Patient Pathway in Radiotherapy

This set of vocabulary flashcards covers the patient pathway in radiotherapy, including positioning devices, CT simulation procedures, target volume definitions, and treatment planning parameters.

Breast Board

An inclined plane with wedges of various degrees used for breast treatment to displace the breast downward and reduce irradiation of critical organs.

Belly Board

A device used to displace intestinal loops when performing radiation treatment on the pelvis with the patient in a prone position.

Foot blocks (Bloccapiedi)

Devices consisting of a support for the heels and the posterior half of the feet to prevent the rotation of the femurs when the patient is in a supine position.

COMBIFIX

A specific device used for the immobilization of the pelvis and the legs.

VAC LOC

Cushions filled with polystyrene particles that are molded around the patient by extracting air with a pump to provide personalized immobilization.

ALPHA-CRADLE

Immobilization cushions for the pelvis and legs filled with polyurethane foam created by combining two chemical elements.

Thermoplastic Masks

Personalized plastic devices that become malleable when heated in water and maintain the patient's shape once they cool down.

Simulation

A historical procedure using a dedicated apparatus (simulator) with a radiogenic tube and image intensifier that matched the geometry of a linear accelerator.

CT Simulation (TC di centratura)

The current first stage of treatment preparation used to visualize anatomy, identify target volumes/OARs, and establish reference points for the treatment isocentre.

CT Acquisition Parameters

Scanning settings typically involving an image thickness of $2.5\,mm$ and a displacement of $2.5\,mm$ for the region of interest.

Treatment Isocentre

A reference point usually placed at the center of the target volume, identified by three skin marks (one anterior/posterior and two lateral).

Fuchsin

A specific dye used to mark reference signs on the patient's skin that is resistant to washing for several days.

TPS (Treatment Planning System)

A computer system networked with the CT scanner used for the segmentation of volumes and the calculation of dose distribution.

GTV (Gross Tumor Volume)

The macroscopically visible extent of the disease, representing the primary tumor or macroscopically involved lymph nodes.

CTV (Clinical Target Volume)

An anatomical concept representing the GTV plus a margin for subclinical microscopic disease or potential lymph node involvement.

PTV (Planning Target Volume)

A geometric expansion of the CTV that accounts for internal margin (organ movement) and set-up margin (daily repositioning inaccuracies).

ITV (Internal Tumor Volume)

The specific margin added to the CTV to compensate for physiological movements of internal organs.

TV (Treated Volume)

The volume of tissue that receives the prescribed dose for curative or palliative purposes.

IV (Irradiated Volume)

The total volume receiving radiation, which includes the target volumes as well as the organs at risk (OAR).

OAR (Organs at Risk)

Healthy organs located within the irradiated area that must be protected or monitored for dose absorption.

MLC (Multi Leaf Collimator)

A multi-leaf collimator used to shape each treatment beam according to the spatial extension of the PTV.

Treatment Beam Energy

The radiation quality chosen during planning, generally using photons with energy levels ranging from $6-15\,MV$.