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Beam Directed Radiotherapy - methods and principles
1.
Beam Directed Radiotherapy
– Principles and practice
2.
Definition Exact Calculations
Beam Directing devices Advance Planning Beam directed radiotherapy
3.
Need for Beam
direction Homogenous Tumor Dose Low normal tissue dose Best therapeutic ratio
4.
Steps Positioning Immobilization
Localization Field Selection Dose distribution Calculations Verification Execution
5.
6.
Examples
7.
8.
9.
Positioning aids… Pituitary
Board Prone Support 3 way support
10.
11.
Breast boards… Modern
Breast Board Indexed Arm supports Indexed wrist support Head rest Carbon fiber tilt board Wedge to prevent sliding
12.
13.
Belly boards &
leg immobilizer`
14.
Mould making
15.
Mould making :
Contd..
16.
Mould making :
Contd..
17.
18.
Thermoplastics : Principle
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
Lateral height method
H 1 H 2 d d H 1 + H 2 2 d =
30.
31.
Tube shift principles
Marker d 2 y f S Tumor x 1 x 2 d 1
32.
Calculation d 1
f y d 2 x 1 x 2 x 1 S = d 1 f – d 1 S x 2 S = d 2 f – d 2 y = d 2 – d 1 = f x 2 + S x 2 - x 1 + S x 1 Tumor Marker
33.
34.
35.
36.
37.
38.
Contour Plotter
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
SAD calculations Total
Tumor dose Number of fields x Number of #s = T Incident dose = T x 100 TMR/TAR Time = ID Output
49.
50.
51.
52.
53.
54.
Electronic Portal Imaging
55.
56.
57.
58.
59.
60.
61.
62.
63.
Applicators: Design Lead
Sheet Box Plastic Cap Metal Plate with hole
64.
65.
66.
Jaws: Disadvantages A
Perspex box may be applied to the head Compression not possible SSD indicator used. Patient to source distance unknown Light beam shining through the jaws Size and shape of field remain unknown Remedy Disadvantages
67.
Front & Back
Pointers
68.
69.
70.
71.
Pin & Arc
Pin Arc Bubble
72.
Pin & Arc:
Principle
73.
Pin & Arc
: Method d D d D D This is the isocenter
74.
75.
76.
Principle of Isocentric
mounting
77.
78.
79.
80.
81.
Conclusion Team Work
Precision Quality Assurance
82.
Thank You
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