A prospective, randomized study addressing the need for physical simulation following virtual simulation

Richard K Valicenti, Frank M. Waterman, Benjamin W. Corn, Walter J. Curran

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: To accurately implement a treatment plan obtained by virtual or CT simulation, conventional or physical simulation is still widely used. To evaluate the need for physical simulation, we prospectively randomized patients to undergo physical simulation or no additional simulation after virtual simulation. Methods and Materials: From July [1995 to September 1996, 75 patients underwent conformal four-field radiation therapy planning for prostate cancer with a commercial grade CT simulator. The patients were randomized to undergo either port filming immediately following physical simulation or port filming alone. The precision of implementing the devised plan was evaluated by comparing simulator radiographs and/or port films against the digitally reconstructed radiographs (DRRs) for x, y, and z displacements of the isocenter. Changes in beam aperture were also prospectively evaluated. Results: Thirty-seven patients were randomized to undergo physical simulation and first day port filming, and 38 had first day treatment verification films only without a physical simulation. Seventy- eight simulator radiographs and 195 first day treatment port films were reviewed. There was no statistically significant reduction in treatment setup error (>5 mm) if patients underwent physical simulation following virtual simulation. No patient required a resimulation, and there was no significant difference in changes of beam aperture. Conclusions: Following virtual simulation, physical simulation may not be necessary to accurately implement the conformal four-field technique. Because port filming appears to be sufficient to assure precise and reliable execution of a devised treatment plan, physical simulation may be eliminated from the process of CT based planning when virtual simulation is available.

Original languageEnglish (US)
Pages (from-to)1131-1135
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume39
Issue number5
DOIs
StatePublished - Dec 1 1997
Externally publishedYes

Fingerprint

Prospective Studies
simulation
Therapeutics
simulators
Prostatic Neoplasms
Radiotherapy
planning
apertures
radiation therapy
grade
cancer

Keywords

  • Conformal four- field technique
  • Physical simulation
  • Port filming
  • Virtual simulation

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

A prospective, randomized study addressing the need for physical simulation following virtual simulation. / Valicenti, Richard K; Waterman, Frank M.; Corn, Benjamin W.; Curran, Walter J.

In: International Journal of Radiation Oncology Biology Physics, Vol. 39, No. 5, 01.12.1997, p. 1131-1135.

Research output: Contribution to journalArticle

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