Clinical Applications of a CT-Simulator: Precision Treatment Planning and Portal Marking in Breast Cancer

Breast cancer is frequently treated with radiation using opposed tangent portals to the involved breast, including the chest wall. Presented is a method for simulating such treatment fields on a CT simulator. A short series of CT images provides a three dimensional model for treatment planning prior to marking the patient. Gantry and collimator angles, as well as wedges or custom blocks, are determined in the planning stage. Upon receipt of an approved treatment plan, the portals are available for simulation. The cross-hair laser and computerized bed movement in the CT simulator aid in marking the entrance of the radiation fields on the patient’s skin. Discussion of the clinical application of the described technique is included.