TOMO的技术特征和临床价值 40页.pptVIP

Adaptive Radiotherapy Week 1 Week 3 Calculate daily doses Modify original contours Map hot dose levels Contour hot spot and make it a constraint Adaptive Radiotherapy Pre-RT KvCT; intra-RT MvCT SCLC after 18 Gy + + Discrete Beam Angles Continuous Couch Motion = Moving Couch Fast Binary MLC (Multileaf Collimator) TomoDirect WBRT Multiple lesions Efficient, IMRT, accurate simple fields e.g. Tangents TomoDirect + Tomo: The Breast Solution Dynamic Jaw Saves Time: Whole Abdominal RT treatment time regular 2.5cm 17 minutes, dose penumbra! djdc 5cm: 5.5 minutes, minimized penumbra Heidelberg The Next Frontier: Theragnostic XRT Basic premise: Deliver non-homogenous RT doses to different tumor sub-volumes, based on an analysis of local control probability derived from predictive functional imaging difference maps early in treatment. The ultimate in “personalized XRT” Generate a baseline agnostic plan Obtain baseline and early in-treatment functional imaging Correlate Δ maps with eventual outcome Develop a prescription model Test the model in a theragnostic dose-painting trial Dose Painting: Feasibility Studies IMRT: HT Dose Painting IMPT (Spot Scan) Dose Painting Early treatment planning results confirm that we can deliver Non-homogenous doses that mimic functional imaging maps Thank You * Table 1 highlights: Maximum Table 2 bold: More than 80% of the time, we are shifting greater than or equal to 2 mm for HN, and 5 mm for lung and prostate Table 3 bold: 69%, 73%, and 80% of the time we are rolling less than 1 degree * Here’s an example of a case we treated with our linac based technique. * I then became curious to see what a more homogeneous, or typical, tomotherapy plan would look like and you can clearly see the difference in conformity. 螺旋断层放疗Tomo的技术特征和临床价值 螺旋断层放疗的技术特征与临床价值 Dr Mesh Meta：全球第一位使用TOMO的放疗科主任 What is Tomo Really Good At? Daily Image Guidance Very large field set-ups Craniospinal, whole abdomen, TMI Multiple lesions/prescr