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Biomedical subjects

T Bortfeld

Publications and source records attributed to T Bortfeld.

41 records · Page 3Linked to original sources

Fractionated stereotactically guided radiotherapy of head and neck tumors: a report on clinical use of a new system in 195 cases.

Between November 1988 and December 1992, 195 patients with tumors of the head and neck (low grade gliomas, meningiomas, neurinomas, chordomas and miscellaneous) were treated with a newly developed stereotactical system for fractionated, conformal, high-precision radiotherapy. The overall preparation time, including head mask production for fixation, CT, MRI, 3-D treatment planning and stereotactical localisation could be reduced to 4-5 h per patient. The use of MR in the target definition was increased to a mean of about 60%. The medial follow-up time is 22 months. Three different patient groups were selected according to pretreatment. Patients with full high-precision radiotherapy survived in 95% of cases, patients with boost treatment in 86% and patients with preirradiated recurrent disease in 64%. Meningiomas as the largest histology group (n = 62) showed partial response in 27% and complete response in 10% of cases. Progression occurred in two patients. All patients are alive. Acute side-effects were minimal and of the order of 10%, no late complications occurred despite tumor doses ranging up to 72 Gy. High-precision radiotherapy as it is performed in Heidelberg can be regarded as an effective, reliable and tolerable system for selected tumors of the head and neck.

Adolescent↗

Optimization of beam orientations in radiation therapy: some theoretical considerations.

The problem of optimizing beam orientations for irradiations with multiple fixed beams is investigated. It is shown that this is a complex, in mathematical terms 'non-convex', optimization problem, whose solution requires sophisticated techniques. In this work, the optimization is performed with the method of simulated annealing. In order to keep the calculation time within reasonable limits, the problem is expressed in the spatial frequency domain using Parseval's theorem. All calculations are then performed in the frequency domain. The algorithm is described in detail. Various treatment techniques, including intensity modulation, are considered. The results for various exemplary cases are presented. They are based on a simplified dose calculation model. A general conclusion is that the optimum beam configuration for multiple-beam irradiations (with more than three beams) tends to be an even distribution over an angular range of 0 to 2 pi.

Algorithms↗

Computer systems and mechanical tools for stereotactically guided conformation therapy with linear accelerators.

An integrated system for fractionated, stereotactically guided conformation radiotherapy has been developed. The system components are a stereotactic fixation system that can be used each treatment day, a localization, and positioning unit that can be used during x-ray computer tomography, magnetic resonance imaging, positron emission tomography, and radiographical examinations as well as for treatment. Conformal precision radiotherapy is planned with a new three-dimensional treatment planning system (Voxel-Plan-Heidelberg) which comprises, among others options, a three-dimensional image correlation procedure as well as routines for the calculation of coplanar and non-coplanar irradiations with irregularly shaped fields. Two different multi-leaf collimators have been designed for precision radiotherapy in the head and neck region. A manual multi-leaf collimator is used for irradiations with stationary beams or for moving beam treatments with invariable irregularly shaped fields. This collimator system is now being used for patient treatments. The design of a computer controlled multi-leaf collimator unit for multiple fixed field irradiation techniques is discussed. All system components are aimed at conforming dose distributions for fractionated radiotherapy treatments to the target to improve sparing of adjacent normal tissues, and at achieving a sufficient geometrical accuracy in the dose application.

Computer Systems↗

Methods of image reconstruction from projections applied to conformation radiotherapy.

The problem of optimizing the dose distribution for conformation radiotherapy with intensity modulated external beams is similar to the problem of reconstructing a 3D image from its 2D projections. In this paper we analyse the relationship between these problems. We show that the main image reconstruction methods, namely filtered backprojection and iterative reconstruction, can be directly applied to conformation therapy. We examine the features of each of these methods with regard to this new application and we present first theoretical results.

Humans↗

Decomposition of pencil beam kernels for fast dose calculations in three-dimensional treatment planning.

A method for the calculation of three-dimensional dose distributions for high-energy photon beams is presented. The main features are (i) the calculation is fast enough to allow interactive three-dimensional treatment planning, and (ii) irregularly shaped or compensated fields, which are required to fit three-dimensional dose distributions to target volumes, are adequately taken into consideration. The method is based on the pencil beam convolution technique and shares its features concerning accuracy. A considerable gain in speed is achieved by decomposing the pencil beam kernel into three separated terms, thus reducing the required number of two-dimensional convolutions. The convolutions are performed in the frequency domain via the fast Hartley transform. Using these techniques, the calculation time for the convolutions is only about 8 s on a DEC VAX station 3100. This is one-fourth to one-third of the calculation time for the ray tracing through the three-dimensional CT data set, which has to be performed in any case. Results of the calculation are compared with measurements in a homogeneous phantom for 15 MV photons. Two irregular fields shaped with a multileaf collimator are considered. The deviations between measured and calculated absolute dose values are smaller than +/- 2%.

Algorithms↗