Clinical Radiation Physics Service

我们制定了常规动态调强放射治疗（dIMRT）。这是最复杂的调强放射治疗，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-21 EX加速器进行。Hi-ART系统（Tomotherapy Inc.）用于通过螺旋断层放射疗法进行治疗的装置已经安装、接受并且目前正在治疗患者。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倡议与我们的Nucletron高剂量率后装机（HDR），使用一个小的，高强度的192 Ir源间质和腔内近距离治疗。我们的放射外科能力已经扩大，获得了3个新的施源器，直径为5 mm，7.5mm和10 mm。新的Philips Brilliance 16层大口径CT模拟器已接受治疗床控制升级。在较新的Clinac-21 EX上安装了机载成像（OBI）。用于提供门控放射治疗的Varian RPM呼吸门控系统的最后一个组件已经采购，我们正在等待交付。呼吸门控将通过补偿治疗期间的规则呼吸运动来提高靶向能力。Radionics SRS头架系统已使用内部制造的特殊支架适应断层治疗装置。已经开发了使用该系统进行患者模拟和治疗计划的程序。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，这使得解剖和基准匹配更加准确。这对前列腺患者尤其有用。RapidArc治疗输送系统已安装在较新的Clinac-21 EX上，并与断层治疗Hi-ART装置提供一定程度的冗余，并提供额外的独特功能。一个新的，全碳纤维患者治疗床面也已安装在这台机器上。这提高了kV和MV图像的质量，从而改善了目标区域的定位。它还允许复杂的治疗技术，以前由于旧床面的钢支撑的衰减和分散而不可能实现。治疗计划系统已升级为新的自适应计划软件。已经采购了一种新的体积质量保证体模，并接受用于临床。该体模包含1386个以螺旋模式排列的二极管探测器，对于Tomotherapy和RapidArc生成的复杂治疗场序列的验证至关重要。它还提供软件，用于将探测器测量值重新映射到患者图像集，并将其与治疗计划等剂量体积进行比较。然后，它会生成计划体积剂量分布与测量体积剂量分布的完整统计分析。

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.