Complex Multifocal Planning and IGRS Requirements


Manuel Todorovic, MD, of the University Clinic Hamburg-Eppendorf (UKE Hamburg) discusses the treatment of complex multifocal radiosurgery situations and how it is challenging in both planning and delivery. First, Dr. Todorovic defines a “complex planning situation”: A large number of lesions (clustered or not), different prescription regimes in one case (fractionated and single shot) or different indications. At the time of this talk, UKE Hamburg had already treated roughly 120 patients with Elements Multiple Brain Mets SRS software and 30-40 with Elements Cranial SRS. To prevent misalignment and rotational errors, which could underdose the lesion and overdose the surrounding healthy tissue, Dr. Todorovic recommends using an imaging solution. He discusses the pros and cons of each: ExacTrac, Cone Beam CT (CBCT) and Optical Surface Monitoring System (OSMS). By way of a case report, Dr. Todorovic demonstrates how these software can be combined and used in conjunction with image guidance to create and execute plans.


Video Transcript

Okay, yeah. I'm happy that everyone made it here this morning after the nice, excellent social event. So thanks for coming. This is where all the cool stuff happens, right, the physics session. So here's my little disclosure. So what I would like to talk about in the next couple of minutes is, more or less, a kind of complex multifocal planning. And then we have a glimpse, look at IGRS requirements because that's quite important when talking about things like that, using virtual isocenter and so on. First of all, we have to reconsider or have to consider, what...

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