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Session: Multi-Disciplinary General ePoster Viewing [Return to Session]

Development of An Image-Plan-Treat Workflow On An Integrated KVCT and Linac System

G Chen, A Tai, K Kainz, Y Zhang, A Amjad, H Jassar*, X Li, Medical College of Wisconsin, Milwaukee, WI


PO-GePV-M-169 (Sunday, 7/10/2022)   [Eastern Time (GMT-4)]

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Purpose: To develop a clinical workflow allowing to acquire image, create a treatment plan, and deliver the plan in one single setup (image-plan-treat) on a highly integrated kVCT and Linac platform (CT-Linac).

Methods: The image-plan-treat workflow was developed based on a newly-available CT-Linac platform with highly integration of kVCT, MVCT, treatment planning, record and verify, and helical and 3D-conformal delivery systems in the following steps: (1) comparing image quality (image uniformity, spatial resolution, contrast, and dimensions) of the kVCT with that of a regular CT simulator (RCT) based on phantom measurements; (2) measuring image doses for a variety of kVCT image protocols on CT-Linac using an ion chamber; (3) establishing CT number-to-density calibration based on measurements using a cheese phantom with various plugs of different materials and densities; (4) verifying kV-MV alignment for image-guided repositioning; (5) testing auto-segmentation and plan creation on the newly acquired kVCT and comparing the obtained dose distribution with the reconstructed dose on RCT; (6) testing planning and delivery data transferring through direct link; and (7) testing plan delivery. The workflow was tested with sample 3D-confromal plans and the time needed in each step was recorded.

Results: The image quality and dose calculation of the kVCT were found to be comparable to those of RCT, with differences in CT numbers by 30HU and in doses by 3%. The kVCT acquired with field-of-view smaller than the body size could result in large CT number difference. Average execution time of the image-plan-treat workflow was <30 minutes: setup (5’), kVCT acquisition (1’), delineation (2-5’), plan generation (8-10’), QA and data transfer (2’), patient position verification (2’), and plan delivery (2-5’).

Conclusion: The newly developed image-plan-treat workflow was efficient and may be used for emergency radiation treatment.


Treatment Planning, CT


TH- External Beam- Photons: Development (new technology and techniques)

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