatment session of the conventional TBI procedure and hence reduced patient discomfort while ensuring accurate shielding of the lungs. |
| Databáze: | OpenAIRE |
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