title: Virtual simulation: fifteen years later.
abstract: In the last two decades there was a radical change in radiotherapy setup. The growing availability of CT equipment and console for computer-aided treatment planning setup enabled the use of advanced technologies as conformal 3D radiation therapy in most centers. In particular in 1987 virtual simulation was proposed for setup. During its use a number of application modalities appeared. Virtual simulation in some centers is applied alone while in others it is associated with conventional simulation. However, from numerous reports published in last years it seems that virtual simulation significantly improves treatment quality independently of radical or palliative intent and of the size of treated volumes (high doses to small volumes or wide shaped fields). Some studies stressed that virtual simulation could significantly shorten treatment planning times with consequent cost reduction. The use of virtual simulation evidenced associated problems and in particular setup limitations due to the CT gantry size, the need to up-date the conventional modalities of setup verification according to the new technologies and more generally to up-date quality assurance procedures in an advanced technological setting. Finally there was the self-evident need of a better knowledge of the anatomy on axial sections, of tumor spread routes in particular.
authors.affiliation: Cattedra di Radioterapia, Istituto di Radiologia, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Roma.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Valentini
authors.forename: Angelo
authors.initials: A
authors.lastname: Piermattei
authors.forename: Alessio G
authors.initials: AG
authors.lastname: Morganti
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Gambacorta
authors.forename: Luigi
authors.initials: L
authors.lastname: Azario
authors.forename: Gabriella
authors.initials: G
authors.lastname: Macchia
authors.forename: Francesco
authors.initials: F
authors.lastname: Deodato
authors.forename: Savino
authors.initials: S
authors.lastname: Cilla
authors.forename: Daniele
authors.initials: D
authors.lastname: Pepe
authors.forename: Luca
authors.initials: L
authors.lastname: Grimaldi
authors.forename: Nicola
authors.initials: N
authors.lastname: Dinapoli
authors.forename: Numa
authors.initials: N
authors.lastname: Cellini
mesh_terms: D003198:Computer Simulation / Q000639:trends; D006801:Humans; D011878:Radiotherapy / Q000379:methods* / Q000592:standards / Q000639:trends*; D011880:Radiotherapy Planning, Computer-Assisted / Q000639:trends*; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface