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A COMPREHENSIVE TOOLBOX FOR PHYSICIANS

A comprehensive toolbox for physicians to efficiently represent the patient anatomy and easily compare and approve plans.

Accurate and efficient contouring

The module contains tools for creating a rich and accurate representation of the patient anatomy for the treatment planning process.

Advanced manual and semi-automatic contouring

The system includes a comprehensive toolset for manual contouring such as polygon, freehand, paintbrush/2D rollerball and local deformations (push-and-pull). It also supports regions-of-interest (ROI) with voxel-based triangulation, 4D visualization and Boolean algebra for combining ROIs. Templates can be saved with or without the geometries included which can then be recalled on future patients.

Model-based segmentation (MBS)

MBS is a semi-automatic tool for delineation of regions of interest based on biomechanical and statistical information about organs. Volumetric images are segmented semiautomatically, utilizing a combination of greyscale gradients and models with knowledge of how organs may change shape. It is possible to delineate multiple regions of interest simultaneously which increases throughput, accuracy and reproducibility.

Atlas-based segmentation*: a versatile auto-segmentation tool

The idea is to take existing data from the clinic database to create templates with multiple image sets – atlases – and use these to segment new image data by locating the best matching atlas through rigid image registration and apply deformable registration to deform the ROI and POI geometries onto the new image set. The geometries contained in each atlas can be manually contoured or generated with MBS. If MBS ROIs are available in the template they may be automatically adapted after atlas-based initialization is completed. Derived ROIs created from a template will automatically be updated after initialization and MBS adaptation.

*Only available in RayStation

Image registration/fusion

Rigid and deformable registration of multi-modality imaging CT, CBCT, PET or MR is fully supported and integrated with the adaptive radiation therapy functionality. It can be used for showing fused images as a reference while contouring, and for mapping regions or points of interest between image sets.

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Plan evaluation

Physicians can easily evaluate, compare and approve treatment plans.

The module is a comprehensive toolbox for evaluation and comparison of treatment plans and plan approval. From a number of predefined layouts, dose distribution, dose statistics, clinical goals and dose volume histograms of up to three different plans can be simultaneously compared. Dose can directly be computed on additional image sets and summed up using the deformable registration provided in rayDeformable. For evaluation of robustness dose can also be computed for a density perturbation or isocenter shift.

Radiobiological optimization and evaluation

The use of radiobiological response models brings the planning process closer to the intent to create a plan with the highest possible probability of curing the patient while keeping the risk of complications to the surrounding healthy tissue as low as possible. The philosophy is to use the biological models to reveal effects that are difficult to understand from the dose distribution alone.

The module provides tools for both biological optimization and evaluation. Optimization tools enable direct optimization on the biological indices in combination with physical dose indices. This makes it possible to configure optimization problems that more closely describe the clinical intentions, such as minimizing normal tissue complication probabilities subject to a guaranteed homogenous target dose within a specified standard deviation.

Evaluation tools include Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) models which can be combined with tissue repair and tumor growth models. The biological tools are integrated into the plan evaluation module. The physical properties of the existing plan can thus be easily investigated if unexpected differences in the biological response are observed between different plans. In addition, there is a biological evaluation module dedicated to the exploration of the biological effects of altering the fractionation schedule of a single treatment plan.

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