Clinical Radiation Physics Service

我们已经建立了常规动态调强放射治疗（dIMRT）。这是IMRT治疗中最复杂的，需要大量的治疗前验证以确保准确执行。这些治疗使用我们的双Clinac-21EX加速器进行。通过螺旋断层治疗提供治疗的Hi-ART系统（Tomotherapy Inc.）已经安装、接受并正在治疗患者。该系统为ROB提供了尖端的治疗技术，以支持未来的临床试验。我们已经开始了一系列的计划，我们的核子高剂量率后置器（HDR），使用一个小的，高强度的192Ir源进行间质和腔间近距离治疗。我们的放射手术能力已经扩大，收购了3个直径为5mm， 7.5mm和10mm的新涂抹器。一款全新的飞利浦华晨16层、大口径CT模拟器进行了沙发控制升级。机载成像（OBI）已安装在较新的Clinac-21EX上。用于提供门控放射治疗的瓦里安RPM呼吸门控系统的最后一个组件已经获得，我们正在等待交付。在治疗过程中，呼吸门控将通过补偿正常的呼吸运动来提高靶向能力。Radionics SRS头部框架系统已经适应使用内部制造的特殊支撑的断层治疗单元。程序已经开发了病人模拟和治疗计划与该系统。最新的瓦里安加速器增加了机载成像功能。这提供了诊断质量的图像，使解剖和基准匹配更加准确。这对前列腺病人尤其有用。RapidArc治疗输送系统已安装在较新的Clinac-21EX上，与Tomotherapy Hi-ART单元提供一定程度的冗余，并提供额外的独特功能。这台机器上还安装了一个全新的全碳纤维病人沙发。这提高了kV和MV图像的质量，从而提高了目标区域的定位。它还允许使用复杂的处理技术，这在以前是不可能的，因为旧沙发顶部的钢支撑的衰减和分散。治疗计划系统已升级与新的适应性规划软件。一种新的体积质量保证模型已经获得并被接受用于临床。这个幻影包含1386个排列成螺旋状的二极管探测器，对于验证由Tomotherapy和RapidArc产生的复杂治疗场序列是必不可少的。它还提供软件，用于将探测器测量结果重新映射到患者图像集上，并将其与治疗计划等剂量体积进行比较。然后对计划的体积剂量分布和测量的体积剂量分布进行全面的统计分析。

We have instituted routine dynamic Intensity Modulated Radiation Therapy (dIMRT). This is the most complex of IMRT treatments and requires considerable pre-treatment verification to ensure accurate execution. These treatments are delivered using our twin Clinac-21EX accelerators. A Hi-ART system (Tomotherapy Inc.) for delivering treatments via helical tomotherapy has been installed, accepted and is currently treating patients. This system provides ROB with cutting edge treatment technology to support future clinical trials. We have started a series of initiatives with our Nucletron High Dose-Rate Afterloader (HDR) , using a small, high intensity 192Ir source for interstitial and intercavitary brachytherapy. Our radiosurgery capability has been expanded with the acquisition of 3 new applicators with diameters of 5mm, 7.5mm and 10mm. A new Philips Brilliance 16 slice, large bore CT Simulator has received couch control upgrades. On-board imaging (OBI) has been installed on the newer Clinac-21EX. The final component of the Varian RPM Respiratory Gating system for providing gated radiation therapy has been acquired and we are awaiting delivery. Respiratory gating will improve targeting ability by compensating for regular respiratory motions during treatment. The Radionics SRS head frame system has been adapted to the Tomotherapy unit using a special support fabricated in-house. Procedures have been developed for patient simulation and treatment planning with this system. On-board imaging has been added to the newest Varian accelerator. This provides diagnostic quality images, which makes anatomical and fiducial matching much more accurate. This is especially useful for prostate patients. The RapidArc treatment delivery system has been installed on the newer Clinac-21EX and provides some degree of redundancy with the Tomotherapy Hi-ART unit as well as offering additional unique features. A new, all-carbon fiber patient couch top has also been installed on this machine. This improves the quality of both kV and MV images, resulting in improved localization of target areas. It also permits complex treatment techniques that had previously not been possible due to the attenuation and scatter of the steel supports of the old couch top. Treatment planning systems has been upgraded with the new adaptive planning software. A new volumetric Quality Assurance phantom has been procured and accepted for clinical use. This phantom contains 1386 diode detectors arranged in a helical pattern and is essential for the verification of complex treatment field sequences generated by both Tomotherapy and RapidArc. It also provides software for remapping the detector measurements onto patient image sets and compares them with treatment plan isodose volumes. It then generates a full statistical analysis of the planned versus measured volumetric dose distributions.