title: An image-guided technique for planning and verification of supine craniospinal irradiation.
abstract: We present a technique for planning and verification of craniospinal treatment with the patient in the supine position. Treatment delivery and verification is streamlined through the use of modern imaging techniques. Treatments use two lateral brain fields abutted to a single or pair of posterior spine fields. Treatment delivery is simplified by aligning all isocenters in the anterior-posterior and lateral directions. Patient positioning is accomplished via on-board kV imaging. Verification of field shape and junctions is accomplished with BB placement and MV portal imaging. Daily treatment is simplified by using only longitundinal couch shifts, which are recorded in the patient chart and RV database. The technique is simple to implement in a clinic that is already using a similar beam arrangement with the patient prone. It requires no additional devices to be fabricated (for immobilization or QA), and it takes advantage of all the existing elements of a modern linac.
authors.affiliation: Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA. ryan.mcmahon@duke.edu
authors.forename: Ryan L
authors.initials: RL
authors.lastname: McMahon
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Larrier
authors.forename: Q Jackie
authors.initials: QJ
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000528:radiation effects; D001932:Brain Neoplasms / Q000532:radiotherapy; D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation; D006801:Humans; D008875:Middle Aged; D010315:Particle Accelerators; D056888:Patient Positioning / Q000379:methods; D019047:Phantoms, Imaging; D011878:Radiotherapy / Q000379:methods; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D013125:Spinal Neoplasms / Q000532:radiotherapy*; D013131:Spine / Q000528:radiation effects*; D016683:Supine Position