Radiotherapy Treatment Planning
Effectiveness of Virtual Reality Simulation Software in Radiotherapy Treatment Planning Involving Non-Coplanar Beams with Partial Breast Irradiation as a Model (409-414)
Virtual reality simulation software (VRS - FocalSim Version 4.40 with VRS prototype, Computerized Medical Systems, St. Louis, MO) is a new radiation dose planning tool that allows for 3D visualization of the patient and the machine couch (treatment table) in relationship to the linear accelerator. This allows the radiation treatment planner to have a “room’s-eye-view” and enhances the process of virtual simulation. The aim of this study was to compare VRS to a standard planning program (XiO - Version 4.50, Computerized Medical Systems, St. Louis, MO) in regards to the time it took to use each program, the angles chosen in each, and to determine if there was a dosimetric benefit to using VRS. Ten patients who had undergone left-sided lumpectomies were chosen to have treatment plans generated. A partial breast irradiation (PBI) treatment plan by external beam radiation therapy (EBRT) was generated for each patient using two different methods. In the first method the full plan was generated using XiO software. In the second method beam angles were chosen using the VRS software, those angles were transferred to XiO, and the remaining part of the plan was completed using XiO (since VRS does not allow dose calculations). On average, using VRS to choose angles took about 10 minutes longer than XiO. None of the five gantry angles differed significantly between the two programs, but four of the five couch angles did. Dose-volume histogram (DVH) data showed a significantly better conformality index, and trends toward decreased hot spots and increased coverage of the planed treatment volume (PTV) when using VRS. However, when angels were chosen in VRS a greater volume of the ipsilateral breast received a low dose of radiation (between 3% and 50% of the prescribed dose) (VRS = 23.06%, XiO = 19.57%, p < 0.0005). A significant advantage that VRS provided over XiO was the ability to detect potential collisions prior to actual treatment of the patient in three of the ten patients studied. The potential to save time with VRS by not having to redo plans because of a collision increases clinic efficiency.
S. Glaser, B.S.1
B. Warfel, C.M.D.1
J. Price, C.M.D.1
J. Sinacore, Ph.D.2
K. Albuquerque, M.D.1*
1Loyola University Chicago, Stritch School of Medicine – Department of Radiation Oncology, 2160 S. First Ave. Maguire Center Rm. 2946, Maywood,
II 60153, USA
2Loyola University Chicago, Stritch School of Medicine – Biostatistics, Department of Preventive Medicine and Epidemiology, 2160 S. First Ave. Maguire Center, Maywood, II 60153, USA
K. Albuquerque, M.D.
This article can be cited as:
Glaser, S. Warfel, B. Price, J. Sinacore, J. Albuquerque, K. Effectiveness of Virtual Reality Simulation Software in Radiotherapy Treatment Planning Involving Non-Coplanar Beams with Partial Breast Irradiation as a Model Technol Cancer Res Treat. 11, 409-414 (2012).
1. Seaby, A. W., Thomas, M. A model simulator for radiotherapy treatment planning and checking. Br J Radiol 72, 293-295 (1999).
2. Yorke, E. D. The geometry of avoiding beam intersections and blocking tray collisions. Med Phys 16, 288-291 (1989). [Crossref]
3. Sherouse, G. W., Chaney, E. L. The portable virtual simulator. Int J Radiat Biol Phys 21, 475-482 (1991).
4. Humm, J. L. Collision avoidance in computer optimized treatment planning. Med Phys 21, 1053-1064 (1994). [Crossref]
5. Kessler, M. L., McShan, D. L., Fraass, B. A. A computer-controlled conformal radiotherapy system: Graphical simulation and monitoring of treatment delivery. Int J Radiat Oncol Biol Phys 33, 1173-1180 (1995). [Crossref]
6. Humm, J. L., Pizzuto, D., Fleischman, E., Mohan, R. Collision detection and avoidance during treatment planning. Int J Radiat Oncol Biol Phys 33, 1101-1108 (1995). [Crossref]
7. Muthuswamy, M. S. A method of beam-couch intersection detection.Med Phys 26, 229-235 (1999). [Crossref]
8. Beange, I., Nisbet, A. A collision prevention software tool for com plex three-dimensional isocentric set-ups. Br J Radiol 73, 537-541 (2000).
9. Tsiakalos, M. F., Schrebmann, E., Theodorou, K., Kappas, C.
Graphical treatment simulation and automated collision detection for conformal and stereotactic radiotherapy treatment planning. Med Phys 28, 1359-1363 (2001).[Crossref]
10. Furhang, E. E., Hanley, J., Chiu-Tsao, S. T., Toner, S., Fan, P.,
Gliedman, P., Harrison, L. B. Clearance assurance for stereotactic radiosurgery and radiotherapy. Med Phys 29, 45-50 (2002). [Crossref]
11. Hua, C., Chang, J., Yenice, K., Chan, M., Amols, H. A practical approach to prevent gantry-couch collision for linac-based radiosurgery. Med Phys 31, 2128-2134 (2004). [Crossref]
12. Chao, M. M., Chao, L. S., Chen, Y. J., Hsieh, C. M., Liou, S. C., Lee, Y. L., Yen, S. H. Image display for collision avoidance of radiation therapy: treatment planning. J Digit Imaging 14, 186-191 (2001).
13. Nioutsikou, E., Bedford, J. L., Webb, S. Patient-specific planning for prevention of mechanical collisions during radiotherapy. Phys Med Biol 48, N313-N321 (2003). [Crossref]
14. Hamza-Lup, F. G., Sopin, I., Zeidan, O. Comprehensive 3D visual simulation for radiation therapy planning. Stud Health Technol Inform 125, 164-166 (2007).
15. Ward, J. W., Phillips, R., Williams, T., Shang, C., Page, L., Prest, C.,Beavis, A. W. Immersive visualization with automated collision detection for radiotherapy treatment planning. Stud Health Technol Inform 125, 491-496 (2007).
16. N NSABP PROTOCOL B-39 – A Randomized Phase III Study of Conventional Whole Breast Irradiation (WBI) Versus Partial Breast Irradiation (PBI) for Women with Stage 0, I, or II Breast Cancer (2007). Available online: http://www.rtog.org/members/