IIP : Imaging for Target Volume Definition Flashcards

1
Q

What is Target Volume Definition?

A

defining what we are going to treat

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2
Q

what is GTV ( gross target volume)

A

the gross tumour thats clearly present

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3
Q

good quality of imaging allows GTV to be outlined accurately
this means

A

less normal tissue irradiation

less normal tissue complications

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4
Q

The ability to identify a tumour and its extent depends on

A

contrast and the surrounding normal tissue

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5
Q

why is CT is vital in RT treatment planning

A
  • electron density is needed for dose calculations due to densities of different tissues
  • delineation of OAR and target volumes can be in 4D or 3d
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6
Q

CT provides

A

Excellent visualisation of tissues with different xray attenuations values eg bone and tissue

not very good visualisation of tissues with same xray attenuations values eg tumour and healthy soft tissue

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7
Q

Improving TVD and OAR localisation:

A

increase quality by removing artefacts , add contrast , reducing motion

combining different modalities w CT eg PET, MRI, ultrasound

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8
Q

CT Images recieved

A

in axial and reconstructed in sagittal and coronal plane

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9
Q

Each acquired image is

A

2D matrix pixels in the x and y axis but has measurement of depth (depth is in slice thickness)

each pixel has a depth in 3D aka a voxel

voxel is given a grey shade during image reconstruction

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10
Q

for maximum image resolution

A

slice thickness should be small as possible

Number of slices ↑ Patient dose ↑

RT planning scan: Range from 1.25mm - 5mm

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11
Q

Partial Volume Effect

A

occurs when tissues of widely different absorption are encompassed on the same CT voxel producing a beam attenuation proportional to the average value of these tissues.

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12
Q

Detrimental effect of slice thickness on image resolution

A

↑ slice thickness

↓ image resolution

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13
Q

Partial Volume Effect: Example

thick slice

A

borders are less defined and attenuation values are difficult to recognise

slice thickness contains normal tissue below and above nodes

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14
Q

Partial Volume Effect: Example

thin slice

A

border and attenuation value more accurate
node occupies whole slice thickness

delineation and measurement are more accurate but
ALARA

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15
Q

Grey Scales –CT Images

A

CT produce 256 grey shades (32 to human eye)

represent different tissues and their electron densities and attenuation

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16
Q

The mapped greyscale value is called

represents

A

Hounsfield units

standardisation of Ct value greyscale

17
Q

Density of tissue can be extrapolated from….

A

CT units of attenuation (hounsfield units)

scale is ranging +3000HU to -1000HU
0 HU being water

18
Q

CT colours

A

more dense structures (radio opaque) display as white

less dense structures(radiolucent) as darker

19
Q

CT Images
what does black mean
what does white mean

A

-low attenuation …. air or lung tissue
•air above diaphragm = respiratory tract
•air below diaphragm = digestive tract

-high attenuation - bone, cartilage , metal

20
Q

CT colours

what does grey mean

A

-medium attenuation

eg organs, muscles , lymph nodes of body fluids (soft tissues)

21
Q

5 Basic Densities in X-ray attenuation

Material. Appearance

A
  1. gas black
  2. fat dark grey
  3. soft tissue / fluid light grey
  4. bone/Calcification white
  5. metal intense white
22
Q

image manipulation

A

setting a window to a particular HU range so you can view those tissues in that range

“Windowing” grey scale bar to adjust contrast and intensity refining of slice

23
Q

CT:TVD

advantages

A
  1. electron densities generated in CT can be in dose calculations for treatment planning
  2. reasonable image quality
  3. widely available
  4. images can be manipulated
24
Q

CT:TVD

disadvantages

A

ionising
only gives structural info
no info on tissue type and functional activity
other modalities required for this …eg PET and MRI