title: Advances in 3-dimensional radiation treatment planning systems: room-view display with real time interactivity.
abstract: OBJECTIVE
  We describe our 3-dimensional (3-D) radiation treatment planning system for external photon and electron beam 3-D treatment planning which provides high performance computational speed and a real-time display which we have named "room-view" in which the simulated target volumes, critical structures, skin surfaces, radiation beams and/or dose surfaces can be viewed on the display monitor from any arbitrary viewing position.
  
  
  METHODS
  We have implemented the 3-D planning system on a graphics superworkstation with parallel processing. Patient's anatomical features are extracted from contiguous computed tomography scan images and are displayed as wireloops or solid surfaces. Radiation beams are displayed as a set of diverging rays plus the polygons formed by the intersection of these rays with planes perpendicular to the beam axis. Controls are provided for each treatment machine motion function. Photon dose calculations are performed using an effective pathlength algorithm modified to accommodate 3-D off-center ratios. Electron dose calculations are performed using a 3-D pencil beam model.
  
  
  RESULTS
  Dose distribution information can be displayed as 3-D dose surfaces, dose-volume histograms, or as isodoses superimposed on 2-D gray scale images of the patient's anatomy. Tumor-control-probabilities, normal-tissue-complication probabilities and a figure-of-merit score function are generated to aid in plan evaluation. A split-screen display provides a beam's-eye-view for beam positioning and design of patient shielding block apertures and a concurrent "room-view" display of the patient and beam icon for viewing multiple beam set-ups, beam positioning, and plan evaluation. Both views are simultaneously interactive.
  
  
  CONCLUSIONS
  The development of an interactive 3-D radiation treatment planning system with a real-time room-view display has been accomplished. The concurrent real-time beam's-eye-view and room-view display significantly improves the efficacy of the 3-D planning process.
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.
authors.forename: J A
authors.initials: JA
authors.lastname: Purdy
authors.forename: W B
authors.initials: WB
authors.lastname: Harms
authors.forename: J W
authors.initials: JW
authors.lastname: Matthews
authors.forename: R
authors.initials: R
authors.lastname: Drzymala
authors.forename: B
authors.initials: B
authors.lastname: Emami
authors.forename: J R
authors.initials: JR
authors.lastname: Simpson
authors.forename: J
authors.initials: J
authors.lastname: Manolis
authors.forename: F U
authors.initials: FU
authors.lastname: Rosenberger
mesh_terms: D003199:Computer Systems; D003626:Data Display; D006801:Humans; D007091:Image Processing, Computer-Assisted; D011880:Radiotherapy Planning, Computer-Assisted