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Craniospinal irradiation using a forward planned segmented field technique

Lookup NU author(s): Dr Helen Lucraft


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Craniospinal irradiation is technically demanding due to the complex shape of the planning target volume (PTV). Radiotherapy treatment techniques have evolved overtime as imaging and radiotherapy treatment technology have improved. However, most are variations on a class solution utilizing a prone patient position with two shaped lateral cranial portals and a matched posterior spinal portal with moving junctions. Major areas of difficulty remain with the accurate definition of the PTV and achieving a homogeneous dose within it, especially at the junctions. We describe a three-dimensionally (3D) planned craniospinal radiation technique that permits rapid image acquisition with reduced localization time, simplified spinal PTV definition and standardized cranial PTV definition. Improved dose homogeneity within the PTV is achieved by use of a segmented "field-in-field" technique (forward planned intensity-modulated radiotherapy (IMRT)) in place of customized compensators. This has negated the requirement for constructing physical compensators. Autosequencing for field delivery enables the junction to be "moved" during a single fraction and reduces the overall treatment time, an important consideration when treating very young patients.

Publication metadata

Author(s): Wilkinson JM, Lewis J, Lawrence GP, Lucraft HH, Murphy E

Publication type: Article

Publication status: Published

Journal: British Institute of Radiology

Year: 2007

Volume: 80

Issue: 951

Pages: 209-215

ISSN (print): 0007-1285

ISSN (electronic): 1748-880X

Publisher: British Institute of Radiology


DOI: 10.1259/bjr/61306844


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