전산화 단층 촬영 장치를 이용한 뇌척수 조사의 치료 계획

Computed Tomographic Simulation of Craniospinal Irradiation

The aim of this study is to improve the accuracy of field placement and junction between adjacent fields and block shielding through the use of a computed tomography(CT) simulator and virtual simulation. The information was acquired by assessment of Alderson Rando phantom image using CT simulator (I.Q. Xtra - Picker), determination of each field by virtual fluoroscopy of voxel IQ workstation AcQsim and colored critical structures that were obtained by contouring in virtual simulation. And also using a coronal, sagittal and axial view can determine the field and adjacent field gap correctly without calculation during the procedure. With the treatment planning by using the Helax TMS 4.0, the dose in the junction among the adjacent fields and the spinal cord and cribriform plate of the critical structure was evaluated by the dose volume histogram. The pilot image of coronal and sagittal view took about 2minutes and 26minutes to get 100 images. Image translation to the virtual simulation workstation took about 6minutes. Contouring a critical structure such as cribriform plate, spinal cord using a virtual fluoroscopy were eligible to determine a correct field and shielding. The process took about 20 minutes. As the result of the Helax planning, the dose distribution in adjacent field junction was ideal, and the dose level shows almost 100 percentage in the dose volume histogram of the spinal cord and cribriform plate CT simulation can get a correct therapy area due to enhancement of critical structures such as spinal cord and cribriform plate. In addition, using a Spiral CT scanner can be saved a lot of time to plan a simulation therefore this function can reduce difficulties to keep the patient position without any movements to the patient, physician and radiotherapy technician.