Jeanette Keil

DOS 793 Fieldwork III

10/16/2018
Craniospinal Irradiation (CSI) Assignment
Craniospinal Irradiation is a technique that is frequently used to treat children with
Medulloblastoma. By using this technique, we can treat the entire central nervous system (CNS)
of the patient who has a high risk of craniospinal axis involvement. It is important to remember
that there are many ways to design a treatment plan and the variables for these planning
decisions are endless. Craniospinal Irradiation has traditionally been performed in the prone
position using static beams, but can be problematic for some patients, such as small children,
who need anesthesia for treatment because of comfort and positioning. For this reason, I decided
to plan this patient in the supine position using VMAT. I have in the past created a treatment
plan for a patient in the prone position so I also wanted to try a new method for future use.
When I was starting this assignment, I wanted to do this plan using the new Halcyon
machine that is currently being commissioned in my department but I kept running into
calculation errors since I am not fluent in Halcyon planning with multi-isocenters. I turned my
attention to using VMAT and planned the patient on a TrueBeam machine using 6MV. The first
thing I did was used the Arc Geometry Tool in Eclipse to help determine my arcs. I chose the “2
isocenter – 2 full rotations” option with a 10° collimator angle. I then copied and pasted each
field, rotated the collimator to 350°, and made sure that they were rotating in the opposite
direction. I then used the Arc Geometry Tool again to fine-tune the fields so that the collimator
fit to the dimensions of the PTV. I did close the x-jaws down on the more superior fields so that
the x-jaw did not exceed 15cm. I ended up with 4 full arcs – 2 superior arcs covering the PTV
Brain and the superior portion of the PTV Spine, and 2 inferior arcs covering the remainder of
the PTV Spine. I used the PTV_TOTAL for optimization and normalization.
 Before optimization, I took notice that the patient’s arms were down so I contoured the
arms and noted what angles needed to be avoided as to not have entrance dose going through the
arms. You can see my avoidance angles listed in the figure below. I did not use avoidance
sectors for fields 1 and 2 because they were more superior and did not enter through the arms. In
addition to contouring the arms I also created a PRV structure for both lenses to be used during
optimization.

During optimization, I used the score card from ProKnow to help decide my dose
tolerances and priorities. I did have to run the plan a handful of times noticing that my optic
nerves were high on the ProKnow scorecard but I went back and looked at the actual dose in
Eclipse and I was well below the limit listed. I decided to stop pushing so hard on these
structures since my score was pretty good in ProKnow and even though it said I missed a
minimum requirement, the DVH in Eclipse says that my dose to that critical structure was fine. I
know that ProKnow and Eclipse have certain bugs to work out so I was happy with the results
that I received from ProKnow.
The plan was normalized to cover 95% of the PTV_TOTAL with 100% of the
prescription dose of 3600cGy in 20 fractions. The plan 3D dose maximum was 112.8% and the
hotspot was in the PTV_Brain and in the bone of the skull. Since I used the arc geometry tool to
help me place my fields, I did not notice any hot or cold spots within the PTV_TOTAL.
I ran a few iterations of this plan and evaluated my score in ProKnow. From there I made my
adjustments but I did not have any big problems achieving good PTV coverage and minimizing
dose to the OAR. As I mentioned earlier, I did try to plan this using the new Halcyon machine at
our department but there is a little bit of a learning curve with multiple isocenters for that plan. I
will be going back to that plan soon to make sure the plan I was attempting would be deliverable.
Overall, I feel like I did a pretty good job at coming up with a VMAT plan for this CSI
case study. I have planned a CSI case in the past but not using this technique. I did find this a
lot easier to plan compared to a 3D prone plan. I think that the therapists must be careful in the
setup of a patient in this position since there are two isocenters, but you can also argue that any
CSI technique requires a lot of attention for setup and delivery. In the future, I would like to do
this case again but with the Halcyon machine so that I can see how each plan compares. I really
enjoyed learning how to do this plan and feel more prepared if a case like this comes along.
Please see the attached photos below for more specific plan details and photos.
References
1. Liu, Yueping, Zhu, et al. Radiation Treatment for Medulloblastoma: a Review of 64
Cases at a Single Institute | Japanese Journal of Clinical Oncology | Oxford Academic.
OUP Academic. https://academic.oup.com/jjco/article/35/3/111/829031. Published
March 1, 2005. Accessed October 14, 2018.
DOE, JOHN (gator)
Printed on Wednesday, October 17, 2018 10:32:01 AM by Keil, Jeanette C (medstar\jcs136) Franklin Square Radiation Oncology Center, Radamerica II LLC
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 112.8 %
Maximum dose in PTV_TOTAL: 112.8 %
Minimum dose in PTV_TOTAL: 59.6 %
Mean dose in PTV_TOTAL: 103.3 %

Hidden field and field accessory outlines not included in the printout
Fields in plan 'CSI1' of course 'VMAT TEST'
Field ID Technique Machine Energy Scale Wedge ID Weight X1 X2 Y1 Y2 Gantry Rtn Coll Rtn Couch Rtn X Y Z SSD MU
[cm] [cm] [cm] [cm] [deg] [deg] [deg] [cm] [cm] [cm] [cm]
1 ARC-I FSROCTB 6X IEC61217 1.262 -5.4 +9.6 -18.7 +18.8 181.0 - 179.0 10.0 0.0 -0.7 1.5 -11.2 95.2 230
2 ARC-I FSROCTB 6X IEC61217 1.167 -8.9 +6.1 -18.5 +18.9 179.0 - 181.0 350.0 0.0 -0.7 1.5 -11.2 95.2 212
3 ARC-I FSROCTB 6X IEC61217 0.858 -7.4 +5.7 -18.7 +18.7 181.0 - 179.0 10.0 0.0 -0.4 3.3 -47.1 97.9 156
4 ARC-I FSROCTB 6X IEC61217 0.825 -5.6 +7.7 -18.7 +18.7 179.0 - 181.0 350.0 0.0 -0.4 3.3 -47.1 97.9 150

Patient Name: DOE, JOHN (gator) Z: 3.00 cm External Beam Planning 15.6.03
Course: VMAT TEST Scaling Factor: 65% Printed Wednesday, October 17, 2018 10:32 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 112.8 %
Maximum dose in PTV_TOTAL: 112.8 %
Minimum dose in PTV_TOTAL: 59.6 %
Mean dose in PTV_TOTAL: 103.3 %

Hidden field and field accessory outlines not included in the printout

Patient Name: DOE, JOHN (gator) Z: -4.50 cm External Beam Planning 15.6.03
Course: VMAT TEST Scaling Factor: 65% Printed Wednesday, October 17, 2018 10:33 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 112.8 %
Maximum dose in PTV_TOTAL: 112.8 %
Minimum dose in PTV_TOTAL: 59.6 %
Mean dose in PTV_TOTAL: 103.3 %

Hidden field and field accessory outlines not included in the printout

Patient Name: DOE, JOHN (gator) Z: -12.00 cm External Beam Planning 15.6.03
Course: VMAT TEST Scaling Factor: 65% Printed Wednesday, October 17, 2018 10:33 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 112.8 %
Maximum dose in PTV_TOTAL: 112.8 %
Minimum dose in PTV_TOTAL: 59.6 %
Mean dose in PTV_TOTAL: 103.3 %

Hidden field and field accessory outlines not included in the printout

Patient Name: DOE, JOHN (gator) Z: -24.50 cm External Beam Planning 15.6.03
Course: VMAT TEST Scaling Factor: 65% Printed Wednesday, October 17, 2018 10:33 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 112.8 %
Maximum dose in PTV_TOTAL: 112.8 %
Minimum dose in PTV_TOTAL: 59.6 %
Mean dose in PTV_TOTAL: 103.3 %

Hidden field and field accessory outlines not included in the printout

Patient Name: DOE, JOHN (gator) Z: -37.00 cm External Beam Planning 15.6.03
Course: VMAT TEST Scaling Factor: 65% Printed Wednesday, October 17, 2018 10:33 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 112.8 %
Maximum dose in PTV_TOTAL: 112.8 %
Minimum dose in PTV_TOTAL: 59.6 %
Mean dose in PTV_TOTAL: 103.3 %

Hidden field and field accessory outlines not included in the printout

Patient Name: DOE, JOHN (gator) Z: -50.00 cm External Beam Planning 15.6.03
Course: VMAT TEST Scaling Factor: 65% Printed Wednesday, October 17, 2018 10:33 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 112.8 %
Maximum dose in PTV_TOTAL: 112.8 %
Minimum dose in PTV_TOTAL: 59.6 %
Mean dose in PTV_TOTAL: 103.3 %

Hidden field and field accessory outlines not included in the printout

Patient Name: DOE, JOHN (gator) Z: -61.50 cm External Beam Planning 15.6.03
Course: VMAT TEST Scaling Factor: 65% Printed Wednesday, October 17, 2018 10:34 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 112.8 %
Maximum dose in PTV_TOTAL: 112.8 %
Minimum dose in PTV_TOTAL: 59.6 %
Mean dose in PTV_TOTAL: 103.3 %

Hidden field and field accessory outlines not included in the printout

Patient Name: DOE, JOHN (gator) Y: 2.19 cm External Beam Planning 15.6.03
Course: VMAT TEST Scaling Factor: 30% Printed Wednesday, October 17, 2018 10:35 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 112.8 %
Maximum dose in PTV_TOTAL: 112.8 %
Minimum dose in PTV_TOTAL: 59.6 %
Mean dose in PTV_TOTAL: 103.3 %

Hidden field and field accessory outlines not included in the printout

Patient Name: DOE, JOHN (gator) X: -0.76 cm External Beam Planning 15.6.03
Course: VMAT TEST Scaling Factor: 30% Printed Wednesday, October 17, 2018 10:36 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
External Beam Planning
External Beam Planning 15.6.03 Franklin Square Radiation Oncology Center, Radamerica II LLC

Patient: DOE, JOHN

Patient IDs: gator
Comment:

Plan Plan Course Plan History

CSI1 VMAT TEST Last Modified: Tuesday, October 16, 2018 4:31:42 PM by Keil, Jeanette C
Unapproved: Tuesday, October 16, 2018 3:44:53 PM by Keil, Jeanette C

DVH Structure Structure Status Coverage [%/%] Volume Min Dose Max Dose Mean Dose Modal Dose Median Dose Std Dev
OpticNerve rt Unapproved 100.0 / 99.3 0.5 cm³ 1156.9 cGy 3475.8 cGy 1954.0 cGy 1349.6 cGy 1865.8 cGy 491.4 cGy
Lens Lt Unapproved 100.0 / 97.7 0.1 cm³ 547.6 cGy 665.5 cGy 585.8 cGy 571.6 cGy 583.6 cGy 21.4 cGy
Lens Rt Unapproved 100.0 / 100.6 0.1 cm³ 526.0 cGy 638.5 cGy 572.6 cGy 571.0 cGy 570.9 cGy 22.6 cGy

Patient: DOE, JOHN (gator) Printed Wednesday, October 17, 2018 10:41:15 AM by Keil, Jeanette C
Course: VMAT TEST
Plan: CSI1 - Unapproved Page: 1/2
External Beam Planning
External Beam Planning 15.6.03 Franklin Square Radiation Oncology Center, Radamerica II LLC

DVH Structure Structure Status Coverage [%/%] Volume Min Dose Max Dose Mean Dose Modal Dose Median Dose Std Dev
OpticNerve lt Unapproved 100.0 / 99.5 0.5 cm³ 1457.8 cGy 3373.1 cGy 2160.9 cGy 2571.7 cGy 2082.4 cGy 437.8 cGy
Submandibular lt Unapproved 100.0 / 100.0 4.4 cm³ 1031.9 cGy 1567.9 cGy 1319.4 cGy 1337.4 cGy 1322.4 cGy 106.6 cGy
Submandibular rt Unapproved 100.0 / 100.0 5.4 cm³ 712.9 cGy 1431.0 cGy 1034.5 cGy 1021.3 cGy 1033.5 cGy 137.1 cGy
Thyroid Unapproved 100.0 / 99.9 7.3 cm³ 584.4 cGy 1683.2 cGy 1043.9 cGy 907.4 cGy 1038.7 cGy 207.5 cGy
Parotid rt Unapproved 100.0 / 99.9 10.9 cm³ 666.5 cGy 2666.7 cGy 1411.8 cGy 1024.5 cGy 1383.1 cGy 427.3 cGy
Parotid lt Unapproved 100.0 / 99.9 11.3 cm³ 652.4 cGy 2489.7 cGy 1422.2 cGy 1326.8 cGy 1433.0 cGy 368.1 cGy
Esophagus Unapproved 100.0 / 99.9 14.0 cm³ 886.9 cGy 2024.0 cGy 1285.3 cGy 1284.3 cGy 1276.4 cGy 179.3 cGy
Kidney rt Unapproved 100.0 / 100.0 114.7 cm³ 100.2 cGy 1161.0 cGy 240.3 cGy 165.4 cGy 206.8 cGy 133.2 cGy
Kidney lt Unapproved 100.0 / 100.0 147.6 cm³ 73.6 cGy 1510.8 cGy 221.6 cGy 132.2 cGy 180.0 cGy 160.4 cGy
PTV_Spine Unapproved 100.0 / 100.0 283.4 cm³ 3237.4 cGy 4046.3 cGy 3727.8 cGy 3747.6 cGy 3734.3 cGy 58.6 cGy
Heart Unapproved 100.0 / 100.0 434.8 cm³ 294.4 cGy 1599.4 cGy 719.9 cGy 668.0 cGy 702.2 cGy 188.4 cGy
Liver Unapproved 100.0 / 100.0 962.8 cm³ 63.4 cGy 1620.6 cGy 486.2 cGy 93.1 cGy 480.3 cGy 275.7 cGy
Lung lt Unapproved 100.0 / 100.0 1054.7 cm³ 105.3 cGy 2407.3 cGy 705.3 cGy 634.0 cGy 650.3 cGy 370.1 cGy
Bowel_Total Unapproved 100.0 / 100.0 1058.3 cm³ 72.4 cGy 2898.4 cGy 691.4 cGy 107.5 cGy 707.6 cGy 364.2 cGy
Lung rt Unapproved 100.0 / 100.0 1234.8 cm³ 105.4 cGy 2520.0 cGy 753.1 cGy 578.7 cGy 688.6 cGy 374.6 cGy
PTV_Brain Unapproved 100.0 / 100.0 1684.0 cm³ 2147.3 cGy 4059.8 cGy 3716.3 cGy 3721.6 cGy 3721.8 cGy 84.4 cGy
PTV_TOTAL Unapproved 100.0 / 100.0 1969.8 cm³ 2147.3 cGy 4059.8 cGy 3717.9 cGy 3734.7 cGy 3723.7 cGy 81.2 cGy

Plan prescription

Plan Sum Plan Total Dose per Number of Planned Treatment Normalization Nor...
Plan Sum Course Weight Plan Plan Course Dose Fraction Fractions Total Dose Percentage Mode Value
- - - CSI1 VMAT TEST 3600.0 cGy 180.0 cGy 20 3600.0 cGy 100.0 % 100.00% covers 95.00% of Target Volume 98.9 %

Patient: DOE, JOHN (gator) Printed Wednesday, October 17, 2018 10:41:16 AM by Keil, Jeanette C
Course: VMAT TEST
Plan: CSI1 - Unapproved Page: 2/2
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 4059.8 cGy
Save Status Not saved! Maximum dose in PTV_TOTAL: 4059.8 cGy
Minimum dose in PTV_TOTAL: 2147.3 cGy
Mean dose in PTV_TOTAL: 3717.9 cGy

Fields in plan 'CSI1' of course 'VMAT TEST'

Field ID Technique Machine Energy Scale Wedge ID Weight X1 X2 Y1 Y2 Gantry Rtn Coll Rtn Couch Rtn X Y Z SSD MU
[cm] [cm] [cm] [cm] [deg] [deg] [deg] [cm] [cm] [cm] [cm]
1 ARC-I FSROCTB 6X IEC61217 1.262 -5.4 +9.6 -18.7 +18.8 181.0 - 179.0 10.0 0.0 -0.7 1.5 -11.2 95.2 230

Patient Name: DOE, JOHN (gator) Field '1' plotted at 50.0 cm External Beam Planning 15.6.03
Course: VMAT TEST Arc Segment: 1/178 - 181.00 [deg] Printed Wednesday, October 17, 2018 10:42 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 4059.8 cGy
Save Status Not saved! Maximum dose in PTV_TOTAL: 4059.8 cGy
Minimum dose in PTV_TOTAL: 2147.3 cGy
Mean dose in PTV_TOTAL: 3717.9 cGy

Fields in plan 'CSI1' of course 'VMAT TEST'

Field ID Technique Machine Energy Scale Wedge ID Weight X1 X2 Y1 Y2 Gantry Rtn Coll Rtn Couch Rtn X Y Z SSD MU
[cm] [cm] [cm] [cm] [deg] [deg] [deg] [cm] [cm] [cm] [cm]
2 ARC-I FSROCTB 6X IEC61217 1.167 -8.9 +6.1 -18.5 +18.9 179.0 - 181.0 350.0 0.0 -0.7 1.5 -11.2 95.2 212

Patient Name: DOE, JOHN (gator) Field '2' plotted at 50.0 cm External Beam Planning 15.6.03
Course: VMAT TEST Arc Segment: 1/178 - 179.00 [deg] Printed Wednesday, October 17, 2018 10:42 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 4059.8 cGy
Save Status Not saved! Maximum dose in PTV_TOTAL: 4059.8 cGy
Minimum dose in PTV_TOTAL: 2147.3 cGy
Mean dose in PTV_TOTAL: 3717.9 cGy

Fields in plan 'CSI1' of course 'VMAT TEST'

Field ID Technique Machine Energy Scale Wedge ID Weight X1 X2 Y1 Y2 Gantry Rtn Coll Rtn Couch Rtn X Y Z SSD MU
[cm] [cm] [cm] [cm] [deg] [deg] [deg] [cm] [cm] [cm] [cm]
3 ARC-I FSROCTB 6X IEC61217 0.858 -7.4 +5.7 -18.7 +18.7 181.0 - 179.0 10.0 0.0 -0.4 3.3 -47.1 97.9 156

Patient Name: DOE, JOHN (gator) Field '3' plotted at 50.0 cm External Beam Planning 15.6.03
Course: VMAT TEST Arc Segment: 1/178 - 181.00 [deg] Printed Wednesday, October 17, 2018 10:42 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Patient Name: DOE, JOHN (gator) Course: VMAT TEST Plan normalization value: 98.9 %
Hospital: Franklin Square Radiation Oncology Center, Radamerica II LLC Plan: CSI1 Calculation grid: 2.5 mm
Plan last modified: Tuesday, October 16, 2018 4:31 PM by Keil, Jeanette C Image: Supine Maximum dose: 4059.8 cGy
Save Status Not saved! Maximum dose in PTV_TOTAL: 4059.8 cGy
Minimum dose in PTV_TOTAL: 2147.3 cGy
Mean dose in PTV_TOTAL: 3717.9 cGy

Fields in plan 'CSI1' of course 'VMAT TEST'

Field ID Technique Machine Energy Scale Wedge ID Weight X1 X2 Y1 Y2 Gantry Rtn Coll Rtn Couch Rtn X Y Z SSD MU
[cm] [cm] [cm] [cm] [deg] [deg] [deg] [cm] [cm] [cm] [cm]
4 ARC-I FSROCTB 6X IEC61217 0.825 -5.6 +7.7 -18.7 +18.7 179.0 - 181.0 350.0 0.0 -0.4 3.3 -47.1 97.9 150

Patient Name: DOE, JOHN (gator) Field '4' plotted at 50.0 cm External Beam Planning 15.6.03
Course: VMAT TEST Arc Segment: 1/178 - 179.00 [deg] Printed Wednesday, October 17, 2018 10:43 AM by Keil, Jeanette C
Plan: CSI1 - Unapproved Head First-Supine Page 1/1
User origin DICOM offset = (0.00cm, 0.00cm, 0.00cm)
Study Name: UWLax Supine CSI

Participant Name: Jeanette Keil

Participant Email: keil1403@uwlax.edu

Participant Role: student

Participant Institution: University of Wisconsin

Created: Tue Oct 16 2018 20:35:16 GMT+0000

TPS Manufacturer: Varian Medical Systems

TPS Model: Eclipse

Number of Treatment Beams: 4

Radiation Type(s): Photon

Delivery Type(s): VMAT