Improvements in Patient Treatment Planning Systems

Abstract

The Boron Neutron Capture Therapy, Radiation treatment planning environment (BNCT_Rtpe) software system is used to develop treatment planning information’. In typical use BNCT_Rtpe consists of three main components: (1) Semiautomated geometric modeling of objects (brain, target, eyes, sinus) derived from MRI, CT, and other medical imaging modalities, (2) Dose computations for these geometric models with rtt_MC, the INEL Monte Carlo radiation transport computer code, and (3) Dose contouring overlaid on medical images as well as generation of other dose displays. We continue to develop a planning system based on three-dimensional image-based reconstructions using Bspline surfaces. Even though this software is in an experimental state, it has been applied for large animal research and for an isolated case of treatment for a human glioma. Radiation transport is based on Monte Carlo, however there will be implementations of faster methods (e.g. diffusion theory) in the future. The important thing for treatment planning is the output which must convey, to the radiologist, the deposition of dose to healthy and target tissue. Many edits are available such that one can obtain contours registered to medical image, dose/volume histograms and most information required for treatment planning and response assessment. Recent work has been to make the process more automatic and easier to use. The interface, now implemented for contouring and reconstruction, utilizes the Xwindowing system and the MOTIF graphical users interface for effective interaction with the planner. Much work still remains before the tool can be applied in a routine clinical setting.