title: Virtual simulation: initial clinical results.
abstract: We have developed a graphics-based three-dimensional treatment design system that permits the physician to easily understand which anatomy will be treated for any arbitrary beam orientation. Our implementation of this system differs from others in that the software (the Virtual Simulator) simulates the full functionality of a (physical) radiation therapy simulator allowing it to be easily used by physicians. The details of the of our initial clinical experience with virtual simulation are presented in this paper. Virtual simulation was attempted in 71 patients and completed in 65. In 41/71 patients (58%), the beam orientations chosen differed significantly from those traditionally used in our department. Although virtual simulation lead to traditional radiation portals in the remaining patients, in 23/71 (32%) secondary blocking was designed which was different from that which would have been conventionally employed. Thus, overall, virtual simulation lead to treatment changes in 64/71 (90%) of the patients in whom it was attempted. In 78% of evaluable patients the treatment designed with virtual simulation could be implemented on the physical simulator with a precision of +/- 5 mm (+/- 3 mm for brain and head and neck). Thus virtual simulation allowed both accurate planning and execution of treatment plans that would be difficult to achieve with conventional methods.
authors.affiliation: Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill 27516.
authors.forename: J
authors.initials: J
authors.lastname: Rosenman
authors.forename: S L
authors.initials: SL
authors.lastname: Sailer
authors.forename: G W
authors.initials: GW
authors.lastname: Sherouse
authors.forename: E L
authors.initials: EL
authors.lastname: Chaney
authors.forename: J E
authors.initials: JE
authors.lastname: Tepper
mesh_terms: D001932:Brain Neoplasms / Q000532:radiotherapy*; D003196:Computer Graphics; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008953:Models, Anatomic; D009369:Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000517:prevention & control*; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods*