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Concepts and Recommendations: For IMRT Planning: ICRU 83
Concepts and Recommendations: For IMRT Planning: ICRU 83
Recommendations
For IMRT Planning : ICRU 83
ICRU
3-DCRT Vs IMRT
Point dose prescription and IMRT
ICRU 83
Levels of reporting
Dose- volume reporting
Problems associated with planning
Summary
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International Commission on Radiation Units and
Measurements(ICRU)
Establishment (in 1925)
Objective :
It has been continously working for development of internationally
acceptable recommendations regarding:
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Difference between traditional and IMRT optimization
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3DCRT Vs IMRT
Simple. Complex.
Forward planning Inverse/optimized planning
Uniform fluence. Non-uniform fluence.
Uniform dose. High dose gradient.
Low MU. High MU.
Dose defined at isocentre. Dose at isocentre is meaningless.
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ICRU Dose/planning Guidelines for EBT
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ICRU-50 Reference Point and Reference Dose
Clinically relevant.
Easy to define.
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Problems with point dose in IMRT
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ICRU Report no.83 (2010)
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Definition of volumes
Three levels
Level 1:
• Minimum standard - all the centers below which radiotherapy should not be performed.
• Sufficient for treatment where the knowledge of absorbed doses on the central axis is known.
Level 2:
• It implies that treatments are performed using 3-D imaging and computational dosimetry. All
volumes of intrests are defined using CT and/or MR , dose distribution include heterogeneity
corrections.
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ICRU-83 Levels of reporting
Level 3:
• Development of new techniques for which reporting criteria are not established till
now.
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Dose – Volume Reporting
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Dose – Volume Reporting
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OAR and PRV Specific Dose-Volume Reporting
A high estimate of D2% will result if only those portions of the organ
that receive a high dose are delineated.
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OAR and PRV Specific Dose-Volume Reporting
For parallel-like structures (e.g. parotid, lung, kidney, liver͙) , more than
one dose-volume specification be considered for reporting.
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Dose Homogeneity and Confirmity
The degree to which the high dose region conforms to the target volume, usually
the PTV.
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Dose Homogeneity and Confirmity
Homogeneity
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Over lapping of PTV and PRV
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PTV in Buildup Region or Outside Body
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Summary
reported.
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THANK YOU
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