Post on 19-Sep-2020
Daniel Saenz
University of Wisconsin-Madison
Department of Human Oncology
VIEWRAY TPS WORK FLOW ANDCOMPARATIVE OPTIMIZATION
OVERVIEW• Last meeting, we presented the basics.
• Today is an update specifically about the treatment planning system.
• Work flow
• Capabilities
• Comparative assessment
WORK FLOW - PATIENTS
The hierarchy is:1. Diagnosis2. Prescription3. Plans
WORK FLOW – DIAGNOSIS AND PRESCRIPTION
WORK FLOW - PLANNING
WORK FLOW – CHOOSE IMAGES
Edit slicesas needed.
CT and MR images
WORK FLOW – FUSION
MR is fused with CT inthis case.Both deformable andrigid registrations can beutilized.
WORK FLOW – CONTOUR
MR is fused with CT inthis case.Both deformable andrigid registrations can beutilized.
Skin isAutomaticallycontoured.
Auto-contourtemplates areavailable aswell.
WORK FLOW – POINTS
MR is fused with CT inthis case.Both deformable andrigid registrations can beutilized.
Range ofvalidisocentersis displayed.
WORK FLOW – POINTS
MR is fused with CT inthis case.Both deformable andrigid registrations can beutilized.
Beams areadded in groupsof three for eachof the threeheads (120degrees apart).
Pseudo-arc beams places as manybeams as desired spaced evenly.
WORK FLOW – POINTS
MR is fused with CT inthis case.Both deformable andrigid registrations can beutilized.
Each beam can be designated as:• IMRT – Full optimization of user-defined beams
each with multiple optimized segments.• Optimized Conformal – User-defined beams and
shapes are optimized.• Fixed Conformal – User places and defines
beam shape and manually chooses theweighting as well.
WORK FLOW – POINTS
MR is fused with CT inthis case.Both deformable andrigid registrations can beutilized.
There are nojaws. Fieldsare definedwith MLCs.
WORK FLOW – DOSE
MR is fused with CT inthis case.Both deformable andrigid registrations can beutilized.Linear importance, exponential power in cost function.
All MonteCarlo.~3 minscalc time.
WORK FLOW – DOSE
User can also review dosestatistics instead of DVH.
WORK FLOW – GATING
Gating is performed byimaging during treatmentwith ~3 images persecond with one plane.Target is registered aftereach image.
Target and boundaryregion are defined.
Up to four points can alsobe tracked.
WORK FLOW – FINISH SCREEN
WORK FLOW – PLAN COMPARISON
WORK FLOW – PLAN REVIEW
Structures notmeetingconstraintsshown here.
WORK FLOW – PLAN REVIEW
Boundary
Auto-contouredtarget inside.
WORK FLOW – CUMULATIVE DOSE REVIEW
Dose from cumulativefractions displayed here.
COMPARATIVE ASSESSMENT• The following plans were created from existing patients with IMRT plans completed in
Pinnacle.
• Objectives in ViewRay were used to match the prescription while normal tissueconstraints were set to match or deliver less dose than the normal structures receivedwith Pinnacle.
• Target Structures: Set prescription dose.
• Critical Structures: Set threshold dose.
• Modify with importances and powers which affect penalty associated with dose at eachvoxel.
COMPARATIVE ASSESSMENT: HEAD & NECK 1
Pinnacle ViewRay
Note:ViewRaydoesn’tcutoff IDLat skin.
COMPARATIVE ASSESSMENT: HEAD & NECK 2
Pinnacle ViewRay
COMPARATIVE ASSESSMENT: HEAD & NECK 3
Pinnacle ViewRay
COMPARATIVE ASSESSMENT: HEAD & NECK 4
Cord
Pinnacle ViewRay
COMPARATIVE ASSESSMENT: LUNG 1
Pinnacle ViewRay
COMPARATIVE ASSESSMENT: LUNG 2
Pinnacle ViewRay
COMPARATIVE ASSESSMENT: PROSTATE 1
ProstatePTV
ProstateRectum
Penile Bulb
Bladder
Pinnacle ViewRay
COMPARATIVE ASSESSMENT: PROSTATE 1
Pinnacle ViewRay
COMPARATIVE ASSESSMENT: PROSTATE 1
Pinnacle ViewRay
ProstateSV