title: High accuracy of virtual simulation with the laser system Dorado CT4.
abstract: OBJECTIVE
  To evaluate the accuracy of virtual simulation, which is less time-consuming than physical simulation, with the new laser system Dorado CT4 in 96 prostate cancer patients.
  
  
  METHODS
  Virtual simulation was based on a spiral scan with 8 mm reconstruction index and 8 mm slice thickness in 64 patients (group A), and 3 mm reconstruction index and 3 mm slice thickness in 32 patients (group B). Both groups were evaluated for impact on maximum difference (Deltamax) regarding the isocenters obtained from virtual simulation versus those obtained from physical simulation.
  
  
  RESULTS
  In the entire cohort, mean differences were as follows: Deltamax 5.7 +/- 3.5 mm, Deltax (left/right) 2.8 +/- 2.9 mm, Deltay (anterior/posterior) 4.5 +/- 3.8 mm, and Deltaz (cranial/caudal) 2.1 +/- 2.2 mm. In group A, mean values were Deltamax 6.2 +/- 3.8 mm, Deltax 2.9 +/- 3.1 mm, Deltay 4.9 +/- 4.2 mm, and Deltaz 2.3 +/- 2.3 mm. In group B, mean values were Deltamax 4.8 +/- 2.8 mm, Deltax 2.7 +/- 2.7 mm, Deltay 3.7 +/- 2.7 mm, and Deltaz 1.7 +/- 2.0 mm. Time of radiotherapy (primary vs. salvage RT) and radiation regimen (external-beam radiotherapy [EBRT] vs. high-dose-rate brachytherapy [HDR-BT] plus EBRT) had no significant impact on Deltamax.
  
  
  CONCLUSIONS
  Virtual simulation with the new laser system Dorado CT4 was very precise for both primary and salvage RT in the treatment of prostate cancer patients. High precision was achieved for both EBRT and HDR-BT plus EBRT. Virtual simulation should be performed with a planning CT with 3 mm reconstruction index and 3 mm slice thickness for high accuracy.
authors.affiliation: Department of Radiation Oncology, University Medical Center, Hamburg-Eppendorf, Germany. Rades.Dirk@gmx.net
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
authors.forename: Thorsten
authors.initials: T
authors.lastname: Frenzel
authors.forename: Rudolf
authors.initials: R
authors.lastname: Schwarz
authors.forename: Jochen
authors.initials: J
authors.lastname: Walz
authors.forename: Florian
authors.initials: F
authors.lastname: Cremers
authors.forename: Dirk
authors.initials: D
authors.lastname: Albers
authors.forename: Winfried
authors.initials: W
authors.lastname: Alberti
authors.forename: Rainer
authors.initials: R
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D003198:Computer Simulation; D006801:Humans; D007834:Lasers; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014584:User-Computer Interface