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Manual TPS BrachyTherapy

Manual TPS BrachyTherapy Note: The software proposed here is designed for research issues. Do not use it for clinic of commercial issues. 1 – Introduction TPS_BrachyTherapy is a software platform for developing and sharing research results in radiation therapy treatment planning. TPS_BrachyTherapy is written in the widely-used Matlab® language (version 7.0 or later), allowing for low-cost development of verification, visualization and analysis tools. TPS_BrachyTherapy can create a brachytherapy treatment plan independently and verifies the dose calculated by the TPS for HDR brachytherapy using either the Sievert Integral or the AAPM TG43 parameters. It can evaluate the estimated dose by constructing DVHs. 2 – Requirements TPS_BrachyTherapy needs Matlab® version 7.0 or later. If you do not have a Matlab® version 7.0 or later, you can use the compile of the Matlab Runtime version libraries (http://www.mathworks.com/matlabcentral/fileexchange/5268) 3 – Getting Started Once all requirements have been downloaded, get start the software by double left click on the executable file «TPS_BrachyTherapy.exe» and you will get the main interface of the software and which is presented in the figure (1) as the follows: 1 - Screen to show the image loaded. 2 - List of the images loaded. 3 - Loading the images button. 4 - Select the first image of the breast zone where you will achieve the treatment planning. 5 - Select the last image of the breast zone where you will achieve the treatment planning. 6 - A checkbox to have the ability to draw the contour around the surgical bed. 7 - A checkbox to have the ability to draw the contour around the lungs. 8 - A checkbox to have the ability to draw the contour around the heart. 9 - A checkbox to have the ability to draw the contour around the skin. 10 - Buttons to delete the contour has been drawn to the surgical bed, the lungs, heart and the skin. 11 - A check box to set the contours on each image has been planned within the first and the last image selected only. 12 - Save contours button. 13 - Load contours button. 14 - Open the dosimetry interface button.

http://www.mathworks.com/matlabcentral/fileexchange/5268


Example Once you have downloaded the baggage «Breast_Brachytherapy_Tools.rar» from the website of U703 and then you have extracted the files, you can find the following: 1 – Series of anonymised patient's images. 2 – The TPS_BrachyTherapy file that contains the executable files «TPS_Brachy Therapy.exe» 3 – Read me Pdf file. You can start now safely: 1 – Double click on the «TPS_BrachyTherapy.exe» and you can show an interface like that in the figure (1). 2 – Load the images series by clicking on the «Loading Images» button, and then select your images to load them, then you can show each image you want by clicking (using the left mouse button) on the image in the list and you can then change it by the «up» and «down» arrows on your keyboard. 3 – To achieve a correct planning you have to select carefully the group of the mages that you will make your plan on them, by select the first image and the ilast image of the clinical region interesting. 4 – If you haven’t any contours text file to load it, you can make as follow: on each image you select from the first to the last image selected exclusively, you achieve the contours for (surgical bed, lungs, heart and skin) respectively. Once you have finished drawing your contours, you can save them by clicking on the «Save contour» button to use them in other time by load them by using the «Load Contours» button.


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Figure 1: Main interface of the dose verification tool for high dose rate brachy‐

y treatment planning.

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Now you can start the brachytherapy dosimetric planning by clicking on the «Dosimetry» button, so you can show a second interface titled «Dosimetry» and this interface is presented in figure (2) as the follows: 1 – List of High-Dose-Rate Iridium 192 models. 2 – Catheters number input. 3 – Seeds number of high-dose-rate iridium 192 in each catheter input. 4 – Dwell time seeds in catheters input. 5 – Air Kerma Strength of the radioactive seeds used (A.K.S.) input. 6 – Total dose delivered. 7 – Input (In) and Output (Out) catheter coordinates buttons. 8 – Input and Output catheter coordinates (x, y and z) of the catheter inserted. 9 – Clear the input and output catheters coordinates’ button. 10 – Dose distribution button to the Sievert integral method. 11 – Dose distribution button to the TG43 formalism. 12 – DVH and conformity index button. 13 – Sievert Integral method checkbox. 14 – Fusion (Dose/Image) checkbox to the Sievert integral method. 15 – Left and Right next (for images and for fusion Dose/Image) buttons. 16 – Screen to show the images and also the (dose/image) fusion for Sievert Integral method. 17 – TG43 Formalism checkbox button. 18 – Fusion (Dose/Image) checkbox to the Sievert integral method. 19 – Screen to show the images and also the (dose/image) fusion for TG43 formalism Once you have clicked on the «Dosimetry» button to start the dosimetric plan, so for create a good treatment plan dosimetric, you have to follow the following steps respectively: 1 – Select the of High-dose-rate Iridium 192 model from the list of models. 2 – Input the number of catheters that you will insert in the interest region. 3 – Input the number of seeds of Iridium 192 and this number of seeds will be placed on each catheter. 4 – Input the dwell time that will be used for each seed in the catheters. 5 – Input the value of the Air Kerma Strength of each radioactive seed. 6 – Select the method of dose calculation by check in on the Sievert Integral checkbox or on the TG43 formalism checkbox. 7 – Using the left «next image» button and right «next image» button, select the image that you will determine the enter coordinates of the catheters. 8 – Click on the «In» button and that enables you to select coordinates points from the screen (16) or from the screen (14) in the figure 2 using the mouse for cursor positioning, the coordinates of the point selected will be showed in fields (8) in figure 2.This coordinates present the input coordinates of catheter. 9 – Click on the «Out» button and that enables you to select points from the screen (12) or from the screen (14) in the figure 2 using the mouse for cursor positioning, the coordinates of the point selected will be showed in fields (8) in figure 2.This coordinates present the output coordinates of catheter. 10 – The number of input clicks and output clicks and the catheters number must be same. 11 – If you have make a mistake to determine the coordinates of input or output


catheters you can use the « Clear coordinates » button to clear the points selected and to re-select a new the input and output points. 12 – Now if you have selected the Sievert Integral method or the TG43 method, click on the « Dose distribution » button related with the method selected. After a few minutes, you will get the results of your treatment plan and you will show the dose distribution slices integrated with the corresponding Images and the total dose delivered in the target volume in the «Total dose delivered » output.


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Figure 2: The interface for dose calculation parameters


Once you have get a dose distribution using the tow methods, you cans achieve the evaluation of the dose calculated by clicking on the «DVH and conformity index» button, so you can show a third interface titled «Dose volume Histogram (DVH) » and this interface is presented in figure (3) as the follows: 1 – DVH Siev Integ button 2 – DVH TG43 button 3 – Draw screen Here, you can get the DVH analysis by click on the DVH button of the method selected Sievert Integral or TG43, then you can show the DVH diagram selected and the different evaluation parameters of covering the dose the surgical bed and the organs at risque (lungs and heart), so that you can use them to compare this treatment planning with other treatment plans.

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Figure 3: The interface of Dose Volume Histogram (DVH) analysis and the dose comparison criteria.


4 – Copyright© Copyright (c) 2009-2010, Inserm U703, CHRU of Lille, France. Permission is granted to use or modify only for non-commercial, non-treatment-decision applications, and further only if this header is not removed from any file. No warranty is expressed or implied for any use whatever: use at your own risk. Contact to Mohamad Feras MARQA for more information [email protected] and Nacim BETRONI [email protected] Address Inserm U703 152, rue de Dr Yersin 59120 Loos France Lille, in 01/04/2010

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