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radiopaque markers

Reference points are determined by __ located at the cross-sections of the lasers

Avoid erasure

put lead in radiopaque markers with tape to

Teradyne tape

tape

Contrast material

is given intravenously by the nurse, if required.

Adequate measures

should be taken for any possible anaphylactic reactions.

CT technician in the CT command room

Any required adjustments are performed by the

radiation oncologist

The region of interest (that for which serial CT slices are to be taken) is determined by the

CT computer

The slice thickness is also determined. All of these data are transferred to the

serial slices are taken

After the region of interest has been verified on screen radiotherapy information system utilizing

PACS

These slices are sent online to the treatment planning room via the network a

virtual digital simulation

is performed after the CT slices have been transferred to the network

radiation oncologist

then performs contouring on the acquired CT slices.

External body contours

are usually delineated automatically.

• GTV

• CTV

• PTV

• organs at risk

The radiation oncologist then contours the:

reference slice

The slice with the reference points determined during CT simulation is recorded as the

planning phase then begins

Contours are carefully checked and recorded, and the

ITV: internal target volume

defined as CTV + IM (internal margin for organ motion)

PTV: planning target volume

defined as ITV + SM (setup margin for setup error)

Radiotherapy portals

are determined during the first stage of planning according to the PTV.

(PTV) planning target volume

Radiotherapy portals are determined during the first stage of planning according to the

beam's eye view

Beams are placed according to the PTV using the

multileaf collimator (MLC) or blocks

Delineation of the __ is performed, and critical structures are spared.

penumbral region

should be taken into account during MLC or block placing.

treatment planning system (TPS)

starts its calculations, and the final dose distribution and dose-volume histograms are formed.

dose-volume histograms

The treatment planning system (TPS) starts its calculations, and the final dose distribution and _ are formed.

DVH

The doses for the target and the organs at risk are evaluated with the _ and the isodoses are carefully checked in each slice.

reference isodose or isocenter

is determined for the dose prescription, and the final treatment plan should be verified by the radiation oncologist.

final verified treatment plan

is sent online to the treatment machine via the network, treatment parameters are recorded on the patient's chart, and isodose curves and DVH printouts are also attached to the chart.

treatment parameters

The final verified treatment plan is sent online to the treatment machine via the network, _ are recorded on the patient's chart, and isodose curves and DVH printouts are also attached to the chart.

isodose curves and DVH printouts

The final verified treatment plan is sent online to the treatment machine via the network, treatment parameters are recorded on the patient's chart, and _ are also attached to the chart.

energy

is selected according to tumor depth and the surrounding normal tissues after determining the radiotherapy fields through simulation.

High energies

are selected for deeply seated tumors

deeply seated tumors

High energies are selected for

lower energies or electron beams

are selected for superficially located tumors.

superficially located tumors

lower energies or electron beams are selected for

target depth

Energy is selected according to

THERAPIES UTILIZING ELECTRON ENERGY

These are preferred for superficial tumors. The target volume should be the 80-95% isodose region of the selected energy, depending on the distance from the skin and underlying tissues.

superficial tumors

THERAPIES UTILIZING ELECTRON ENERGY These are preferred for

80-95% isodose region

THERAPIES UTILIZING ELECTRON ENERGY These are preferred for superficial tumors. The target volume should be the __ of the selected energy, depending on the distance from the skin and underlying tissues.

Deeply seated normal tissues

are spared in electron therapies.

80% isodose

corresponds to one-third of the electron energy (E/3).

Bolus

can be used to increase the superficial dose if required.

treatment volume

is determined virtually after contouring the target volume and the organs at risk in serial CT slices.

Blocks or the MLC and isodoses

can be seen and selected digitally in the TPS.

(TPS) treatment planning system

Blocks or the MLC and isodoses can be seen and selected digitally in the

radiotherapy treatment

depends on determining the optimal technique for the target volume and surrounding normal tissues as well as the accurate application of this technique.

cells that form tumors

are destroyed while causing minimal damage to the surrounding normal critical structures.

Brachytherapy treatment

ICRU 38(1985), ICRU 58 (1958), and ICRU 72(2004)

Proton therapy in (2007)

ICRU 78