Bootstrap Framework 3.3.6

[robertr]

Hi all,

I wanted to get input into the use of SGRT for DIBH in patients with multiple plans. We plan our SCF patients as a separate plan (Plan 1: Tans, Plan 2: SCF), but they have a common ISO position. Technically it's BeamSets in a single plan in RayStation, but they come across to Aria/AlignRT as two plans.

The issue we have is that although they share an ISO, in AlignRT as they are two plans they can't share ref surface captures (or not that we can see). This means we are having to take multiple ref surface captures for the multiple plans, even though they should be that same surface.

Any help appreciated.

Rob

[jerin_mathew]

Dear Rob,
If we consider both chest and Scf movement during DIBH ,the movement of chest is more .
If they have common iso for both ,we can track the chest for set up and during treatment and can deliver treatment if they are fine .

If they not happy with this ,it will be better to treat with different ISO . which will precisely track both area and deliver better and safe treatment
Eg:1) While treating SCF chin will play apart, somethings it will be down and may comes in SCF field .in this case if we are treating with same iso we won't come to know.This can be observed if the fields are different.
2)for chest wall case we use bolus , in this case there are chances of bolus to come in the SCF field if it is not properly placed.

[ricky2_straw]

Hi Rob, the 2 plans will be treated with the same structure set, I would recommend just using one to cover both

[GeorgeG]

Hi Rob

Did you manage to find any solution to this? I've just posted the same Q in General.

Thanks
George

[robertr]

We just added it into our treatment process so:

Set-up patient in FB -> Get patient into BH -> Image -> Patient FB -> Match image -> Patient into BH -> Apply shifts -> Ref capture for Tans plan -> Switch to SCF plan -> Ref capture SCF plan

It's a lot of quickly pressing buttons whilst keeping the patient in BH which is a faf, but it's how we've gotten this working.

[GeorgeG]

Thanks for your reply.
That is what we are doing currently but you're right it's a bit of a faff. Especially ensuring the correct surface is selected to treat on when switching back between plans. We have stopped selecting 'Default to CT SIM' for our SCF patients for that reason.