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User's Guide
iSis 3D
WARNING
The iSis 3D software has been carefully developed, and checked as far as
possible. In spite of this efforts, some errors remains because it is not
possible to test every path neither every situations. We expect from you to
help us to enhance this product by let us know the coming up errors with
the help of fault sheet. Also thank to let us know which enhancement
you'd like with help of upgrade required sheet.
The clinical utilization is under the user's responsibility, whose has to
validate the obtained results. The most critical aspects, in term of
quality results or security, are indicated in bold characters.
TABLE OF CONTENTS
ISIS 3D - V 2.35 - March 2003 i
I. First contact and starting the application .......................................................... I-1 I.1 Introduction ...................................................................................................... I-1 I.2 User interface - generalities............................................................................ I-1 I.3 Starting the application ................................................................................... I-3 I.4 Customization of the application ................................................................... I-4
II. ISIS 3D - GENERAL PRINCIPLES ....................................................................... II-1 II.1 The functions hierarchy ................................................................................. II-1 II.2 Coordinate system and geometrical conventions...................................... II-1
II.2.1 Reference system and conventions for imaging equipment ........................ II-2 II.2.2 Machine parameters...................................................................................... II-3
II.3 Dose calculation.............................................................................................. II-5 II.3.1 Computing options......................................................................................... II-5 II.3.2 Taking heterogeneity's into Account ............................................................. II-7 II.3.3 Taking penumbra into account...................................................................... II-9 II.3.4 Theoretical and effective contribution ......................................................... II-10 II.3.5 Equivalent radiobiological doses................................................................. II-13
II.4 Elements of dialog ........................................................................................ II-15 II.4.1 Generalities.................................................................................................. II-15 II.4.2 Box for selecting the calculation plane ....................................................... II-16 II.4.3 Box for selecting the beam.......................................................................... II-18 II.4.4 Graphical representation of beams :........................................................... II-20 II.4.5 Management of the images and the box for adjusting the image contrast II-27 II.4.6 Box for the management of the list of isodoses ......................................... II-28 II.4.7 Options box for the calculation of the voxel’s volume ................................ II-29
II.5 Print................................................................................................................. II-32 II.6 Concept of “zone”......................................................................................... II-33 II.7 Statistics of activity ...................................................................................... II-34 II.8 Digitizer .......................................................................................................... II-34 II.9 Matching images (option) ............................................................................ II-36
II.9.1 Principle ....................................................................................................... II-36 II.9.2 Format of the series .................................................................................... II-36 II.9.3 Utilization ..................................................................................................... II-37
II.10 DICOM RT exchanges................................................................................... II-37
III. File menu .............................................................................................................. III-1 III.1 New .................................................................................................................. III-1
III.1.1 Creation of a new study starting from zero.................................................. III-1 III.1.2 Importation of external elements.................................................................. III-3
III.2 Open ................................................................................................................ III-6 III.3 Close................................................................................................................ III-8 III.4 Save ................................................................................................................. III-9 III.5 Kill .................................................................................................................. III-10 III.6 List of slices.................................................................................................. III-12 III.7 List of beams ................................................................................................ III-12 III.8 Treatment time.............................................................................................. III-13 III.9 Dose/volume contributions ........................................................................ III-16 III.10 Print current plane ....................................................................................... III-17 III.11 Print study..................................................................................................... III-19 III.12 Eject sheet .................................................................................................... III-20 III.13 Import ............................................................................................................ III-20
TABLE OF CONTENTS
ii ISIS 3D - V 2.35 - March 2003
III.13.1 Import contours ...........................................................................................III-20 III.13.2 Import Beams ..............................................................................................III-22
III.14 Export .............................................................................................................III-24 III.14.1 Export beams ..............................................................................................III-24 III.14.2 Exporting DICOM RT Contours/Beams......................................................III-27
III.15 Quit .................................................................................................................III-29
IV. Slices Menu.......................................................................................................... IV-1 IV.1 Header and list of slices ............................................................................... IV-1 IV.2 Create from..................................................................................................... IV-6
IV.2.1 Create from image ....................................................................................... IV-6 IV.2.2 Create from digitizer..................................................................................... IV-8
IV.3 Modify............................................................................................................ IV-10 IV.4 Duplicate/Adjust........................................................................................... IV-10 IV.5 Kill .................................................................................................................. IV-11 IV.6 Origin............................................................................................................. IV-11 IV.7 Opposed Z .................................................................................................... IV-12 IV.8 Structures/Bolus .......................................................................................... IV-12 IV.9 Expansion ..................................................................................................... IV-14 IV.10 Volumes ........................................................................................................ IV-17 IV.11 Points Of Interest ......................................................................................... IV-18
IV.11.1 Points Of Interest’ management box ........................................................ IV-18 IV.11.2 Input box for the characteristics of the points of interest........................... IV-20
V. procedure creation/ modification of contours ................................................. V-1 V.1 Selection of the slices to contour................................................................. V-3
V.1.1 The box for selection of images.................................................................... V-3 V.1.2 Passing from a slice to another .................................................................. V-10 V.1.3 The Slice Menu ........................................................................................... V-10
V.2 Contouring (slice by slice)........................................................................... V-11 V.2.1 Manual contouring....................................................................................... V-14 V.2.2 Automatic contouring .................................................................................. V-15 V.2.3 Contouring - modify..................................................................................... V-17 V.2.4 The trace mode ........................................................................................... V-20 V.2.5 Automatic Densities Calculation ................................................................. V-21 V.2.6 Structures/Bolus .......................................................................................... V-22
V.3 Display............................................................................................................ V-22
VI. Beams Menu ........................................................................................................ VI-1 VI.1 New and Change ............................................................................................ VI-2
VI.1.1 The window for creation/ modification of beams......................................... VI-2 VI.1.2 Creation and modification of the current beam ........................................... VI-4 VI.1.3 Beam parameters......................................................................................... VI-6 VI.1.4 Display options: .......................................................................................... VI-22
VI.2 Duplicate ....................................................................................................... VI-23 VI.3 Opposed........................................................................................................ VI-23 VI.4 Mirror ............................................................................................................. VI-24 VI.5 Kill .................................................................................................................. VI-24 VI.6 Dose per fraction ......................................................................................... VI-25 VI.7 Virtual simulation and field shape............................................................. VI-25
VI.7.1 The View Concept...................................................................................... VI-27 VI.7.2 Creation/Modification of a beam or of a view ........................................... VI-28
TABLE OF CONTENTS
ISIS 3D - V 2.35 - March 2003 iii
VI.7.3 Introducing and adjusting the field shape ..................................................VI-29 VI.7.4 Exporting the field shape............................................................................VI-34 VI.7.5 Multi-leaf collimator.....................................................................................VI-37 VI.7.6 Display options and calculation of DRR.....................................................VI-40
VII. ISODOSES MENU ...............................................................................................VII-1 VII.1 Calculation .....................................................................................................VII-1
VII.1.1 All beams .....................................................................................................VII-1 VII.1.2 Current beam...............................................................................................VII-2 VII.1.3 Calculation options ......................................................................................VII-2 VII.1.4 Saving the dose calculations.......................................................................VII-5
VII.2 List ..................................................................................................................VII-6 VII.3 Normalization.................................................................................................VII-8 VII.4 Dose at one point ..........................................................................................VII-9 VII.5 Profiles and exportation.............................................................................VII-10 VII.6 Dose/ Volume Histogram ...........................................................................VII-14 VII.7 New plane.....................................................................................................VII-20 VII.8 Kill plane.......................................................................................................VII-23 VII.9 New zone......................................................................................................VII-23 VII.10 Zone display ................................................................................................VII-23 VII.11 Importation of doses ( stereotactic ) ........................................................VII-24
VII.11.1 Generalities................................................................................................VII-24 VII.11.2 Launching the import.................................................................................VII-24 VII.11.3 Mechanism of associating the existent and imported planes...................VII-25 VII.11.4 Display and printing the results.................................................................VII-26
VIII. Display menu .....................................................................................................VIII-1 VIII.1 Image .............................................................................................................VIII-1 VIII.2 Contours........................................................................................................VIII-2 VIII.3 Beams............................................................................................................VIII-2 VIII.4 Isodoses ........................................................................................................VIII-2 VIII.5 Registered image .........................................................................................VIII-2 VIII.6 Isodoses 3D ..................................................................................................VIII-2 VIII.7 Level/Window ...............................................................................................VIII-3 VIII.8 Zoom..............................................................................................................VIII-5 VIII.9 Restore ..........................................................................................................VIII-7 VIII.10 Grid ................................................................................................................VIII-7 VIII.11 Distance measurement................................................................................VIII-7 VIII.12 Angle measurement.....................................................................................VIII-8 VIII.13 Visualization 3D (option) .............................................................................VIII-8
IX. Windows Menu .................................................................................................... IX-1 IX.1 Open on selection .......................................................................................... IX-1 IX.2 Store current plan .......................................................................................... IX-1 IX.3 List of photographed studies ....................................................................... IX-2
X. 3D Visualization ....................................................................................................X-1 X.1 surface reconstruction ...................................................................................X-1 X.2 Change zoom and the point of view .............................................................X-2 X.3 Display or hide objects...................................................................................X-3 X.4 Change object representation mode, color and transparency .................X-3 X.5 Change the value of the isodose surface ....................................................X-3 X.6 Print window ....................................................................................................X-4
TABLE OF CONTENTS
iv ISIS 3D - V 2.35 - March 2003
X.7 Display other scenes...................................................................................... X-4 X.8 Return to calculation mode ........................................................................... X-4
APPENDIX A. Text editor B. Description of set-up file
B1. Default set-up of application B2. File access zones configuration file B3. List of protocols B4. Defaults set-up Level/Windows B5. Color table B6. Automatic FTP parameters
C. Conversion, of Hounsfied number to densities, curve format D. Descriptiion of study files
D1. Slices file D2. Beams file D3. Administrative file
E. Export doses file format F. Waterphantom Program G. Photon Compensators
G1. Users’ guide G2. Description of Compensator file "DEPTH" (.PRF) G3. Description of Compensator file "REAL" (.CPR) G4. Description of Compensator file "THEORETICAL" (.CPT] G5. Description of Compensator file "HEK" G6. Description of Compensator file "Machine file"
H. Menu summary I. List of figures and tables
CHAPTER I - FIRST CONTACT
iSis 3D - V 2.35 - March 2003 I-1
I. FIRST CONTACT AND STARTING THE APPLICATION
I.1 Introduction
ISIS3D is part of the “ISIS” package of programs for radiotherapy. It concerns the
treatment planning part and the calculation of dose distributions for external
radiotherapy. Before starting the application some preliminary stages concerning data
preparation should be accomplished:
• create of the treatment unit library
• adapt the application to the needs and requirements of the user
• acquire the anatomical information of the patient under treatment
Not all these aspects are referred in the present brochure. The interested reader
should refer to the documents dedicated specifically to the subjects enumerated
before for more details.
I.2 User interface - generalities
The user interface is of the “MOTIF” type. All along the application will be encountered
a homogenous presentation, making use of pop-up menus, multiple windowing, dialog
boxes and buttons.
It is thus important to get familiar with this environment, very similar to those
encountered under Windows or Mac OS. In particular, the same important role is find
for the mouse, having the possibility to move, open or close graphical windows, to
access pop-up menus, select a string of characters, position the cursor in the text,
etc…
There are however some specific features :
The mouse has three buttons. In most of the cases the left button is used. The other
buttons are used only for some specific functions. The double click is sometimes used,
mainly to enter into the change mode (of slice or beam) or to select the field containing
the value selected to be replaced with another value, introduced from the keyboard.
CHAPTER I - FIRST CONTACT
I-2 iSis 3D - V 2.35 - March 2003
Every window, (including some boxes or menus) have in the upper part a title bar that
can be “dragged” with the mouse in order to move the window. On either sides of the
title bar is found a small box. The one at the left of the title bar accesses a control
menu of the graphical windows and the one at the right permits to transform the
window into an icon. This last process can be used at any moment. It transforms the
window into a small square (“icon”) identified by a drawing and a title recalling the
content of the window. The icon appears in a corner of the screen and can be
displaced to any other position. Double clicking on the icon makes the window retrieve
its original dimensions. On the contrary to what happens in the standard accessible
applications, in ISIS3D the dimensions of the window cannot be modified by clicking
and dragging their margins. The way a window is closed is again controlled by specific
buttons, the traditional “closing boxes” have no effect in this case. The user can
customize the screen as he wishes, transform the graphic windows into icons when he
wants them to be at hand but prevent the screen from being agglomerated without
reason.
Inside the windows are frequently found two types of buttons:
• The rectangular buttons on which is found a text or a symbol are used to start a
process.
• The on/off buttons have a characteristic appearance reflecting their status
(pressed or not). They allow the selection of some options. Sometimes they are
replaced by small boxes to be marked by the user.
CHAPTER I - FIRST CONTACT
iSis 3D - V 2.35 - March 2003 I-3
I.3 Starting the application
After keyboarding the user name and the password a window having on the upper part
a menu bar will appear on the screen, allowing the user to select the application
(Figure I-1).
Figure I-1 : Launch menu
This menu bar contains the “External R.T.” pop-up menu, which gives access to
starting the application ISIS 3D.
By choosing the option ISIS 3D from the pop-up menu you actually start the
application. A window is displayed at the upper left of the screen, showing that the
initialization is taking place. When the initialization is finished there are two important
possibilities:
• A study was interrupted following an accident and the computer asks if you want to
work again on this study,
• No previous study was interrupted and the computer displays the main menu bar of
the application ISIS 3D (Figure I-2)
Figure I-2 : iSis3D main menu
The main menu bar proposes the following choices:
• FILE :
o Create, open, save, print or close a file.
o Display summary of slices, beams, treatment time, dose/volume contribution
o Contours and Beams data import / export
CHAPTER I - FIRST CONTACT
I-4 iSis 3D - V 2.35 - March 2003
• SLICES :
o Acquisition and/or modification of the anatomical data
• BEAMS :
o Define, position and modify the beams.
• ISODOSES :
o Calculation and display of the dose distributions.
o Define non-transverse plan
o Dose / Volume Histogram
• DISPLAY :
o Chose the options for displaying the treatment plan.
o Display grid, measurement tools
• WINDOW :
o Options and "snapshot" of windows.
Each of the previously enumerated choices gives access, if simply clicking with the
mouse on it, to a specific submenu listed on the vertical. An arrow situated at the right
of the specific option indicates the presence of a supplementary choice level.
The detail of functions associated to each menus is explain later (see page III-1),
immediately after the section related to general principles of iSis 3D.
I.4 Customization of the application
Numerous elements of the application could be parameterized according to the user’s
preferences.
These preferences are specified through the files whose full description is given in
Annex 2: “Description of the parameter files and of calibration”.
The options and principal customizations of parameters are:
CHAPTER I - FIRST CONTACT
iSis 3D - V 2.35 - March 2003 I-5
o the working zones (cf : Appendix B2, Description of the parameter files and
of calibration, Format of the calibration file for accessing the files),
o the protocols (cf : Appendix B3, Description of the parameter files and of
calibration, Format of the protocol file),
o the optimal visualization of a tissue type (cf : Appendix B4, Description of the
parameter files and of calibration, Format of the file containing the list of the
pre-settings),
o the options for the automatic calculation of the complex fields (cf : Appendix
B1, Description of the parameter files and of calibration, Format of the file
containing the parameters of the terminal),
o the default options for the dose calculations (cf : Appendix B1, Description of
the parameter files and of calibration, Format of the file containing the
parameters of the terminal),
o the display options (cf : Appendix B1, Description of the parameter files and
of calibration, Format of the file containing the parameters of the terminal),
In a general frame, the mentions “customizable” and “customizable file” of this manual
make reference to the “parameter file of the terminal” described in Appendix B1
CHAPTER I - FIRST CONTACT
I-6 iSis 3D - V 2.35 - March 2003
CHAPTER II - GENERAL PRINCIPLES
iSis 3D - V 2.35 - March 2003 II-1
II. ISIS 3D - GENERAL PRINCIPLES
II.1 The functions hierarchy
After transferring to the system the images to be used, if this is necessary, the general
principle of functioning of iSis 3D is the following:
1. Creation of the file for a new patient
2. Creation of a set of contours from a series of slices (introduced via
digitizer or from images)
3. Assigning characteristics to the internal contours
4. Creation of the beam configuration
5. Calculation and study of the dose distribution in different slices
6. Saving and eventually printing the study
7. Eventually modify the study and return to 5
8. End session
More than this, as soon as a series of contours has been defined, it is possible to
obtain a surface 3D representation of the structures, completed if it is the case, with
the beams representation and the surface isodoses (option “3D surfaced”).
Apart from this standard scheme, many other similar schemes are possible, having, in
particular, the option to go back at any time to a previous function and to perform at
that stage a correction. The interdictions are controlled by the program and the
“dangerous” maneuvers or anomalies are signaled with dialog boxes.
99 slices, 40 structures and 56 beams can be defined at maximum.
II.2 Coordinate system and geometrical conventions
The introduction of the noncoplanar mode and other more and more automatic
treatment techniques, requires a high precision from the coordinates system and the
geometrical conventions. For the description of the machine’s parameters we have
CHAPTER II - GENERAL PRINCIPLES
II-2 iSis 3D - V 2.35 - March 2003
tried to comply as close as possible to the norms of the International Commission for
Electrotechnology (ICE 1217).
II.2.1 Reference system and conventions for imaging equipment
The reference coordinate system is link to the couch. The patient is supposed lie on
his back, the head towards the gantry (related to the patient), it is an orthogonal
system whose Z axis coincides with the longitudinal axis of the patient oriented from
the toes to the head. The X,Y plane is a transverse plane through the patient (X has
the sense from the right to the left of the patient and Y is parallel to the anterior-
posterior direction, as shown in the figure II-1). This system is associated with the
isocentric rotation of the table.
In this system, the anatomical structures are represented by an assembly of
transverse contours (perpendicular on the Z axis). The contours can be introduced
from the digitizer or directly from scanned images (or IRM).
.
Y
X
Z
o
Figure II-1 : Reference coordinate system
In this last case, the images corresponding to the slices acquisition are
necessarily axial (perpendicular to the Z axis). They must be acquired in treatment
position with the gantry and the table at zero degrees orientation. They are always
supposed to be looking towards the gantry. On the other hand, the patient position
CHAPTER II - GENERAL PRINCIPLES
iSis 3D - V 2.35 - March 2003 II-3
relative to the gantry is arbitrary: he may lie on his back, on the belly or on his side, the
head towards the gantry or in the opposite direction.
The patient position during the image acquisition in the scanner tunnel is specified
generally and transmitted together with the images. In the program iSis this
information is illustrated with indicators of the orientation (anterior, posterior, right, left)
which are displayed on the screen and on the printed document. In case of the images
are acquired "foots first", there are doubt on the way to interpret the orientation and an
warning message is displayed. If the position is not defined, the orientations X, Y, Z
are those previously specified.
The origin is defined when the contours are created. Afterwards it can be displaced
using the function “SLICES/Origin”. The measurement unit is the cm. A specific
function permits to invert the orientation of the Z axis, if necessary (“SLICES/Z
opposed”).
In most of the graphical windows, the position of the cursor is indicated by the pair (x,
y). For the transverse slices, it deals with the coordinates in the radiotherapy
coordinates system. On the other hand for other representation planes (oblique, virtual
simulation), the (x, y) pair represents the coordinates relative to the origin of the
displayed window. To avoid any possible confusion, the corresponding labels are
noted u (instead of x) and v (instead of y).
II.2.2 Machine parameters
For the machine parameters we followed rigorously the last recommendations of IEC
(1217). Relative to the anterior versions of iSis, some supplementary specifications
should be made:
- The field dimensions and the collimator rotation keep the same conventions.
However the terms “length” and “width” are avoided. They have been replaced by FX
and FY defined as follows (for a zero degrees collimator rotation):
• FX (instead of “width” La) perpendicular to the gantry rotation axis
• FY (instead of “length” Lb) parallel with the gantry rotation axis
CHAPTER II - GENERAL PRINCIPLES
II-4 iSis 3D - V 2.35 - March 2003
Note that convention from CEI for FX and FY dimensions has changed FX and FY, as
a result, for a certain number of treatment units, FX corresponds to the “Y” dimension
and FY to the “X” dimension!!
Note as well, that the “collimator opening” is henceforth defined at the isocenter. In
SSD, it does not deal anymore with the field dimensions defined at the skin surface. A
message reminds the user if a SSD treatment is done with a SSD value different than
SDA.
- For asymmetrical collimators, the values employed are the coordinates in the
coordinate system defined by the axes FX, FY, in such way that for a zero degrees
rotation of the table and the collimator, the gantry positioned at zero degrees, the
orientation of the axes FX and FY should coincide with the x and z axes orientation
respectively. In this way are obtained:
• X1 negative for a symmetrical field
• X2 positive for a symmetrical field
• Y1 negative for a symmetrical field
• Y2 positive for a symmetrical field
As in the case of FX and FY we refer now to the “collimator opening” (the field at the
isocenter) and not any more to the field at the skin surface.
- The only rotation allowed for the table is an isocentric rotation of the “patient
support”, in such way that the angle is increasing when the table rotates in the
counterclockwise sense, beams eye view, with the gantry at 00. Attention, the
convention from CEI for couch rotation has changed. It is thus in contradiction with
what is used for most of the tables installed, and with the program STEREO version
V038 !!
ATTENTION !
Generally speaking it is up to the user to check the conformity between the
conventions used in iSis and those of the treatment unit. In the case that they do
not agree the user should make sure that the appropriate conventions are properly
applied, in the case of putting into practice a treatment planned on iSis, or to
CHAPTER II - GENERAL PRINCIPLES
iSis 3D - V 2.35 - March 2003 II-5
calculate the dosimetry of a patient already in treatment position on a given
treatment unit.
II.3 Dose calculation
It is important that the user be aware of the possibilities and limitations of the dose
calculation algorithms therefore to know the basic principle of the method. These
principles are described in specific documents to which the interested reader is invited
to refer for more details (cf : Creation of the treatment unit library for the utilization of
iSis2, iSis3D, Calcum, Plex programs).
However, in the following paragraphs are given some indications with the aim to clarify
the selection of calculation options, the way to account for the heterogeneities, for the
penumbra and the weighting factors.
II.3.1 Computing options
The rich variety of new calculation options possibilities (since version 2.0) may confuse
the users. It is important to understand the fact that these possibilities are the result of
the following developments:
a) accounting for the real depths; the calculations are not any longer done like in
the versions anterior to 2.0, parallel o the beam axis but they are done
accounting for the beams divergence
b) the amelioration of the computational model so that it accounts for the
modifications of the lateral scatter, important especially in the case that a part of
the beam is in air (“double cutting out” method)
c) introduction of the noncoplanar mode, where the depths must be calculated on
the basis of three dimensional representation of the entrance surfaces and not
only on the basis of a cylindrical extension of the calculation section
d) introduction of the heterogeneity correction for electron (and proton) beams
e) the necessity to have as much as possible compatibility between the calculation
times and an interactive use of the system.
CHAPTER II - GENERAL PRINCIPLES
II-6 iSis 3D - V 2.35 - March 2003
f) Introduction of the equivalent radiobiological dose (cf.: § II.3.5, iSis3D – General
principles , Equivalent radiobiological dose).
To these developments is adding up the possibility to have a higher precision in the
isodoses representation by introducing a finer calculation grid and with variable step.
In the following paragraphs are presented schematically the principles:
• The “double cutting out” permits to account for the scatter variation as a
function of the depth of the element who gave this contribution. It is thus
important when the entrance surface present irregularities and even more when
a part of the beam is in air. It is not (for the moment) applied to account for the
scatter variation due to the presence of the wedge filter: it is the total dose which
is modified by the effective wedge transmission in the considered point. To
ensure its validity, the entrance surface of the patient should be defined for the
entire field surface. Hence it cannot be applied if a sufficient number of slices of
adequate thickness were not defined. Note that in the case the slices are not
joined (signaled by a message), the continuity between slices is realized through
interpolation and the detailed data are available from list of slices” (Z and
rescaled thickness). A warning message signals if the distance between the
slices seems not suitable with the field dimensions.
• The “simple cutting out” method was used in the previous versions. It
accounts for the scatter on the basis of a planar surface, perpendicular to the
axis and passing through the entrance point of the beam joining the source with
the calculation point. It is well adapted to regular entrance surfaces, entirely
covered by the field.
• The choice “fast” option is referring to the manner how the depths are
calculated for the primary beam attenuation:
o The “fast” mode considers only the first point of intersection of the
source-calculation point ray with the entrance surface; hence the rapid
method should be avoided if there are significant concavities and the
beam risks to get out in air, before meeting the calculation point.
o In “standard” method (answer “no” to the option “fast”), if the beams are
coplanar or not, the depth calculation is based on the “real” surface,
CHAPTER II - GENERAL PRINCIPLES
iSis 3D - V 2.35 - March 2003 II-7
corresponding to the slices packing, and it accounts for partial passages
through air (the case of arm, or ear).
II.3.2 Taking heterogeneity's into Account
The heterogeneity corrections can be applied either based on the introduced contours
(from the digitizer or from scanned images), or, in the case of images, using directly
the density information from the corresponding pixels matrix (option “voxel/voxel”).
Note that the conversion from Hounsfield numbers (“CT numbers”) to density is done
using the file « sc.den », which must contain the calibration curve of the scanner ( cf: :
Appendix C, : Conversion of Hounsfied number to densities, curve format ).
a) Correction based on Contours
Each closed contour is assigned a uniform density different from 1 (valid for all the
slice thickness) in one of the four following cases:
1 - the contour is created and associated to a structure previously defined with a
density different than 1
2 - the option “automatic calculation of densities” is not selected but a density
different from 1 is explicitly assigned to the contour (function "change")
3 - the option “automatic calculation of densities” is selected, the assigned
density is the average of the values obtained for the pixels in the interior of the
contour.
4 - the density of a structure is modified (function “structures”) - the densities of
all the contours associated to this structure are modified as a consequence.
The contours declared as “free makers”, i.e. those which are not associated to any
structure, even if they have a density different from 1, are taken into account for
coplanar photon beams but are not (for the moment) taken into account as
heterogeneities neither for electron beams, nor for proton beams, nor for noncoplanar
photon beams (rotation of the couch different from 0). Warning messages announce
the user about these particular cases.
CHAPTER II - GENERAL PRINCIPLES
II-8 iSis 3D - V 2.35 - March 2003
In the case it is effective, the following method is applied:
• For photons, the Batho method with beam subtraction (Kappas) accounts for
the scatter modifications including those due to small heterogeneity's located in a
big field or in points located laterally relative to the heterogeneity's. This method is
considered “standard”. So as it is implemented, it gives sometimes aberrant results
for heterogeneity's of complicated shapes (mainly “ring” shapes). More, it is not
applicable for noncoplanar beams.
For noncoplanar beams the Simple Batho method is used as “standard
method (based on the field dimensions at he level of the calculation point).
Differences may appear relative to the corrections applied for coplanar
beams in the case a small heterogeneity is placed in a big field and for points
located at the margins of the heterogeneity (in the interior or exterior of it). To
pass from the method “beam subtraction” to the “simple Batho” method it is
sufficient to modify slightly the table rotation (for example taking 0.10 instead
of 00).
• For electrons the method of equivalent “radiological depth” is applied (isodoses
translation). As it is implemented it is not compatible with the double cutout
method. If is required a double cutout together with heterogeneity correction, then
the simple cutout method will be used in fact for electron beams.
• For the protons, whatever is the chosen calculation method, only the primary is
accounted for. The heterogeneity correction through the “equivalent depth” does
not rise any problems.
The heterogeneity correction factor at the normalization is displayed in the beam
list for the beams which were used for isodoses calculation. It is equal to the ratio of
dose with on dose without heterogeneities.
b) Correction voxel by voxel
The Correction voxel by voxel does not require the explicit introduction of the contours
delimiting the structures. The voxels densities reconstructed directly from scanned
images are used. In order to be a valid reconstruction, a complete scanning of the
joined slices should be previously performed to acquire the necessary data. From
these scanned images the program will start reconstructing a voxel matrix. The
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characteristic of the voxels volume calculation are defined into dialog box. (cf.: § II.4.7,
iSis3D – General principles, Option box for calculation of voxel’s volume) These data
are display into each calculation plan as well as into dose/volume histogram windows.
“Het. Cor. : vox/vox P=0.85 R=2 NbZ=55”
where : P is the sampling step, R is the reduction factor to convert CT resolution to
Voxel resolution and NbZ is the number of voxel along the Z axis of the voxel volume.
For each calculation point, the program searches, within a surface limited by the
external contour, the voxels located between the source and the calculation point, on
the basis of a sampling process, the sample being of half the calculation grid step, as
defined on “calculation options”. The sum of the transverse thickness, weighted by
the elementary densities of each voxel, allows the calculation of an “equivalent
depth” for the point of calculation.
• For the photons, the dose is then correcte3d by the tissue-phantom ratio (TPR)
for this equivalent depth and for the true geometrical depth, taking as the field
dimensions the dimensions of the square field equivalent to the collimator opening
at the measurement point level. This TPR (or TAR) method is not as good as the
Batho method with beam subtraction for the interior of the heterogeneity or its
proximity. Apart from this case it gives equivalent results.
• For electrons and protons, the equivalent depth is used directly as in the case
of contours based correction.
II.3.3 Taking penumbra into account
The representation of the penumbra region makes use of the collimation constants
previously adjusted and stored in the treatment unit library, and accounts for the
influence of scatter and the lack of electronic equilibrium nearby the beam’s edges.
ISIS 3D makes automatically the difference between the field edges delimited by the principal collimator and those delimited by the additional blocks (secondary collimation). When a polygon segment which defines the field shape is superimpose to the edge defined by the principal collimator (with a margin of ± 2 mm), the principal collimator is taken into account for that segment. If this is not the case, the secondary collimator is taken into account (at the distance source-tray and for a transmission corresponding to the no. of trays used). According to the different segments
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considered, the penumbra width will be thus different, especially on the case of Cobalt 60 and electron beams.
For the trimmers, the distance source - trimmers and the transmission corresponding
to the no. of trimmers used are preserved for the entire field contour.
II.3.4 Theoretical and effective contribution
It is recommended to give particular attention to the importance of each beam’s
contribution (also called weighting) and to the relation with the calculation of the
treatment time (or number of monitor units). This contribution may be expressed as
absolute dose (Gy) or percentage, conform to the user choice. The point where this
contribution is calculated is called normalization point (see c, principles and example
of use) .
a) notion of “theoretical contribution” and “effective contribution”
The notions of “theoretical” contribution (or weighting) and “effective” contribution have
been introduced in order to take maximum advantage of the performances of the dose
calculation algorithms and in order to keep a link with the most accessible quantities
including in some complex situations (such as blocks placed on the beam axis) :
- the theoretical contribution (on the theoretical weighting point) refers to the
following conditions:
• Semi-infinite, water-equivalent, homogeneous medium with a flat surface
perpendicular to the beam axis at the entry point (intersection with the skin)
• Field defined by the primary collimator, having the actually used dimensions but
being always symmetrical in respect to its axis.
• Without any additional shielding blocks or multileaf collimator but with possible
presence of a block tray
• With possible presence of a trimmer
• With possible presence of a wedge and/or a bolus and/or a compensator
- the effective contribution (on the effective weighting point) takes into account all
the “real” characteristics of both the patient (irregular entry surface, heterogeneities
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etc.) and the radiation beam (asymmetrical collimator, additional blocks, multileaf
collimator etc).
In the case of electron beams only the “effective weighting” mode is authorized due to
the modification of the depth of maximum dose when an electron block is added.
b) Position of the weighting point
The weighting point is a point inside the patient, in principle associated to the radiation
beam, where the beam contribution is provided. This point may be placed either on the
collimator axis (most frequent case) or outside this axis (e.g. whenever there is a block
on the axis). The weighting point defined by the user is always the so called “effective”
weighting point. It is superimposed to the “theoretical” weighting point (where the
“theoretical” contribution is being provided) only when it is placed on the beam axis
and it is a matter of a photon beam. On the other hand, if the “effective” weighting
point is not placed on the beam axis, then the “theoretical” weighting point is placed on
the beam axis at the same depth with the “effective” point. Furthermore, for electron
beams, the “theoretical” weighting point is always placed at the depth of maximum in
absence of electron blocks, independently of the depth of the “effective” weighting
point.
The various possibilities are shown bellow:
• On-Axis Weighting :
o SSD Technique :
- For photon beams, the weighting point on the beam axis is either
at a depth specified by the user (a depth greater than the depth of
maximum dose), or at the depth of maximum dose, calculated
automatically for a field defined by the primary collimator (when the
depth entered by the user under theoretical conditions is zero).
- For electron beams, the depth of the weighting point is always the
depth of dose maximum, calculated under “real” conditions, taking
into account the additional electron blocks.
- For proton beams, the weighting point must be placed on the
modulation plateau. The point can be placed automatically in the
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II-12 iSis 3D - V 2.35 - March 2003
middle of the modulation plateau by entering a weighting depth
equal to zero.
o SAD or ARC Technique :
The weighting point is always the isocenter, that may be found beyond the
depth of maximum dose.
• Off-Axis Weighting :
In that case, it is a matter of a point defined as a “Point Of Interest” of the type
“Weighting Point” (cf.: § IV.11, iSis 3D - Slices Menu, Points Of Interest).
o For photon beams, the depth of the ‘Point Of Interest’ must be greater
than the depth of dose maximum.
o For electron beams, there isn’t any verification over the depth of the
‘Point Of Interest’.
o For proton beams, the depth of the ‘Point Of Interest’ must correspond to
the depth of a point placed on the modulation plateau.
Weighting at the depth of max.
dose
Weighting on the axis Weighting at any point
photons Yes depth > depth of max isocenter if SAD or ARC
depth > depth of max
electrons Yes Prohibited in SSD mode Isocenter if SAD or ARC
no verification
protons Prohibited on the modulation plateau isocenter if SAD or ARC
depth of the modul. plateau
Table II-1 : Possibilities and system verification – Summary
c) Principles and examples of use
When the dose (or the percentage) contribution from a beam at the effective weighting
point is being expressed as “effective contribution”, it is taken into account in the
calculation of the dose distribution and the treatment time as an “effective” one and we
can be sure that the desired dose (or percentage) will be attributed to that point. On
the other hand, if that dose is expressed as “theoretical contribution”, then it will be
modified such that the actual characteristics of the irradiation are taken into account in
the calculation of the dose distribution. For example, in the case of a field defined by
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iSis 3D - V 2.35 - March 2003 II-13
blocks that reduce by 10% the dose at a point situated on the beam axis at a certain
depth (due to the reduction of the total scattering volume), a “theoretical contribution”
of 10 Gy (5 fractions of 2 Gy) at that point corresponds to an “effective contribution” of
9 Gy and a treatment time of 1min per fraction. If we imagine that the contribution of
10 (Gy) is expressed either as a “theoretical contribution” or as an “effective
contribution”, then we have the following results:
contribution of 10 expressed
as:
calculated theoretical
contribution
Calculated effective
contribution
dose at the weighting point
Calculated treatment time
per fraction theoretical 10 (9) 9 1 min
effective (11,1) 10 10 1,11 min
Table II-2 : Example of calculation with theoretical and effective contribution
The interest of this approach is the possibility to use independent and simplistic
software for the calculation of the treatment times (or the Monitor Units) under
theoretical conditions. For example, in the case described above, this software would
give directly a treatment time of 1 min for the delivery of 10 Gy at the weighting point,
under theoretical conditions (or 1.11 min for 11,1 Gy etc.). It is also a way to keep a
weighting point on the beam axis, even if it is situated under a block, provided that we
work in “theoretical contribution” mode.
The deviations between “effective” and “theoretical” contribution appear explicitly in the
“List of Beams” in the form of two corrective factors :
• A corrective factor for the modifications in respect to a water-equivalent
homogeneous medium : Ef/Th(hom).
• A corrective factor for the tissue heterogeneities: Het. Cor..
Note : A part of the deviations appears due to the difference between the penumbra of
the primary collimator and the penumbra of the additional collimator. This difference
may, in some extreme cases, result to corrective factors (Ef/Th(hom)) slightly greater
than 1 (for example when a block creates a penumbra that is narrower than the
penumbra of the primary collimator).
II.3.5 Equivalent radiobiological doses
The representation in radiobiological equivalent dose distributions is intended to
translate the biological effects caused by the fractionation, taking into account the fact
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II-14 iSis 3D - V 2.35 - March 2003
that at each session the patient receives in every point a dose different from that
prescribed. This effect is amplified, since the beams are not delivered all the same
day. The representation is expressed under the form of “classical fractionation
equivalent dose”, and can be adjusted at request, generally corresponding to a 2 Gy
per session. The used method is based on a linear quadratic model.
II.3.5.1 The Linear Quadratic model
The linear quadratic model is a mathematical model, which allows taking into account
the fractionation of an irradiation, in order to calculate its biological effect. The
mathematical model (given below) maintains its validity while the doses per fraction
are comprised within 1 and 5 Gy. It is up to the user to take into account this validity
range for the interpretation of the results.
Mathematical formula:
Let D be the total physical dose applied at a point P, for a fraction of d Gy.
Let a be the biological coefficient alpha/beta (expressed in Gy) corresponding to point P
The equivalent radiobiological dose per fraction of 2 Gy (LQED2Gy) to point P is:
LQED2Gy = D*(a+d)/(a+2)
This corresponds to a total dose delivered at the point P in 2 Gy fractions, which would
have the same biological effect as the total dose D delivered in d Gy fractions.
II.3.5.2 Seizure of the parameters
The visualization under ISIS 3D of the equivalent doses necessitates the knowledge of
the following parameters:
o alpha/beta coefficient
o doses per session and per beam, at the weighting point
o distribution of the dose expressed in total dose (Gy)
o grouping of the beams
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a) Choice of the alpha/beta coefficient
This parameter allows taking into account the biological nature of the irradiated
structures. It is generally fixed at 3 Gy for the healthy tissues with late response and
10 Gy for the healthy tissues with early response and the tumors.
The choice is performed within the dialog box which allows the management of the
structures (cf : § IV.8, iSis3D – Slice menu, structures/Bolus). This coefficient actually
is unique and is applied to all the points within the patient. The default value of the
coefficient (for example 3 Gy) is fixed within the customizaton file.
b) Choice of the doses per session and the grouping of beams
The values of the doses per session are those given for the calculation of the
treatment time (cf : § VI.6, iSis3D - Beams menu, Dose per fraction). At the
corresponding input box one can equally specify the group number to which each
beam belongs. All the beams of the same group are assigned to the same treatment
session.
For the calculation to be valid, the weights of each of the beams should imperatively
be expressed in total doses (in Gy) at the weighting point.
c) Visualization of the equivalent doses
The type selection of the displayed doses is performed within the dialog box of the
calculation options. The choice is proposed between the physical doses and the
radiobiological equivalent doses (cf : § VII.1.3, iSis3D - Isodoses Menu, Options of
calculation). The change is immediately taken into account; this is reflected on the
display of the isodoses for every calculation plane and on the representation of the
dose volume histograms (DVHs), the calculation type (EQUIVALENT RADIOBIOLOGICAL
DOSES) and the used parameters being recalled for this calculation.
II.4 Elements of dialog
II.4.1 Generalities
The main elements with which one can work while preparing a treatment plan are the
following:
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II-16 iSis 3D - V 2.35 - March 2003
o a principal menu bar
o a box for selecting the calculation plane
o a box for selecting the beam
o graphical window
The basic graphical windows represent the calculation planes, wherein are displayed
images, contours, beams and isodoses. One of these windows, selected by a mouse
click is brought in front of the others, it is the current window, on which are effective
the functions from the principal menu. For more efficiency, the other windows, apart
from the current one, are not updated systematically. The windows not updated are
signaled with the message “DISPLAY TO REFRESH” displayed in the upper left corner of
those windows. When a window becomes the current window it is automatically
updated.
Other windows or boxes may remain permanently open to give access to certain
functions. It is, for example, the case of the window which permits to adjust the image
contrast (level/window) and of that window which permits to modify the list of
isodoses. Other windows are temporary and created only to realize certain stages of
the dialog. They must be closed in order to continue working and to access other
functions (see in mode virtual simulation, summary of slices, beams, Treatment
time,… zoom, selection, contouring, etc...).
The stage contouring, (creation and then modifications of contours) behaves like a
separate application which uses a specific window and a specific menu (cf.: § IV,
iSIs3D - Slices Menu).
Note: The menus and the windows logically inaccessible are automatically
transformed into icons, and they retrieve automatically their original size when they
become again accessible.
II.4.2 Box for selecting the calculation plane
The box for selecting the calculation plane (Figure II-2) permits to decide on the plane
to work with and to adjust the dimensions of the associated graphical window. It
contains the list of planes previously defined, identified by a code and their position:
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- The transverse slices wherein at least an external contour was defined are
identified by Ci, where i is the n° of order of the slice, as well as by its associated Z
value (in the radiotherapy coordinate system). These slices are ordered in ascending Z
order.
- The calculation planes which do not correspond to slices are identified by two
letters followed by a number: FR for frontal, SA for sagittal, FO and SO for oblique
frontal and sagittal oblique. Their position is identified by the distance d to the origin of
the coordinates, and for the oblique planes, by their angle.
The current plane, i.e. the plane on which are applied the selected functions is
identified by a frame. To make a plane the current plane click (once) on the plane
name in the box. The same result can be obtained if the window is already open by
clicking on it, this will make it pass in the front plane.
The selected planes are identified by a cross at the left of their name. When a
nonselected plane is made the current plane, it is automatically selected. To deselect
the current plane click (once) on the button labeled “no”. It switches then to “yes”. A
new click on this button makes it switch again and reselects the plane. The selected
planes are those for which the dose distribution is wanted. Only the selected planes
are taken into account for the automatic calculation of the isodoses in “all” the planes
(cf.: § VII.1.3, iSis3D - Isodoses Menu, Calculation Options) and during the global
print of the study (cf.: § III-8, File Menu, Treatment time).
The selected planes can be or not displayed. According to the chosen option
(cf.: § IX.1, iSis3D - Window Menu, "Open on selection"), they can be or not
automatically displayed in the moment they are selected. One click on the button
window, while it is labeled “open” displays the window of the current plane, using the
default dimension. Pressing one of the buttons in the upper part of the selection box:
“<” for small, “-“ for medium, or “>” for big, it is possible to open the window directly at
the desired size or to change its actual size.
This symbol is always present at the right of each plane name, when its corresponding
window is opened. The window can be closed clicking on the window’s button when it
is labeled “close” or made an icon if clicking on the corresponding small box of title
bar.
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Figure II-2 : Calculation planes selection box
Double clicking on the line corresponding to a slice in the selection box has the
meaning of a demand to modify the selected slice Si (cf.: § IV, iSis3D - Slice Menu).
The box for the selection of the calculation plane is permanently displayed while not in
the mode creation/modification. It can be displaced or made an icon, but it cannot be
nether resized nor deleted.
II.4.3 Box for selecting the beam
The box for selecting the beam (Figure II-3, Figure II-4) is made up of two area:
o the first lists horizontally the names of all the beams of the current study and
allow to define the display options.
o the second makes the correspondence between each beam and its activity
status. It specifies as well if the weighting factors of the following line are
expressed as “theoretic” or “effective” (cf.: § VI, iSis3D - Beam Menu), and allow
to define weighting factor.
The name of the current slice is recalled in the upper left part of the box for
selecting the beam. The name of the current beam is highlighted, it is the beam
which will be taken into account by the functions accessible from the BEAM menu.
The current beam is traced with red and has a more complete representation in the
graphical window than the other beams of the study.
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iSis 3D - V 2.35 - March 2003 II-19
Figure II-3 : Beams selection box (1)
The name of the current slice is recalled in the upper left part of the box for selecting
the beam. The name of the current beam is highlighted, it is the beam which will be
taken into account by the functions accessible from the BEAM menu. The current beam
is traced with red and has a more complete representation in the graphical window
than the other beams of the study.
The display mode for non-coplanar beams or for non-transverse planes can be
selected in a pop-up list that offers three options : “all”, “none” and “ax/pt” for the “axis
and the intersection point between the axis and the plane”. The only available options
for the display of coplanar beams on transverse planes are “all” and “none”.
The beam display modes are explained in detail in the paragraph II.4.4, Graphical
representation of beams
The selection of the current beam is done by a simple mouse click. A double click has
the meaning of a demand to modify the selected beam. A simple mouse click on the
current beam cancels this property, as a consequence no beam is at that moment the
current beam, and only the option “New”, from the BEAM menu is accessible.
For the current slice, the status of the beam is shown in the second line of the box
(Figure II-4); the beams for which a dose calculation was done are emphasized by
shaded rectangles. In this case, the buttons, pressed or not, indicate the activation
status of each beam.
The “calculated” beams are traced with thick green lines in the graphical window of the
corresponding slice.
The calculated beams can be activated all with the button “All”, while the current
beam can be activated and in the meantime all the other beams deactivated with the
button “Curr. B”.
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Finally every beam can be activated or deactivated individually (Figure II-4), clicking
on the button which shoes the activation status of the beam. The individual
activation/deactivation become effective only after clicking with the mouse on the
validation button located in the lower left part of the box (“Display isodoses for
beams:”).
Figure II-4 : Beams selection box (2)
It is possible to search the best combination of the weighting factors, which gives the
desired dose distribution, editing directly the weighting factors values in the
corresponding fields. The introduced values are validated by touching the Tab button
(or clicking in a different field) and immediately accounted for.
When the maximum capacity of the box (11 beams) is exceeded, an arrow appear
allowing to analyze all the defined beams.
II.4.4 Graphical representation of beams :
The graphical representation of the beams depends on the nature of the beam :
coplanar or non-coplanar, the nature of the calculation plane : transverse or non-
transverse, and the status of the beam : current or not, calculated or not.
The current beam is always drawn with red. The rest of the beams are drawn with
green (for calculated beams) or white (for not calculated beams). Furthermore, the
calculated beams are drawn with lines of double thickness.
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iSis 3D - V 2.35 - March 2003 II-21
In general, the following elements are drawn (cf.: § VI.1.3, iSis3D - Beams Menu –
Beam Parameters) :
• the beam axis,
• the reference point,
• the weighting point,
• a legend reminding, among other things, the beam index,
• the limits of the primary collimator,
• the field limits,
• the presence of a wedge if there is any.
a) Graphical representation of coplanar beams in transverse planes:
When a beam is coplanar and the plane is transverse (Figure II-5), the drawing
corresponds to a truncated cone with a divergence that depends on the field size and
the source-isocenter distance. For the current beam, the field limits are extended
beyond the reference point (by 25cm in SAD mode and by 40cm in SSD mode) and
the field shape follows the external contour. Otherwise, the field limits are drawn up to
the patient surface and the field shape is not drawn at all. The field limits are drawn
using dashed lines, the field shape is drawn using solid lines and the beam axis is
drawn using a solid line on the reference slice and a dashed line on any other slice.
In the case of irregular shaped fields, the drawing of the field limits is enhanced using
“T”-shaped bars perpendicular to the beam axis illustrating the distance between the
limits of the primary collimator and the border of the irregular field. The field shape is
shown using two drawings: the first one shows the limits of the primary collimator
using dashed lines, the second one shows the shape of the irregular field using solid
lines (Figure II-6).
The reference point is represented by a crosshair having the form of a « ». The
weighting point is represented by a crosshair having the form of a « » (Figure II-6).
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II-22 iSis 3D - V 2.35 - March 2003
Figure II-5 : Coplanar beams into a transverse plane (1)
In the case of irregular shaped fields, the drawing of the field limits is enhanced using
“T”-shaped bars perpendicular to the beam axis illustrating the distance between the
limits of the primary collimator and the border of the irregular field. The field shape is
shown using two drawings: the first one shows the limits of the primary collimator
using dashed lines, the second one shows the shape of the irregular field using solid
lines (Figure II-6).
The reference point is represented by a crosshair having the form of a « ». The
weighting point is represented by a crosshair having the form of a « » (Figure II-6).
The legend denotes the name of the treatment machine and the Source – Reference
Point Distance (SAD or SSD). In case of collimator rotation there is an « R » added on
the legend (Figure II-6).
Coplanar Beam (not the current one) : color is white, field shape is not drawn, field limits are drawn up to the patient surface, beam axis is not on the slice.
Coplanar beam (current beam) : color is red, field shape is drawn, field limits are extended, beam axis is on the slice
Coplanar Beam (not the current one) : color is white, field shape is not drawn, field limits are drawn up to the patient surface, beam axis is on the slice.
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Figure II-6 : Coplanar beams into a transverse plane (2)
When a wedge is being used, there is a triangle drawn on the beam axis, just outside
the external contour, oriented according to the wedge orientation (cf.: § VI.1.3, iSis3D -
Beams Menu, Beam Parameters, Wedges). The following figure presents the 4
available wedge orientations (provided that the collimator rotation is equal to 0°):
“right”, “left”, and “gantry”, “target” (Figure II-7).
When a compensator is being used or when the beam intensity is being modulated
(e.g. using a dynamic multileaf collimator), a line segment is drawn perpendicular to
the beam axis indicating that this is an Intensity Modulated Beam (Figure II-8).
Bars indicating the difference between the primary collimator limits and the irregular field limits.
Reference Point
Weighting Poin
« R » indicating a collimator rotation
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II-24 iSis 3D - V 2.35 - March 2003
Figure II-7 : Wedge representation
Figure II-8 : Intensity Modulation with Compensator or MLC
Right orientation Wedge
Left orientation Wedge
Target orientation wedge
Gantry orientation Wedge
Intensity Modulated Beam by physical compensator or dynamic collimator
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b) Graphical representation of non-coplanar beams in any type of planes (transverse or
non-transverse) and representation of any type of beams (coplanar or non-coplanar) in
non-transverse planes:
When the beam is non-coplanar or the plane is non-transverse, the beam is
represented by its intersection with the plane, limited by the external contour. The
irregular fields are drawn using solid lines and the primary collimator using dashed
lines (Figure II-9).
Figure II-9 : Plane perpendicular to the beam axis of an anterior beam
The beam axis projection is drawn with a solid line when the axis is situated on the
observer’s side, with a dashed line when the axis is situated to the other side. A circle
marks the intersection point between the beam axis and the plane. The drawing is
extended up to the reference point if the later is located beyond the point of
intersection with the plan.
Structures (dashed)
Primary Jaws (dashed)
Irregular Field Shape (solid)
Circle indicating the intersection of the beam axis with the plane
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The legend associated to the beam, is located close to the external contour when the
drawing of the beam axis extends beyond the contour, otherwise close to the
intersection point between the beam axis and the plane.
Whenever there is a collimator rotation an « R » is added on the legend. A « B » is
added when a bolus is being used, a « P » is added when a trimmer is being used, a
« C » is added when a compensator is being used and a « M » is added in the case of
Intensity Modulated Beams.
Wedges are represented by a 3D dihedral having its base perpendicular on the beam
axis. Those points that are found in front of the representation (i.e. foreground) are
surrounded by a circle and the line segments that link them are drawn with solid lines
while the segments located behind the representation (i.e. background) are drawn with
dashed lines.
Figure II-10 : Non coplanar beam into transverse plane
NOTE : During the graphical representation of coplanar beams, it may happen at the
field edge, that the truncated cone appears to be closed but a field shape is being
drawn. This is the case when the beam limits do not intersect the external contour due
to the beam divergence: the truncated cone appears then to be closed, but there is still
an intersection between the beam and the representation plane.
Wedge
Extension of the beam axis projection from the intersection point to the reference point
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II.4.5 Management of the images and the box for adjusting the image contrast
The images to appear on the screen and serve as basis for the contours definition
must have been previously converted to the format ISIS 3D. These images should
exist as “with threshold” (or “calibrated”). According to the options valid at the moment
of the translation they were converted, but as well as “raw” images (Figure II-11).
Figure II-11 : Gray level selection
In the images with threshold are preserved only 64 gray levels, regularly distributed
between the low level and the high level chosen during the conversion. These levels
are by default (in the Hounsfield scale) between -1000 and +3000.
To benefit of a better image quality, the raw image can be saved during the image
conversion. In this case is occupied more space on the disk and the times of access
are longer but all the information present in the original image will be preserved. The
idea is then, before the display, to cutout a part of the raw image density scale and
rescales it in 64 levels. The choice of this density region belongs to the user, as well
as its moment and is free of constraints, and is done entering the mode high
resolution. This mode is particularly useful for the brain images, where the contrast is
generally low.
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The adjustment of the image contrast on the screen is done with the function
level/window (cf.: § VIII, iSis3D - Display Menu) which opens a box for adjustment
(Figure II-7). This box for adjustment, described in the chapter DISPLAY menu, makes
the correspondence between the selected density intervals (or Hounsfield numbers)
and a gray scale, going from white to black. The adjustment box for the image contrast
remains permanently open, so that the user has all the time “at hand” the tools
allowing him to adjust the quality of the display according to his wish.
Figure II-12 : Level / Windows adjustment box
II.4.6 Box for the management of the list of isodoses
This box (Figure II-13) contains the current list of isodoses. The values displayed by
default are either “standard” values, calculated automatically from the dose values of
the current plane, or ”initial” values, predefined by the user in a given protocol.
The user can modify (button Change) or delete (button Kill) individually, the value of
each isodose. Other buttons allow going back to the “standard” list or the “initial” list
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iSis 3D - V 2.35 - March 2003 II-29
and redrawing all the isodoses. A button allows adding isodoses, while a list permits to
define their colors to be displayed on the screen. Finally, a button permits to close this
window.
Figure II-13 : Isodose management box
II.4.7 Options box for the calculation of the voxel’s volume
ISIS 3D offers the possibility to choose the calculation options for the voxel’s volume,
the DRR’s and the dose calculations in voxel/voxel heterogeneity, in order to allow the
user to optimize the quality/speed ratio. The dialog “Options DRR and voxel/voxel” is
systematically proposed since the first calculation of the DRR or since the first
calculation of voxel/voxel doses performed after the opening of the folder or after the
modification done on the slices data affecting the external contours.
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It is equally accessible within virtual simulation, by the push-down menu
“DRR/options…” and within the “Calculation options” dialog by the “Options…” button,
which is activated if the heterogeneity correction voxel/voxel option is chosen.
At the first opening, the option box contains the default parameters adapted to the
study and to the used workstation. When the study is retaken, the parameters used
from the preceding session of the same case are preserved.
Once the options are modified, all the dose calculations should be performed again
excepting for the already reconstructed DRR’s, which are saved.
CHARACTERISTICS OF THE VOXEL’S VOLUME
The characteristics of the voxel’s volume, influences the calculation of the DRR’s and
the voxel/voxel calculations.
- Dimensions of the images XY (pixels) (not adjustable)
The numbers of image pixels on X and on Y (slices) are used for the construction of
the voxel’s volume.
- XY reduction factor
Ratio (integer) between the X and Y dimensions of voxel volume « images » and
original images.
Ex: Dimensions of the images XY (pixels) : 512 x 512
If Factor = 1 (high resolution), the dimension of the voxels volume: 512 x 512 x Z
If Factor = 2 (medium resolution), the dimension of the voxels volume: 256 x 256 x Z
If Factor = 4 (coarse resolution), the dimension of the voxels volume: 128 x 128 x Z
By default: 1 for the stations having 128 MB RAM
2 for the stations having less than 128 MB RAM
- Adjacent images having the same thickness (not adjustable)
Information field (yes or no) indicating if the slices are homogeneous. If affirmative, the
volume reconstruction time is diminished.
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Figure II-14 : DRR and Voxel options box
- Number of voxels in Z
Number of equidistant “images” recalculated for constructing the voxel’s volume.
By default: - nbcoup (number of slices) if the slices are homogeneous
- nbcoup*2-1 if the slices are non-homogeneous
Validity: from 1 to 198
- Volume Dimension (voxels) (not adjustable)
Recapitulative of the dimensions of the reconstructed volume (in number of voxels)
following the precedent definition of parameters.
- Dimension of one voxel (mm) (not adjustable)
Recapitulative of voxel dimensions in millimeters, following the precedent definition of
parameters.
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CALCULATION OPTIONS FOR THE DRR’S
- Calculation step (mm)
Not used for sampling the points on the source -> target segment (point of the DRR)
By default: half of the smaller dimension of a voxel
Validity: minimum 0.01 mm
- Sharpness factor (dim vox/dim pix)
Ratio, between the dimension of a voxel and a dimension of a DRR pixel, allows
modifying the grain sharpness of the DRR. The image resolution is getting better as
this ratio is higher, but the DRR generation time is longer.
By default: 1.00
Validity: real number (preferably between 0.5 and 2)
- Dense tissues threshold (Hounsfield)
Starting value from which one point is considered dense for the DRRs reconstruction
of the dense tissues and DRR soft tissues.
By default: 350 (parameters file)
Validity: 0 to 2900
CALCULATION OPTIONS VOXEL/VOXEL
- Calculation step (mm)
Not used for sampling the points on the source -> target segment for the calculations
in voxel/voxel heterogeneity.
II.5 Print
The printing of most types of windows is possible at any time, either by pressing the
button "print", or selecting the item “print current plane” from the file menu. The
presentation of the document on paper is very close to what you see displayed on the
screen, according to the principle "WYSIWYG" ("what you see is what you get"),
keeping a strict control of the scales. At each print command, a confirmation box is
opening, allowing to select the output peripheral, and to specify a certain number of
options. The printing is always done as “background printing”, so that the user to
continue his work without having to wait for the end of the job printing. All paper
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iSis 3D - V 2.35 - March 2003 II-33
formats are compatible, especially A4, A3, and A2. In some cases, more windows can
be printed on the same page, under the control of the operator.
The texts (tables, lists) can be directed, according to the choice, to “text” printers
(alphanumeric) or graphic printers but the graphics can only be directed to graphical
printers (HPGL or Postscript for example). The images are as well printed when the
printer allows it (Postscript).
It is as well possible to start printing globally an entire study, choosing the elements we
want to be effectively printed. In this case should be selected the item “Print study”.
The detailed description of the printing process control can be found in the paragraph
dedicated to the issue "Print study" from the “File” menu.
II.6 Concept of “zone”
The operations of creating or deleting a study, contours or beams import, beams or
doses export, creation from images, etc. make use of the concept “zone”.
A zone is a location identified by a name chosen by the user, where he can regroup
according to his wish the files or other elements for a better organization of his work.
From the advantages of this organization we count just the following:
o possibility to regroup the studies by zones in view of retrospective studies (for
example “breast” zone, “stereotactic” zone, “conformal” zone, zone “Dr. Dupont”,
…),
o possibility to use directly files or images located on other media (the case of
many drives) or on another network node,
o possibility to “import” elements (images, contours, beams) originating from other
applications and located on other media or on another network node: it is for
example the case when a file is destined to a virtual simulation station (e.g.:
"Advantage Sim" of GEMS, or "Acqsim" of PITKER)
o possibility to create libraries of contour types (phantoms) or beam configurations
in zones specially dedicated to this, and to “import” them in order to facilitate the
creation of new studies.
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The definition of new zones (regions), their path, and the associated authorizations are
to be done in a parameters file, created at the installation which may be later adjusted
(cf.: Appendix B2, Access Zones file).
II.7 Statistics of activity
A file of “statistics” can be created and updated systematically at each file closure,
in order to have available at posteriori information on the use of iSis 3D.
This file contains, for each study, information such as the patient and the calculation
identifications, the number of contours or beams.
This file can be then accessed by a text editor or exported to a program for database
management to extract from it useful information on the activity of preparing treatment
plans.
II.8 Digitizer
The digitizer is a device use to acquire manually contours (anatomical contours,
complex field) from film or other supports.
The digitizer is divided between 4 areas :
• One working area using the most surface of the digitizer, in which one the
objects are acquired (contours, ...),
• Three dialog areas, these area could be located in one of the corner of the
working area, this depend of the model and configuration of the digitizer. On
ACCUGRID digitizer the dialog area are replaced by button on the cursor. In this
case the area named CALL doesn't exist anymore.
This areas are :
o CALL (Not used with ACCUGRID)
o CORRECTION (button N° 2 on ACCUGRID)
o END OF WORK (button N°4 on ACCUGRID)
An acquisition sequence can consist of the acquisition of several objects (external
contours, internal structures, free markers, ...), all this objects should be located inside
the working area.
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- Call :
An acquisition sequence is controlled by messages displayed in the dialogue zone in
left bottom corner of the visualization window.
E.G. : Plot middle of table - absolute origin - C1
Plot contour C1, at the end do "END OF WORK"
Plot marker 1 of contour C1,
etc....
The points are acquired by positioning the pointer (the pen or cross of the cursor) on
the point to acquire and by pressing the pen or the button of the cursor).
A point will be valid only if a short sonorous signal (bip) is emit. A long bip indicate the
needed to get this point one more time. A message is displayed in the execution
program window.
- Correction :
It is possible to correct the point that you have just acquire if you think that it is a wrong
point.
To do this, you have to click in the correction area then get this point one more time
If you click twice in the correction area, you delete the current contours, then you have
to acquire all the point for this contours.
- End of work :
One click inside this area tell to the computer that the object is completely acquired
and that we want to go to next step of acquisition.
When several object can be successively acquired, a simple click inside END OF WORK
area achieved the acquisition of this object, when the last object has been acquired a
double click inside END OF WORK area achieve the sequence.
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II.9 Matching images (option)
II.9.1 Principle
The use under ISIS 3D of two images series belonging to the same folder (study case)
makes possible the elaboration of a treatment plan with the support of different nature
images (Scanner/MRI, Scanner/fusion,…). The user can switch from one series to the
other one, according to the specific needs of each elaboration phase (contouring,
beam creation, dose visualization).
WARNING !
In order to be able to use two image series it is suitable to previously have
rescaled the images with appropriate external software (for example an image
analysis workstation). One distinguish the main image series (generally scanner
slices), which serve as basis for the matching, and the matched image series
(usually MRI slices), whose geometrical characteristics (orientation, position,
thickness of the slices) were recalculated in order to be identical to those of the
principal image series.
It is up to the user to ensure that it effectively works with compatible image
series.
II.9.2 Format of the series
In order to jointly be used under ISIS 3D, the two image series should respect the
following constraints:
o the names of the image folders should be in “name_series” and
“name_series_r” forms, where the full character strings should have a length
less or equal than 16 (or a maximum of 14 characters for series_name before
adding the “_r” suffix).
o The image folders should be found in the same image “zone”.
o Within these 2 folders, the image files should bear the same names if they
belong to the same slice, so as to find the correspondence of the image
couples. (cf : Technical documentation – Descriptive of files – 10.5 module of
homogenization the file names of two image series).
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II.9.3 Utilization
The existence of the two image series is detected after one study is created and
specifically at the moment when the choice regarding the images is taken into account.
This happens again when the study is retaken. It is possible in most of the cases when
an image is displayed (slice or restored plan), to switch immediately between the
principal image and the corresponding rescaled image. This switch is obtained by
selecting the “Matched Images” item from the “Display” menu. It is equally obtained by
pressing simultaneously the “Ctrl” and “r” keys (with lowercase “r”).
Despite the existence of the two series, certain functions are applicable only to the
principal images: calculation of the densities, calculations voxel by voxel, calculation
and representation of the Digitally Reconstructed Radiographs (DRRs).
II.10 DICOM RT exchanges
ISIS 3D offers the possibility of importing and exporting data concerning contours and
beams according to the DICOM RT standard.
Objects of “DICOM RT Structure” and “DICOM RT Plan” are supported.
• With regard to the importation, a server is permanently available for the
reception of DICOM RT objects. When the server receives a DICOM RT object,
the later is being converted to ISIS format and saved in files having the name of
the patient followed by the study number and the extension “.CTR” for the
contours and the extension ".FSC" for the beams. These files are saved in a
predefined directory (see "ISIS 3D – technical documentation – DICOM
module"). It is then recommended to create a new folder inside ISIS 3D and
“import” the contours and beams corresponding to the DICOM RT objects either
into a new study (cf.: § III.1, iSis3D - File Menu, New) or into a currently used
study (cf.: § III.13, iSis3D - File Menu, Import).
• The exportation of DICOM RT objects can be done inside ISIS 3D using the
following commands: File Menu -> Export DICOM RT, Contours/beams. The
principle of the operation is described in the paragraph III.14.2, File Menu,
Export DiCOM RT Contours/beams.
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CHAPTER III - FILE MENU
iSis 3D - V 2.35 - March 2003 III-1
III. FILE MENU
The file menu proposes the following items:
- New...
- Open...
- Close...
- Save...
- Kill...
-----------------------------------
- List of slices...
- List of beams...
- Treatment times...
- Dose / Volume Contribution…
-----------------------------------
- Print current plane...
- Print study...
- Eject sheet
-----------------------------------
- Import >
- Export >
-----------------------------------
- Quit
III.1 New
The choice New is accessible only if no file is in use. It allows the creation of a new
study in a specified “zone” and gives the possibility to import some elements like the
contours or the beams from already existing files.
III.1.1 Creation of a new study starting from zero
- Create on allows to choose the zone where the study will be saved (Figure III-1).
The patient data file includes the following fields:
• Name: alphanumeric string
• First name : alphanumeric string
• File number : alphanumeric string
• HOSPITAL : scrolling list
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III-2 iSis 3D - V 2.35 - March 2003
• PROTOCOL : scrolling list of "protocols"
Default file name chosen from Name or File Number
Figure III-1 : New study creation box
Once the NAME of the patient is introduced, the apostrophe “ ‘ “ and space “ “
characters are automatically replaced by the dollar $ and underline “ _ “ characters,
because the apostrophe truncates the name of the patient at the display, and the first
space character is considered as a separator between the surname and name of the
patient. The inverse correspondence is established after the export of the beam data.
The keyboarding of the File NUMBER could be optional according to the setup of the
customization file.
The Hospital is initialized with the value of the first hospital found in the library. It can
be modified in order to access the machines of other hospital in the library.
The other data given in the patient data file serve mainly to identify the study to be
created and to propose by default a file name.
Following the chosen option: (Name or File N°), the current study will have by default,
during the first saving procedure, a name based on either of these element. This
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iSis 3D - V 2.35 - March 2003 III-3
possibility is particularly useful when having homonymy problems with the names of
the patients, and is preferable to use the file numbers. The option selected by default
can be set as a parameter at the installation.
With Ok and Import is tested if it exists another study with the same name. If it exists
another study with the same name, the file description, is presented, including patient
name, file number and name, date and the time of the study, comments, ...) and the
user may confirm or refuse the replacement of the previous file.
Remark : Even if the replacement of the file is being asked, this will become effective
only in the moment the file will be saved. It cannot be performed neither if the study
name is modified during the procedure of saving nor if the file is closed without being
saved (cancellation of the file creation). In any case, each time a file with the same
name exists, a confirmation message (or modification message) is displayed in order
to warn the user. This message appears in both cases: when saving ("Save") the
study or closing it ("Close").
The choice of a Protocol makes available, for the next stages of the study, a list of
particular structures, and a list of isodoses, proposed by default. These lists are to be
defined by the person who performs he installation or by the user in a file containing
the studies’ parameters (see the document describing this file). In the case the
contours are imported, only the list of isodoses of the protocol is used, the list with the
structures associated to the imported contours being dominant over the one of the
protocol.
The button Cancel permits to cancel the current procedures.
After confirming by pressing the Ok button, the menu Slices becomes accessible and,
if there is place, the boxes for selecting the calculation plane and the beams are
displayed.
III.1.2 Importation of external elements
The button Import allows the import in a new created study of contours or beams from
the same zone or a different zone, no matter what is the name of the corresponding
files. This function may be useful in the following cases:
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III-4 iSis 3D - V 2.35 - March 2003
Figure III-2 : Object selection box
• systematic studies based on the same contour(s), stored forever in a particular
“zone”,
• recover the contours or the beams created by an external application (linked to
other “stations for virtual simulations” or with system for recording/verifying the
parameters),
• recover “standard configurations” (for example 4 beams in the “box” technique)
stored forever in a particular “zone”,
• recover in a new file the elements already used for other studies (creation of a
demo file, recover after an identification error).
From Import... a dialog box is opening (Figure III-2), including the following elements:
The type of the object to be imported is indicated by a scrolling list: Import. The
importable objects are the Contours and the Beams, in a format specified by the
scrolling list. Actually only the objects in format ISIS are directly importable.
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iSis 3D - V 2.35 - March 2003 III-5
After having eventually selected the region of interest (From), the whole group of
objects present in the region and conforming to specific criteria (type, format) and the
date of their last save are displayed, with an informative notice about the number of
found objects and the searching pattern (for example *.fsc for the beams). The
corresponding list may be displayed either in ascending alphabetical order, or in
descending date order, according to the selected option button).
The selection of a particular button can be done in two ways:
• scrolling the list and selecting the object with the mouse,
• typing the first letters of the object in the field Selection. The list will be
automatically positioned on the firs name which begins with these letters.
The rubric Import into recalls the name and the zone of the file where the objects will b
imported.
The objects can be visualized before the importation by clicking on View..., which
opens the files Header and list of slices and Beams description, for the objects type
contours and type beam respectively.
The import is effectively realized clicking on the button Import or double clicking on the
list. An informative message recalls then the type and the name of the imported object
as well as the file where to the import was done.
The import to the same contours and beams file requires two stages. The first
consists in selecting and importing the first object (either contours or beams, it makes
no difference). The second stage consists in changing the type of the object to be
imported - if it exists, the object with the same name will be selected - and start the
importation.
Once finished the procedures of visualization and import, pressing the button Close
permits to go back to the dialog for creating a new file.
Remarks :
• The object importation is irreversible, there isn’t any “cancel” function. However,
a new importation that will replace the previous one can always be performed.
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III-6 iSis 3D - V 2.35 - March 2003
• While attempting to replace a folder by specifying a folder name that already
exists, even after the initial confirmation by the user, for security purposes, there
appears a second dialog box offering the possibility to restore the existing
contours and/or beams. If the user refuses to restore them, then the new
contours and/or beams may be imported. They will overwrite the existing ones,
even if the folder creation is subsequently abandoned.
• Contours and/or beams can also be imported while a study is in progress. In that
case they are added to the existing contours and/or beams. (cf.: § III.12, iSis3D
– File menu, Importing contours and beams )
III.2 Open
Open is accessible only if no file is in use. It permits to select a patient file from a list of
files located in a certain “zone” (Figure III-3).
After having eventually selected the region of interest (scrolling list), the whole group
of studies, previously saved in the region, and the date of their last save are displayed.
The corresponding list may be displayed either in ascending alphabetical order, or in
descending date order, according to the selected option button.
A particular file can be selected in one of the following two ways presented below:
• read the list and select the file with the mouse (double click to open);
• type the first letters of the chosen file. The list is automatically leading to the first
name starting with these letters. Once having reached the file press OK.
After having selected the name of a file (= study name) and then clicked on the Ok
button, the file is going to be opened and displayed in the stage is has been saved.
According to the customization file, the date of backup of the file and the disk capacity,
the result of dose calculation could be or could not be , recover (cf. : § VII.1.4, iSis3D -
Isodoses menu, Saving the dose calculations). In all cases the automatic calculation
option is deactivated.
At the opening of file the user is inform of the possible presence of 2 series of
matching images (cf.: § II.9, iSis3D - General Principles, Matching images). A
message window give the name of the primary series and specify that the density
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iSis 3D - V 2.35 - March 2003 III-7
calculation, DDR and voxel/voxel heterogeneity will be calculate from the primary
series.
Figure III-3 : Study selection box
If the options corresponding to the open study are not found, we can either Continue
without images, or Find the images in the same region or in a different region.
The message "images not found" indicates that the folder with the image files
associated with the study has been found but at least one image (sometimes all of
them) cannot be associated. For example this is the case when certain files containing
these images have been renamed or deleted.
Remark 1 : A fast access to list of studies has been set up. This fast access could
lead to absence of studies in the list. In this case you should select again the zone to
refresh the list of studies.
Remark 2 : The number of folders that can be listed in the corresponding list is limited
to 1000. Whenever this number is almost reached it is recommended to archive some
folders or move them into a new zone.
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III-8 iSis 3D - V 2.35 - March 2003
Remark 3 : Opening a folder that has been saved using an older version of ISIS3D
(older than version 2.3) may cause a modification of the beam weighting method. This
may happen in the following cases:
In SAD mode, if the weighting point is not the isocenter, then a new Point Of Interest is
created in the place of that point. The weighting method becomes “weighting on a
Point Of Interest” using an “effective contribution”.
For electrons, in SSD mode, the weighting depth must be equal to the depth of
maximum dose. If the specified weighting method was “theoretical”, then it will become
“effective”.
If the case arises, an information message will clarify any modification that has taken
place, concerning the weighting mode/type, the weighting depth and/or the creation of
“Points Of Interest”.
III.3 Close
allows to close the current study in order to be able to create or open another study.
If important changes have been made to the study since its last save, a confirmation
box will open to allow to effectively close - without saving - (Ok), to go back to the
current study (cancel), or to save the file before closing. In this last case, the dialog of
the Save.
Otherwise, if the study is closed, the characteristic data set the of the eventually
incomplete study is printed and only the principal menu bar remains on the screen.
Remark : to access the dialog of the box Save… with the function Close… allow to
rearrange the slices (cf.: § III.4, iSis3D – File menu, Save).
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iSis 3D - V 2.35 - March 2003 III-9
III.4 Save
The dialog box for the saving of the files (Figure III-4) includes :
Figure III-4 : Save study box
• it recalls the zone where it was saved, the name and the number of the patient
file,
• it recalls the properties of the last saving (plan name, date and time of the last
modification performed and comments),
• the possibility to save as under a new name of the Study name and to modify
the comments.
The field study indicates by default the name of the last saved study. If the old file
name is preserved, the old study plan will be replaced (so the corresponding data will
be lost) after confirming the option in the dialog box. On the contrary, a new name can
be proposed to save another version of the treatment plan. This name will be used to
open the study. It can be different from the name of the file which contains the images.
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III-10 iSis 3D - V 2.35 - March 2003
the field comments allow to introduce a text relevant to the study and will appear on
the output documents (it has maximum 72 characters). This field takes by default the
commentaries of the last saved study.
two buttons are dedicated exclusively to save the study with slices filing by
increasing Z. (the slice with the smallest Z becomes C1) or without filing. This
choice is not accessible when the slices are arranged.
Remark : The rearrangement of the slice requires to close and open again the study,
hence this possibility is recommended only when the saving dialog box is open in
the moment of closing the file (File/close... then press the button Save... of the
confirmation box); by File/Save..., the rearrangement of the slices is not
accessible.
Controls are performed by asking the user to press the Ok button to confirm the
eventual replacement of an already archived file (including the case of an update of a
file under the same name). Each saved study corresponds to a different file. To save
more than one study, different names should be used. In case of coincident names the
study is effectively saved, the characteristic data set the of the eventually incomplete
treatment plan is printed and the save dialog is closed.
On Cancel, the study saving is given up.
In the case that problems appear during the process of saving a file, a dialog box
signaling the failure of the process appears.
The user has two options:
• Restart the procedure,
• Interrupt ISIS 3D, search the source of error (the disk is full…) and restart ISIS
3D answering Yes to the question Recover interrupted study ?.
III.5 Kill
permits to delete one or more files from a given zone.
Kill... is accessible only if no study is loaded.
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iSis 3D - V 2.35 - March 2003 III-11
Figure III-5 : Deletion studies box
After having eventually selected the region to be deleted (scrolling list), the whole
group of studies, previously saved in the region, and the date of their last save are
displayed. The corresponding list may be displayed either in ascending alphabetical
order, or in descending date order, according to the selected option button.
A file is selected with a simple mouse click and its name is recalled in the field "File to
be deleted”.
The combination Caps/small fonts + the left button of the mouse permits to include in
the selection all the files between the first selected file and the current position of the
mouse.
The combination Ctrl + the left button of the mouse permits to add files to the current
selection.
The name of the file to be deleted can be introduced from the keyboard, the character
“*” allowing to select the files having in common a part of their name. For example,
*dupon* will select to be deleted all the files 1dupond, dupond, dupont…
Remark : The selection of many files from the list and marking a file name are
mutually exclusive.
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III-12 iSis 3D - V 2.35 - March 2003
If clicking on Ok or Kill a dialogue box will be displayed, presenting the name(s) of the
file(s) to be deleted and proposes to perform or cancel the delete procedure.
III.6 List of slices
displays a window with the principal characteristics of the slices included in the study.
Printing of the list into the chosen peripheral text (cf.: § III.9, iSis3D – File menu, Print
current plane), is done thank to the Print button.
The Ok button permits to close the window
For more details see ,§ IV.1, iSis3D - Slices menu, header and list of slices and figure
IV-1.
III.7 List of beams
displays a window (Figure III-6) describing in a table format the detailed description of
the beams of the study (cf.: § VI.1.3, iSis3D - Beams menu, Beam parameters).
Figure III-6 : List of beams
If there are more than 8 beams, the display (and printing) is done on more than one
page, and to pass from one page to another is necessary to use the buttons next or
previous (materialized by an arrow < or >).
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iSis 3D - V 2.35 - March 2003 III-13
Printing of the list into the chosen peripheral text (cf.: § III.9, iSis3D – File menu, Print
current plane), is done thank to the Print... button.
Pressing the Ok button allows to close the window.
Remark 1 : In case of electron beam, asterisk is displayed beside weighting point
depth in both following cases :
• Technique is not SSD
• Weighting point depth is different as the maximum depth
Remark 2 : In SSD technique, asterisk is displayed beside collimator size if SSD is
different as SAD.
Remark 3 : If the weighting point is not located on the collimator axis, then an asterisk
is displayed in the place of the weighting depth.
Remark 4 : The contribution (“theoretical” or “effective”) that does not correspond to
the specified type is being displayed within brackets.
Remark 5 : The contribution type (“in depth on-axis”, “at the depth of dose max.”, “on a
Point Of Interest”, "at isocenter") is being reminded
III.8 Treatment time
In the case the doses per fraction were defined for at least one of the beams (see
Dose per fraction of the Beams menu) it is possible to display a table (Figure III-7)
giving for each of the beams the time or the number of monitor units to display
(Display). This table recalls as well a certain number of beams characteristics, which
influence the calculation of the treatment time. Finally, the depth of maximum on the
axis (Depth mx) is displayed, in cm, and the dose per session at this point (Th dose
mx) in Gy.
From ISIS 3D-Version 2.3 it is possible to define a weighting point either on the beam
axis, or off-axis on a Point Of Interest. The calculated dose per fraction (Dose T)
corresponds to this weighting point, defined during the creation/modification of beams.
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III-14 iSis 3D - V 2.35 - March 2003
Figure III-7 : Treament time
• For photon beams and for “on-axis weighting ”, it is expressed in terms of
either a “theoretical” dose (without taking into account the influence of blocks
and/or tissue heterogeneities) or an “effective” dose (accounting for blocks
and/or tissue heterogeneities), according to the selected option for each beam.
• For electron beams or else for “off-axis weighting”, it is necessarily expressed
in terms of an “effective” dose. The various correction factors, accounting for
the filed size (Colli), the block tray (Bl. tray), the wedges (Wedge), the blocks
for irregular filed shapes, the definition of an off-axis weighting point (
Ef/Th(hom) ), and the heterogeneities (Heter .), are also reminded. The first 3
come directly from library data. The last 2 are calculated by the system
depending on the field shape, the location of the weighting point and the
existence of tissue heterogeneities. If the dose is expressed in terms of
“theoretical” dose, then they are not taken into account and therefore they are
displayed in brackets.
For further details concerning the “theoretical” or “effective” weighting mode and their
repercussions on the calculation of treatment times, refer to § II.3.4, iSis3D - General
Principles, theoretical and effective contribution.
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iSis 3D - V 2.35 - March 2003 III-15
When a bolus is associated to a beam, the bolus name is recalled (Bolus name), as
well as its thickness along the axis beam (Thickness), and its density (Density).
When bolus is use, the SSD and depth are calculated from the skin. One line
informs about this particularity.
The selected options for dose calculation are recalled.
It is remind that in case of asymmetric or multi-leaf collimator, the calculation doesn't
take in account a eventual influence from this elements on the primary dose : the
Collimator Opening Factor (C.O.F.) used is the one corresponding to the maximum
opening. Only the modification of the scatter is take in account.
The doses and the treatment time are displayed only for the beams for which have
been defined doses per fraction different from zero.
Remark 1 : The treatment for electron beams is not calculated if technique used is
not SSD. Asterisk is displayed beside weighting point depth.
Remark 2 : The weighting mode is displayed and an asterisk next to the weighting
depth is used as a reminder of the distinctive characteristics of that mode
If there are more than 8 beams, the display (and printing) is done on more than one
page, and to pass from one page to another is necessary to use the buttons next or
previous (materialized by an arrow < or >).
Printing of the list into the chosen peripheral text (cf.: § III.9, iSis3D – File menu, Print
current plane), is done thank to the Print... button.
ATTENTION !
The validity of the treatment time calculations are the direct responsibility of the user.
This calculation is strongly dependent on the way the basic data of the treatment unit
library are introduced and interpreted. The data related to the “reference dose flow”,
the collimator opening factor, the accessories’ transmission are particularly important.
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III-16 iSis 3D - V 2.35 - March 2003
III.9 Dose/volume contributions
A window appears (Figure III-8) showing a table including the dose delivered to each
“dose”-type point of interest by each beam (cf.: § IV.11 , iSis3D - Slices Menu, Points
Of Interest). These “dose points” are, in general, chosen so that they are
representative of the “volumes” of interest such as the target volumes or the organs at
risk.
These tables are used in order to separate the contribution of each beam and be able
to cumulate (either by hand or using a Control & Verify system) the dose delivered to
each volume during the treatment.
A first table shows the “absolute” dose delivered by each beam. It concerns not-
normalized values, calculated as the sum from the contribution of each beam (also
shown in the table). This table becomes particularly interesting when each
contribution is expressed in terms of total dose per beam (Gy). In that case, the sum of
each column gives the total dose delivered to each volume (Gy). All values are
rounded within 0.1 Gy.
A second table shows the “relative” dose (%) delivered by each beam to the dose
points. It’s purpose is to facilitate the task of recalculating the beam contributions when
it is necessary to express them in a different way, e.g. in terms of dose per fraction.
The treatment machine library identification, its creation/modification date as well as
the calculation options are also reminded.
The page format allows the display of only 16 beams and 9 dose points per page. If
there are more than 9 dose points, then only the first 9 will be displayed. If there are
more than 16 beams, then the absolute and relative dose tables will be displayed in
two pages.
The dose tables can be printed to the selected “text” printer using the “print” button
(cf.: § III.9, iSis3D – File menu, Printing the current plan).
The “close” button is used in order to close the window.
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iSis 3D - V 2.35 - March 2003 III-17
Figure III-8 : Dose Volume contribution table
III.10 Print current plane
permits the immediate printing of the current plane.
The dialog box which appears (Figure III-9) is common to all printing request, if it
concerns a current plane, a study or a text window or graphical window. It permits to
confirm the printing option after having eventually specified certain options. It is made-
up of 4 area.
• the upper area recalls the detail of what we want to print. It is recommended to
verify carefully the agreement of this demand before the confirmation, the
according particular attention to the specification with images or “without
images”, whose consequences are important in terms of the time it takes to
print.
• the second area (Printers) permits to choose the output peripheral. Depending
on their characteristics, the peripherals have different possibilities: graphic with
or without image, text, many paper formats. So, or the graphic printer, the
scrolling list of the paper formats depends on the formats accepted by the printer
or the tracer chosen as destination. The text printer includes a scrolling list for
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III-18 iSis 3D - V 2.35 - March 2003
the choice of the destination for the recapitulative files (“list of slices”, “list of
beams”, “file of the treatment time”, …). If no printer is specified, the output is on
the graphic printer. The choice of a text printer is not taken into consideration for
printing a study, or, for a homogenous presentation, all the pages come out
systematically on the selected graphic peripheral.
A name for the output file can be proposed as well (this file is temporary when
the chosen destination is a printer).
Figure III-9 : Printing box
• the third area (Options) permits to specify the objects that will appear on the
printed document (image, contours, beams,…)and if it is the case, the elements
of the study that we want to print and the desired number of copies.
If there are no images to print or the printer does not allow them to be printed,
the corresponding option is not accessible (appears gray). On the contrary, we
may want or not to print them. The other representation options refer to the
contours, the beams, and the isodoses. If the dose distribution was analyzed
deactivating some beams it is recommended to reactivate all the beams.
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iSis 3D - V 2.35 - March 2003 III-19
• the inferior area contains buttons allowing to effectively start printing (Ok), to
cancel printing (Cancel), or to start saving before printing (Save...).
Remark : The drawing of the calculation planes and the virtual simulation views are in
real format (Ai) selected during the creation or modification by the Zoom function (cf.: §
VIII.7, iSis 3D, Display menu, Zoom). When the paper format of the graphic printer
allows it, many drawings may be done on the same page (for example: for a printer
with paper format A4 and the calculation plans in windows A5 => 2 drawings per
page). The recapitulative forms, the dose-volume histograms, the pages describing the
multi-leaf collimator and even the “Isodoses 3D” are always printed on A4 format. The
command draw is not given until the page is completely filled. To force the output of an
incomplete page, select the article Eject sheet (cf.: § III.11, iSis3D - File Menu, Eject
sheet).
ATTENTION !
If the command print is given before having saved a study, there is a risk to have
printed documents not conforming with the final saved file. It is recalled the date and
the time of the last modification, printed on all the documents and saved with the
study, allow to ensure the coherence of the file.
III.11 Print study
permits to start printing a series of pages corresponding to the whole current study, on
a given printer.
It is opened the previously described box to confirm the printing option. The area
Option/Contain of this box allows to specify the elements of the study to be printed. At
minimum, a study is composed of the assembly of the selected calculation planes
(identified by a cross). If the isodoses calculation was not performed for some of the
selected planes, a warning message appears.
It is also possible to avoid printing some elements of the study (such as the list of
slices, the list of volumes and points of interest, the list of beams, the dose
contribution tables, the treatment times (if calculated) and the shapes of irregular
fields) by deselecting the corresponding buttons. Other elements become available
for printing as soon as they are calculated: dose-volume histograms, dose profiles,
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III-20 iSis 3D - V 2.35 - March 2003
“3D Isodose”, block shapes exported to a polystyrene cutting machine, MLC details
etc…
Remark 1 : while attempting to print the list of slices, if there isn’t any point of interest
defined, then the list of volumes and points of interest is not printed . In the same
way, the dose contribution tables are not printed if there aren’t any dose points of
interest defined
Remark 2 : To invite the user save the study before printing, a dialog recalls (if there
have been made modifications) that the study has not been saved and allows to
cancel printing.
III.12 Eject sheet
permits to terminate printing an incomplete page (for example a single A4 drawing on
an A3 page, or less than 4 drawings A6 on an A4 page). This item is gray (hence
inaccessible) if there is no incomplete drawing in queue.
III.13 Import
Displays the following sub-menus:
- Import contours...
- Import beams...
It is possible, while a study is in progress, to import contours and beams in order to
add them to the existing objects. The dialog box for importing contours and beams
during a study is similar to the previously described one (cf.: § III.1.2, iSis3D – File
menu, Importation of external elements), but the importation mechanism is totally
different since it concerns a simple addition of objects and not a global importation.
III.13.1 Import contours
Importing contours during a study offers the possibility to add structures, Points Of
Interest and slices to the existing slices. In order to avoid any confusion between the
imported objects and the existing objects, only the structures and Points Of Interest
that are not yet defined are being imported. However, there is an exception to this rule,
concerning the Points Of Interest declared as “isocenter” that are always imported
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iSis 3D - V 2.35 - March 2003 III-21
(modifying, if necessary, their identification). Only those slices that do not match to the
existing ones are being created.
Once the file containing the contours to be imported is selected, a confirmation window
shows the objects that are about to be imported (Figure III-10) : list of structure names,
number of Points Of Interest, number of existing slices to be modified and number of
slices to be created (including their corresponding Z).
Figure III-10 : Demand of confirmation of structures importation (1)
In the case where there isn’t any slice to be created, there are 2 buttons, Import and
Cancel, offering the possibility to confirm or abandon the importation :
Figure III-11 : Demand of confirmation of structures importation (2)
If the structures for importation are defined on slices that do not match with the
existing ones, then there are 3 buttons, Import structures and Slices, Import
structures only and Cancel, offering the possibility to confirm the importation
accepting the creation of new slices, or to confirm the importation without creation of
new slices (in which case only the structures corresponding to already defined slices
are imported), or to abandon the importation.
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III-22 iSis 3D - V 2.35 - March 2003
If all the structures to be imported already exist in the structure list of the current study,
then a message (Figure III-11) informs the user that there is nothing to import.
Remarks :
- During the creation of slices, the imported slices receive an arbitrary index.
- In order to perform a meaningful importation, it is recommended that the
coordinate systems of the existing study and the imported contours be in
coherence. Possible changes of origin are taken into account. It is still possible to
import the contours after having changed the coordinates, but with the condition
that the initial coordinate systems (generally the “image” systems) are the same.
Figure III-12 : Information about structures importation
III.13.2 Import Beams
Importing beams during a study, offers the possibility, at any moment, to add beams to
the existing beams (e.g. import a typical beam configuration or the beams of a
previous study concerning the same patient …). In order to avoid any confusion
between the existing and imported beams, the index numbers of the later are
arbitrarily modified in case of conflict.
Once the file containing the beams to be imported has been selected, a confirmation
window shows a list of the beams that are about to be imported (Figure III-13)
indicating their old and their new index. The user can confirm or abandon the
importation using the “Import” or “Cancel” buttons respectively.
Remark : In older versions of ISIS 3D (older than version 2.3), beam importation was
possible only if there weren’t any beams defined in the current study. In that case,
beam importation was resulting to a global importation of all “external” beams.
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iSis 3D - V 2.35 - March 2003 III-23
Figure III-13 : Demand of confirmation of beams importation
With the Import Beams function, beams are “shifted” on the origin of the coordinate
system as this is defined at the moment of the importation. In the case of beams
defined according to the SSD technique, the entry points become the points of
intersection between the beam axis and the contours. Importing a “Beams” file that
has been created with a version of ISIS3D older than version 2.3 could cause the
modification of some beams (cf.: § III.2, iSIs3D - File Menu, Open).
In the case of beams attached to a common isocenter or associated to a Point Of
Interest defined as a “weighting point” (cf.: § IV.11, iSis3D - Slices Menu, Points Of
Interest), future treatments may be affected as follows: If the imported beam is
attached to a common isocenter, then the program searches for this point among the
existing Points Of Interest, using its identification code. If this Point Of Interest exists
and it is defined as “isocenter”, then the reference point of the beam is shifted on this
point. Otherwise, the corresponding Point Of Interest is being created. If the new
isocenter cannot be created, then the new beam is imported as a “free” beam. If the
case arises, a message informs the user that a new isocenter has been created, or
that the beam has been attached to an existing isocenter, or that the beam has been
detached from a common isocenter.
Likewise, if the weighting point of an imported beam is a Point Of Interest, then the
later is being searched among the existing Points Of Interest using its identification
code. If the Point Of Interest exists, then the weighting point of the imported beam is
being shifted on this point, otherwise it is being created. If the depth of the weighting
point (existing or created point) is valid, then the weighting method is kept. Otherwise,
the weighting method is being changed to “On-Axis weighting”, isocentric or on the
beam entry, according to the current technique. This method is also applied if the
creation of a Point Of Interest has failed. If the case arises, a message informs the
user that the weighting point has been changed or that a new Point Of Interest has
been created.
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III-24 iSis 3D - V 2.35 - March 2003
III.14 Export
Display following submenu
- Beams >
- Contours/Beams DICOM RT (Option)
III.14.1 Export beams
allows to export globally all the data for the beams with multi-leaf collimators.
Sub-menu will propose following options :
to Varian's MLC…
to Elekta's MLC…
to Lantis…
to Varis RTP file…
to ISIS RTP file…
Whatever is the chosen option the system will create RTP file into the exportation
zone. This file can be automatically transferred to external system using FTP protocol.
The setup of the ftp connection is done into the file I3D_EXPORTATION.CFG (see
appendix B6, i3d_exportation file setup).
Figure III-14 : Beams exportation box
The zone where to the files are exported is as well chosen from a scrolling list (To).
The file name (without extension) is specified in the rubric File. The extension of the
file is automatically added depending on the nature of the exported objects.
A rubric "format" is designed in order to be able to specify the exportation format,
variable for certain “objects”. For the multi-leaf collimators, this rubric has no meaning
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iSis 3D - V 2.35 - March 2003 III-25
since the format selection is automatic according to the function and type of the
considered collimator (= accelerator type).
The Ok button permits to start the export and to close the dialog box.
The button Cancel permits to close the dialog box without starting the export.
An informative box indicating the created file(s) is subsequently presented. The file
name proposed by default is chosen automatically in such way that it is unique. In
case of modification of the name, the export is refused if it already exists a file with the
same name.
Remark : other “objects”, as the field forms or the dose distributions can be as well
exported. The procedure is slightly different in this case because these elements are
transported file by file in the moment they are manipulated on the screen while for all
the beams of the same study (of a treatment unit) only one file was globally exported.
For other exportations, the interested reader should refer to the specific functions.
III.14.1.1 Export Beams towards a VARIAN MLC
Offers the possibility to export MLC data only of Varian beams unit only.
This option create RTP file according to the following specifications :
MLC-G and MLC-F varian file format.
III.14.1.2 Export Beams towards an Elekta MLC
Offers the possibility to export MLC data of Elekta beams unit only towards
treatment units equipped with Elekta Multileaf Collimators, using a file format that is
compatible with the following Elekta specifications:
« Elekta Oncology Systems – Philips Medical Systems Radiotherapy » « User Manual for Interfacing External Computer Systems to the MLC » Doc. No : 4522 934 12111/764, 12-92
CHAPTER III - FILE MENU
III-26 iSis 3D - V 2.35 - March 2003
ATTENTION !
Nevertheless, there are certain constraints and limitations, specific to the Elekta
multileaf collimators, that are not explicitly taken into account by ISIS 3D. At the
moment, they do not allow to formally guarantee the validity of the exported files.
If the case arises, the refusal will come from the Elekta workstation during the arrival of
the erroneous beam. The beam should then be corrected in ISIS and re-exported
towards the Elekta workstation.
Elekta MLC constraints and limitations that are not taken into account by ISIS 3D are
as follows:
• Heterogeneity of leaf position limits
• Maximum leaf positions (absolute values)
o Leaf pairs 1 and 40 : 16.4 cm
o Leaf pairs 2 and 39 : 17.5 cm
o Leaf pairs 3 and 38 : 18.4 cm
o Leaf pairs 4 and 37 : 19.5 cm
o Leaf pairs 5 to 36 : 20 cm
ISIS-3D does not offer the possibility to have different leaf position limits for
each leaf pair.
• Minimum leaf spacing between opposite leaves and adjacent opposite leaves
ISIS-3D offers the possibility to define a minimum leaf spacing between opposite
leaves of the same leaf pair, but cannot apply the same rule to the opposite
adjacent leaves.
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iSis 3D - V 2.35 - March 2003 III-27
Jaw positions
Elekta imposes that all the leaves that are completely covered by a jaw, be completely
closed and that all the leaves that are not covered by a jaw, be completely open.
Additional accessories
If an additional accessory is used in conjunction with an Elekta MLC, then it must be
included in the « accessory mount » and « accessory fitment » fields inside the Elekta
beam file. These fields cannot be updated by ISIS 3D.
III.14.1.3 Export Beams towards Lantis
Offers the possibility to export, MLC and beam data of siemens beams unit only.
This option create RTP file according to the following specifications :
"Siemens LANTIS RTP Link Interface Guide - Revision A 10/96", the version 6 and
version 7.
III.14.1.4 Export Beams towards Varis RTP file
Offers the possibility to export MLC and beam data of all beams unit.
This option create RTP file according to the following specifications :
"Open RTP " ISS1701.doc Rev 1.1 of Impac Medical System, modified according to
the Varian RTP-Exchange application, driving the communication on VARIS system.
III.14.1.5 Export Beams towards ISIS RTP file
Offers the possibility to export MLC and beam data of all beams unit.
This option create RTP file according to the following specifications :
"Open RTP " ISS1701.doc Rev 1.1 of Impac Medical System, norme CEI
III.14.2 Exporting DICOM RT Contours/Beams
Offers the possibility to export contour and or beam data towards a server that
handles DICOM RT objects.
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III-28 iSis 3D - V 2.35 - March 2003
The corresponding dialog box (Figure III-15) shows a sliding list offering the
possibility to choose the name of the exportation target among those defined in the
“zones” file (cf.: Appendix B2: format of the access configuration files). The option
“Other” offers the possibility to directly type in the identification of an exportation
target that is not in the list :
Figure III-15 : Dicom RT object exportation box
Application (AE title) : "application entity title", of the DICOM target, this field is
optional.
Address : IP address of the target. This field is compulsory.
Port : Communication port number between the two applications. This field is
compulsory.
Checking on the Contours and/or Beams checkboxes allows to choose the objects to
be exported.
Ok starts the exportation ; Cancel abandons the exportation.
The exported DICOM RT objects are RT Structure and RT Plan. More technical details
are found in the document entitled : "Appendix I-2, ISIS 3D – Technical Documentation
- Conformance statement DICOM RT".
Remark : Once ISIS 3D finishes the exportation the system control is handed to the
user. If the exportation target does not respond for a long time, then it is recommended
to interrupt the application.
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iSis 3D - V 2.35 - March 2003 III-29
III.15 Quit
gives the same options as Close and more, it permits to quit the application ISIS 3D
after the confirmation demand.
Remark : in case an incident occurs during the application, to recover the current
work, restart immediately ISIS 3D and answer Yes to the question Recover
interrupted study?. You can then explicitly save with Save.
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III-30 iSis 3D - V 2.35 - March 2003
CHAPTER IV - SLICES MENU
iSis 3D - V 2. 35 – March 2003 IV-1
IV. SLICES MENU
Allows the creation and modification of the contours belonging to the slices of the
patient (cf.: § II.2.1, iSis 3D - Reference system and convention for imaging
equipment) , and it gives access to the following functions:
- Header and list
- Create from >
- Change...
- Duplicate/Adjust...
- Kill
--------------
- Origin...
- Z Opposed
--------------
- Structures/Bolus...
- Expansion...
- Volumes...
- Point of Interest
The submenus Create from and Modify lead directly or indirectly to the phase of
Creation/Modification of the contours. Recall that it is the same as double clicking in
the box for the selection of the calculation plane.
Remark : After creation, modification or killing a slice, the calculations must be
restarted for all the slices.
IV.1 Header and list of slices
Displays a dialog box composed of 4 parts (Figure IV-1):
The first part allows the study identification.
The second part presents the header of the SLICES FILE, composed of the following
fields:
• Patient name : is the name introduced at the moment of the file creation.
• File N° : is the name introduced at the moment of the file creation, it can be
changed.
CHAPTER IV - SLICES MENU
IV-2 iSis 3D - V 2.35 – March 2003
• Exam date : this field is eventually fund on the images, if they exist, it can be
changed.
• Exam N° : this field is eventually fund on the images, if they exist, it can be
changed.
• Series : this field is eventually fund on the images, if they exist, it can be
changed.
• Source : indicates if the file have been created starting from images (SC) or
from the digitizer (DI), it cannot be changed.
• Associated image index : if the images have been created starting from
images, this field indicates the folder where they are found (i.e. the name given
when creating them from images). It cannot be changed.
• Density conversion File : this is the name of the file containing the
Hounsfield/density conversion curve. The conversion file can be changed by
selecting a name from within a drop-down list. This list is formed from the
ensemble of the file names having the <<.den>> extension which are present
within the machines data directory.
A default file can be specified within the parameter customization file. This file will be
used by default following the association of an image series to a study case.
The modification of the scanner calibration curve during the execution of a study case
has as consequence all the heterogeneities to be assigned 1 density and the
cancellation of the already performed calculations.
The user is warned by a message asking for confirmation.
• Longitudinal anatomic origin : reference point used as reference for defining
the zero point of the longitudinal scale (Z) while acquiring the images. It can be
modified.
• SCREEN ORIENTATION/patient : Three scrolling lists (patient position, RIGHT,
HIGH) allow to define the patient position, and are mutually updating themselves.
The texts written with capital letters are referring to the SCREEN, those in
lowercases are referring to the patient. If the contours are obtained from
CHAPTER IV - SLICES MENU
iSis 3D - V 2. 35 – March 2003 IV-3
scanned images, the correct values are normally recovered automatically in the
image descriptions and displayed by default. If this is not the case or the
orientation is not defined in the images, the position can be changed. In all
cases, the choices made determine the way the axes orientations are indicated
in the various graphic windows. In the absence of the patient position indicator,
the axes labels are expressed as (X,Y, Z) (cf.: § II.2.1, iSis 3D - Reference
system and convention for imaging equipment).
ATTENTION!
It is the responsibility of the user to make sure that the indicators of orientation are
correct. In particular, the system does not control the cases where the image encoding
is such that the images appear to be seen “from the head” and not “from the foot” of
the table of the acquisition system.
• Origin coordinates: recalls the values defined with the function Origin (cf.: §
IV.6, iSis 3D - Slices Menu, Origin). They cannot be changed.
• Comments : are commentaries on the slices. They can come from the images,
if they exist and if they contain commentaries. They can be changed.
The third part presents the STRUCTURES defined in the slices.
It opens the data produced by the function Volumes (cf.: § IV.10, iSis 3D - Slices
Menu, Volumes).
The fourth part displays the LIST IF SLICES (in the Z ascending order) and the following
characteristics:
• The name (Ci) - allowing to identify the slice. The index i corresponds to the
order in which the slices have been created. The names can be reaffected by
the ascending Z order by closing the dossier and saving with reorder. (cf.: § III-
3, File Menu, Close).
• The position Z (Z) as well as the thickness (EP) are obtained from image
related information, if images are used, or from the values given during the
process of introducing the data with the digitizer, after eventually using the
functions Duplicate/Adjust, Origin or Z opposed.
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IV-4 iSis 3D - V 2.35 – March 2003
Figure IV-1 : Header and list of slices
• The position Z (Zregist) and the register thickness (EPregist) are normally
equal with their previous values, if there are joined slices. On the other hand, if
there are blanks or overlapping between the slices, the program performs a
“registering” of these values according to a list indicated so that the result will
be set of joined “equivalent” slices. The algorithm used for this rescaling
accounts for the slices thickness. If there is an empty space to be filled, each of
the two neighboring slices will fill half of the free space, accounting for the
corresponding thicknesses. Correspondingly, in case of overlapping, each of
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iSis 3D - V 2. 35 – March 2003 IV-5
the slice thickness, each of the two slices will shrink back from half of the
overlap region.
The register values are used mainly for the following functions:
• Point of Interest display
• expansion of the structure in 3D,
• calculation of the structures volumes,
• depth calculations,
• reconstruction of structures’ contours in non-transverse planes (“other”),
• dose-volume histograms calculation.
• image and Zimage are respectively the name and the position of the image
associated to each slice (if it exists).
• heter. allows to know the names and the number of contours defined as
heterogeneities in each slice
Finally there is a control zone, allowing to print the file (Print), to validate (Ok) or to
cancel (Cancel) the changes performed, and there are buttons to change the page if
the slices to not all fit on the same page.
ATTENTION!
It is up to the user to make sure about the validity of the reconstruction of anatomical
structures, especially in the cases where the given slices are not joined or not
sufficiently thin to accurately represent the reality. The lack of information may cause
large errors in what concerns: the depth calculation, the volume calculation, the
automatic creation of structures by expansion, and the computation dose-volume
distributions.
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IV-6 iSis 3D - V 2.35 – March 2003
IV.2 Create from
displays the following menu:
- images...
- digitizer...
images is used if an ‘image file” was previously created from the scanned images (or
IRM) transferred and converted to the format iSis 3D, and if the contours are to be
created from these images.
digitizer is used the contours, at a certain scale, are available on paper or film.
For coherence reasons, the first selected choice (image or digitalizer) is preserved for
creating the contours in the following slices. It is impossible to combine the two
modes of creating (or modifying) the slices.
IV.2.1 Create from image
While first calling Image, displays a box for the selection of the image files names,
giving the list of the available folders in each zone of the predefined images (Figure IV-
2).
Next is selected from a scrolling list the name of the image zone that is to be
analyzed. This zone can point to different local or distant media. Depending on the
selected zone, there will appear indications on the number of existing dossiers, and
about the available space, expressed as number of ”blocks” (512 Bytes) and as
number of images.
The names of the image dossiers and the corresponding dates of creation are
displayed as a list, and there is the possibility to rearrange the list either is ascending
alphabetical order, or in decreasing date order.
The name of the image dossier corresponding to the patient is selected with a simple
mouse click. The number of available images in this dossier is displayed in the lower-
left part of the box. The confirmation with Ok or by a double mouse click on the name
opens a graphic window for “selecting the images”, which gives a global view of the
images set in the dossier.
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iSis 3D - V 2. 35 – March 2003 IV-7
Figure IV-2 : Set of image selection box
The button View has the same function as Ok, but it incites to use this function to
explore faster the content of different image dossiers without necessarily relating them
to the radiotherapy dossier which is open.
Figure IV-3 : Image selection box
In the window for selecting the images (Figure IV-3) all the images from the open
dossier appear in small format (icons). This window is used for the
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IV-8 iSis 3D - V 2.35 – March 2003
creation/modification of the contours, which will be later described in detail. It may be
used as well to explore rapidly the content of the image files from many dossiers.
Actually, by clicking on Cancel, we return to the box for selecting the dossier name
and we can restart the operation for a new patient.
Remark : When the slices have been defined, unexpected results may appear if the
images referred to by the slices are altered (their content is modified). On the other
hand, new images can be added and is allowed to define supplementary slices.
Moreover, if the images corresponding to created slices are deleted, the current
dossier can be still used but a warning message warns announces that some images
have not been found.
IV.2.2 Create from digitizer
lead to creation of contours from digitizer function (cf.: § II-8, General principles,
Digitizer)
The slice creation from digitizer consist of two step. The first one consist of plot
contours, the second one consist of specify the characteristics of the slice (Z and
thickness) and the scale factor of the plot.
When plotting contours, a window come on (on the bottom left corner) which guide the
acquisition of the external contour and eventually internal contours by the way of
messages displayed.
- PLOT MIDDLE OF THE TABLE - ABSOLUTE ORIGIN - Ci
Plot the middle of the table which is normally located in the sagital median plane. The
axes Oy is merge with the sagital median plane.
- PLOT SAGITTAL MIDDLE PLANE, UP, -AXIS Y > 0
Plot a point on the Oy axes to positives y. This point should be located at least 10 cm
from the origin. Otherwise, a warning message appear and the user have to redo the
point.
- PLOT COMMON CENTER OF CONTOURS, (ORIGIN)
This is the O point of the Oy axes by which one the Ox axes perpendicular to Oy go
through
Then the plot of external contour start, with the display in real time of points plotted.
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iSis 3D - V 2. 35 – March 2003 IV-9
- PLOT CONTOUR Ci, AT THE END DO "END OF WORK"
the number of points plotted for the external contour should be lowest or equal to 99.
The plot of internal contours follow the external contour acquisition.
- A THE END OF A PLOT DO "END OF WORK"
after the last, redo "end of work"
PLOT MARKER 1 OF CONTOUR Ci
The maximum number of internal contours is 40. The maximum number of point
plotted for all internal contours is 999. The internal contour plotted are named by
default, "contour 1", "contour 2", etc... in the acquisition order, they have a density
equal to 1, and their colour is yellow. The plot and their characteristic could be
modified (cf.: § V.2.3, iSis 3D - Procedure of creation/modification of contours,
contouring, change).
If the slices do not have any internal contours, you just have to do "END OF WORK", to
end the acquisition.
Remark : all contours are plotted in only one phase: external contour then internal(s)
contour(s). to add a markers to a slice, you should (at this time) re-plot all the contours
for this slice.
Once the contours plotting for one slice is achieved, a dialog box appears, proposing
the following options:
• Z Position : to introduce the Z of the slice, initialized to 0 by default
• Slice Thickness : to introduce the slice thickness, initialized to 0.5 cm by
default
• Scale X : introduce the X (horizontal) scale initialized to 1 by
default
• Scale Y : to introduce the Y (vertical) scale.
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IV-10 iSis 3D - V 2.35 – March 2003
And the buttons:
- Next slice
- Ok and Cancel
Next slice saves the contours of the current slice and returns the control to the
digitizer for the introduction of a new slice.
Ok saves the contours of the current slice and then passes to the phase
Creation/Modification.
Cancel deletes the result of the digitization (after confirmation) and returns to the
principal menu.
Figure IV-4 ; Characteristic of plot box
IV.3 Modify
passes to the phase Creation/Modification of the current slice.
The same function is obtained by double clicking on the slice to be modified in the box
for selecting the calculation planes.
IV.4 Duplicate/Adjust
permits to copy and displace the current slice to a different longitudinal position (Z)
(Figure IV-5) saving all the other previously defined contours, together with their
characteristics.
The dialog box which opens permits as well (eventually keeping the same Z value) to
modify the thickness, the scale (relative to the current slice) by separating the
horizontal (X) and vertical (Y) directions and/or changing the origin. The new origin
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iSis 3D - V 2. 35 – March 2003 IV-11
can be defined by its coordinates (relative to the old origin) or graphically, pressing the
button mouse capture (cf.: § IV.6, iSis 3D - Slices menu, Origin). Note that the
modifications are affecting only slice which is obtained (after duplication or
displacement). There is a risk of modifying the coherence of the slices set and thus,
these functions should be carefully used. For a global modification use the item origin.
Figure IV-5 : Duplicate / Adjust a slice
If the current slice was defined from a scanned image, the fact that it is duplicated or
displaced does not affect its association with the originally chosen slice.
IV.5 Kill
destroys the current slice after validation.
IV.6 Origin
permits to modify the position of the anatomical origin for the whole set of slices. The
slice whose Z corresponds to a given value in the options field of the dialog box (this of
the current slice by default) will take the Z value specified in a second options field (it
becomes by default the origin slice Z = 0) (Figure IV-6). If a displacement of the origin
was done before, the initial Z value of the current slice (called Z image) is recalled in
the dialog box.
The dialog box permits as well to get the position of the origin, X and Y, either by
reading the coordinates values in the options field specific for X and Y, or with the
mouse (displacing the principal axes in the graphical window with continuos display of
the current position, and exit by clicking on the Ok button of the graphical window).
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IV-12 iSis 3D - V 2.35 – March 2003
Figure IV-6 : Origin for all slices
IV.7 Opposed Z
This function which starts the rearrangement of the slices, replacing each Z value by
its opposed value (-Z). It allows to retrieve a coherent order in the radiotherapy
coordinate system when a set of images was acquired inversely (e.g.: the Z is
increasing from the head to the toes). Note that, even if the images continue to be
correctly associated with the slices from which they originate, the correspondence is
lost in the box for selecting the image, because the Z images remain unchanged.
In the case a mistake occurs in the procedure, restarting the function Opposed Z
retrieves the initial order.
IV.8 Structures/Bolus
gives access to a dialog box dedicated to the management of structures and bolus
(Figure IV-7). This box includes the lists of: Names, Densities, Colours and Types of
the existing structures, as well as their option fields: Name, Density, Colour and Type
which allow to create new structures or to modify the existing ones.
This box is also provided with the buttons:
- Add, Change and Kill
- Ok and Cancel
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iSis 3D - V 2. 35 – March 2003 IV-13
Figure IV-7 : Structures / Bolus management box
Add : creates a new structure of name, density, color and type specified in the option
field.
Change : assigns to the selected structure (click for example in the list Names) the
name, density, color and type specified in the option field. These characteristics are
influencing the whole set of contours affected by the structure, including the density
which replaces the previously given or calculated values for each individual contour.
Remarks : - 2 structures cannot have the same name
- a structure cannot have the same name with a previously defined
contour
Kill : deletes the selected structure. If the structure affected one or more contours, a
dialog box is opened, recalling the number of contours and the number of slices
affected and proposes either to save the contours after deletion (renaming them or
not), or to delete them as well.
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IV-14 iSis 3D - V 2.35 – March 2003
Cancel : reestablishes the initial list of structures and contours affected by the
eventual deletions.
Ok : validates all changes and closes the dialog box.
The structures defined in this way (maximum 15) appear in a scrolling list, accessible
in the contours modification mode. When a contour is associated to a structure it takes
its color and properties. They are as well displayed at the right of the window:
creation/modification of contours.
The notion of structure becomes of major interest during three -dimensional
representations (virtual simulation or “beam’s eye view”, 3D visualization) and for
dose-volume histogram calculations.
The boluses are special structures, to whom is assigned the type “bolus” selecting it
from the corresponding scrolling list. The structures of type “bolus” are contoured, slice
by slice, in the same way like the ordinary structures but they may “come out” from the
patient external surface. The rules for introducing their data are given in the paragraph
V.2, Procedure Creation/ Modification of Contours, Contouring (slice by slice). They
can be afterwards associated to one or more beams and are making “fusion” with the
external contour, during the dose calculation for the associated beams. They can be
also generated with the function “expansion” (cf.: § IV.9, iSis 3D - Slices menu,
Expansion).
IV.9 Expansion
Permits to create a structure (for example a clinical target volume) starting from an
existing structure (for example the macroscopic tumor volume), allowing a uniform
margin in 3D and accounting for “obstacle” structures (Figure IV-8). The source
structure (“from”) must be defined in at least one slice. The destination source ("to")
must have been previously defined in the list of structures but a priori it does not
include any associated contour. Except for the case of bolus, the destination structure
must be different from the source structure.
In the case of expansion with positive margins, the algorithm used for expanding is
relatively complex (see the bibliography). Schematically, the introduction of a margin M
in a given slice (called “current” slice) is done by scanning all the slices located at a
distance less or equal to M, and projecting for each of them the contours of the source
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iSis 3D - V 2. 35 – March 2003 IV-15
structure increased by a residual margin m. m is a fraction of M, increasing as the
projection slice is closer to the current slice. It results an expansion of the limits of the
source structure., not only on the lateral direction but also on the longitudinal direction,
It can be shown that to ensure an acceptable precision, the slices wherein is defined
the source structure, as well as the structures located laterally (on one side or the
other) (a distance smaller than M) must have a thickness at most equal to 0.5 M and if
possible of the order 0.1 M.
Figure IV-8 : 3D expansion of structure or bolus box
In the case of expansion with negative margin, the expansion is done in 2D in each
slice where the source structure is defined. This possibility in attractive in the case we
want to create the automatically inner side of an organ.
The "envelope" is a structure enveloping the source structure and limiting its
expansion in all the directions in space. It is for example the external surface of a
patient, or a whole internal structure (lung, meningial envelope limited by the cranial
skull,…). In the longitudinal case, there cannot be an expansion in the slices
immediately adjacent to the envelope (i.e. the first slices situated on one side or
another do not include any contour belonging to the “envelope” structure).
The structures defines as “obstacles” stop the expansion in the plans where they are
defined. Nevertheless, because of the three dimensional character of the calculation, it
may happen sometimes that obstacles are “surpassed” by the expansion process.
During the process of choosing the structures involved in the expansion, a control of
the coherence is done to avoid aberrant combinations.
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IV-16 iSis 3D - V 2.35 – March 2003
It may happen that the process of expansion does not succeed. An informative
message is displayed and there are two possibilities:
1. Ignore and continue the expansion in other slices
2. Stop the expansion
The function expansion can be used as well for the automatic creation of a bolus of
given thickness. The user interface and the expansion mode are slightly modified in
this case:
a source structure of type "bolus" should have been previously defined in the
structures’ box (cf.: § IV.8, iSis 3D - Slices Menu, Structures/Bolus),
• Bolus should be define into Volume / Bolus management box
• this source structure is introduced slice by slice, following exactly the external
contour in the region where the bolus is applied,
• the chosen margin corresponds to the bolus thickness,
• the destination structure is, by default, identical to the source structure. It comes
to replace it but if the expansion does not succeed, the original structure is lost
and it must be introduced again.
• the expansion of boluses has the following characteristics:
1. It is a 2D expansion where the margin M is applied slice by slice, without
accounting for adjacent slices. In particular, the process is stopped in the
longitudinal; direction, at the level of the last slices where the source
structure has been introduced.
2. The target structure has straight sides, perpendicular to lateral ends.
3. The destination structure is “amputated” from its intersection with the
interior of the external contour. Only the “bolus” is effectively subsisting.
Remark : In case of later retouch of the bolus shape, it is recommended to make sure
that there is no space left between the bolus (the destination) and the skin. On the
contrary, there so inconvenience if the bolus “penetrates” in the interior of the contour,
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iSis 3D - V 2. 35 – March 2003 IV-17
except that the external part only will be accounting for in the dose distribution
calculations (cf.: § V.2.b, iSis 3D - Creation/Modification of contours).
IV.10 Volumes
Shows a sheet (Figure IV-9) containing 2 parts.
The first part indicates the geometrical characteristics of the structures : the center,
the volume and the diameter of the smallest sphere containing exactly each one of
the existing structures. The volume and diameter are not shown in the case of
boluses.
Figure IV-9 : Geometric characteristics of structures
Structure volumes are calculated by multiplying the structure contour surface with the
slice thickness. Note that these calculations are not strictly valid if the structures are
not defined on consecutive adjacent slices. Indeed, if they are not, the system
restores the wanted continuity by “inventing” the missing information (cf. : § IV.1, iSis
3D - Slices Menu, Header and list of slices, Thickness Register). For security
purposes, if the case arises, the lack of continuity is mentioned by the system when
the “creation/modification of contours” phase ends.
The second part shows a summary of the defined Points Of Interest : their name,
their type, their coordinates and any comment associated to them.
Depending on the number of structures and the number of Points Of Interest, the
presentation may occupy one or two pages. The sheet can be printed from the
selected “text” peripheral using the Print button.
The window can be closed using the Close button.
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IV-18 iSis 3D - V 2.35 – March 2003
IV.11 Points Of Interest
The Points Of Interest are points related to the patient anatomical structures, defined
either graphically, or by their numerical coordinates. They have various roles
according to their properties (“type” of point). According to their type, they can
eventually be “attached” to beams.
Slices / Points Of Interest… opens a dialog box showing the list of the defined
points, allows their management and gives access to the dialog box relative to the
properties of the Points Of Interest.
IV.11.1 Points Of Interest’ management box
Slices / Points Of Interest… gives access to the dialog box relative to the
management of the points of interest (Figure IV-10 ).
Each point of interest has an identification code with 2 alphanumerical characters, a
name, a color, one ore more types, coordinates and a comment.
The defined Points Of Interest are:
• Isocenter point, for grouping beams in respect to a common isocenter (cf.: §
VI.1.3, iSIs 3D - beams menu, beam parameters, point of reference)
• weighting point, for the definition of an off-axis weighting point, (cf.: §VI.1.3,
iSis 3D - menu beams menu, beam parameters, weighting)
• dose point, for the dose calculation at a point and for the dose/volume
contributions (cf.: § 3.8.1, iSis 3D - Beams file, dose/volume contributions)
At present, the types “mark” and “reference” are not exploited (except of a simple
graphical representation in the results sheet).
The dialog box contains :
• a list containing the identifying elements : ID:Name and Type of the selected
Points Of Interest depending on the display filter.
• a group of checkboxes offering the possibility to filter the displayed types of
Points of Interest. All of the types can be selected using the “All” button. A help
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iSis 3D - V 2. 35 – March 2003 IV-19
button marked with the ? symbol opens an information box relative to the
available types and the use of the filter for the creation of the list.
• the buttons : New, Modify, Delete and Close, Print.
Figure IV-10 : Point of Interest management box
At present, the types “mark” and “reference” are not exploited (except of a simple
graphical representation in the results sheet).
The dialog box contains :
• a list containing the identifying elements : ID:Name and Type of the selected
Points Of Interest depending on the display filter.
• a group of checkboxes offering the possibility to filter the displayed types of
Points of Interest. All of the types can be selected using the “All” button. A help
button marked with the ? symbol opens an information box relative to the
available types and the use of the filter for the creation of the list.
• the buttons : New, Modify, Delete and Close, Print.
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IV-20 iSis 3D - V 2.35 – March 2003
- New : opens an input box for typing-in the characteristics of the Points of Interest
(Figure IV-11). An identification code is suggested by default. It is the first available by
alphabetical order.
- Modify : opens an input box containing the characteristics of the selected point. If the
type of the Point of Interest is « isocenter » or « weighting point », then a modification
of the point results to the modification of any beam associated to the point. Following
user confirmation, the beams that have become invalid, are being detached from the
« common isocenter » or their weighting mode changes to on-axis weighting.
- Delete : deletes the selected point (if it is not used as “common isocenter” or
“weighting point”) and updates the list of Points Of Interest. In order to delete a point
associated to a beam, it is necessary to detach it first, using the beam modification
dialog (cf.: § VI.1.3, iSis 3D - beams menu, beam parameters)
- Print… opens the print-sheet described in the paragraph entitled Volumes (cf.: §
IV.10, iSis 3D - Volumes)
- Close : closes the dialog box.
IV.11.2 Input box for the characteristics of the points of interest
The input box for the characteristics of the interest points (Figure IV-11) opens
from the dialog box relative to the management of the Points of Interest, or during the
creation of a “common isocenter” or a “weighting point” (cf.: § VI.1.3, iSis 3D - Beam
parameters). It contains the input fields Code, Name, Color and Type.
The position of the Point of Interest can be defined either by entering its coordinates,
or using the automatic centering function on a structure (spherical or parallelepipedic),
or graphically in the current window. A comment can be associated to each point.
In order to enter (or modify), the position of a point graphically in the current window,
click on the mouse button of the dialog box. A cursor appears, that can be placed at
the desired position on the current window. While moving around the mouse keeping
the mouse button pressed, we can see in real time, at the lower left corner of the
window, the point coordinates (and the corresponding dose if this is a dose point).
Once the mouse button has been released the point is placed but not yet created
unless there is a validation in the characteristics input box.
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iSis 3D - V 2. 35 – March 2003 IV-21
Figure IV-11 : Creation / Modification point of interest box
Ok : validates the creation or modification of the Point of Interest and closes the dialog
box.
Delete : deletes the Point of Interest (if it is not used as a “common isocenter” or as a
“weighting point” – see above)
Cancel : cancels the creation or modification of the Point of Interest and closes the
dialog box.
Remark : it is possible to change the current window for the graphical definition of the
point using the mouse, without closing the dialog box, by simply clicking on the desired
graphical window
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IV-22 iSis 3D - V 2.35 – March 2003
CHAPTER V - CREATION / MODIFICATION OF CONTOURS
iSis 3D - V 2. 35 – March 2003 V-1
V. PROCEDURE CREATION/ MODIFICATION OF CONTOURS
This procedure is accessed either directly after selecting the item Create from from
the SLICES menu, or from the item Change of the same menu, or double clicking on
one of the slices from the box for selecting the calculation plans.
During this procedure, the main menu bar, the selection boxes for the calculation
plane, the beams, and the selected slices are kept in small format (icons).
A specific menu bar appears for this procedure. It is attached to an active window
and it allows the display of the slice to be modified (image and/or contours). The active
window has a title recalling the name of the image file, the chosen image and the slice
position. Note that this title can be only partially defined.
By select Create from/images, a box for selecting the images (or the slices)
appears. It is particularly useful for giving a global view over the whole set of images or
contours available and for giving the possibility to follow the progress of the operation
creation/modification of contours. The box for selecting the images is available and
can be called at any moment.
The creation/modification of contours behaves like an independent application,
called by iSis3D. The return to the main application is done through the item Quit from
the SLICE menu. In the case the series of slices taken into account does not constitute
a continuous volume (non joined slices), a warning message appears, indicating the
associated risks of error.
In the following paragraphs is described the procedure of creation/modification of
contours.
The menu bar of the procedure (Figure V-1) contains the following options:
• Slices : choice of the current slice whereto trace the contour,
• Contouring : function helping for the creation and/or modification of the
contours in the current slice,
• Display : choice of the display options.
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V-2 iSis 3D - V 2. 35 – March 2003
Figure V-1 : Creation / Modification of slice
At the right of these 3 menus, appear 3 buttons which give direct access to the
following functions:
• Zoom... : allows to adjust at any moment the scale and the centering of the
image and the contours present in the window,
• Restore : allows to go back to the previous zoom (without opening the box),
• Level/Window... : allows to adjust the image contrast. Contrary to many other
boxes, this one does not need to be closed to continue the procedure, it may
remain open and it may be accessed at any moment.
To see the detailed description of these last three functions refer to the description of
the DISPLAY menu.
Three buttons located at the inferior part of the window, permit to start with a simple
click the operation of contouring in mode: manual, automatic or change.
Three buttons located at the lower right part of the window contain arrows which allow
to perform the selection of the slices on which to work.. The two extreme buttons
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iSis 3D - V 2. 35 – March 2003 V-3
(right arrow and left arrow) allow to pass to the previous slice or to the next one on
the list of slices previously created. The central button (oblique arrow) allows to recall
or refresh the box for selection of images (or slices).
V.1 Selection of the slices to contour
V.1.1 The box for selection of images
a) Presentation
The box for selection of images (Figure V-2) permits to choose the slices serving as
basis for the anatomical representation of the patient. This representation requires the
acquisition of contours (internal and external) associated to each image. Only the
slices including at least an external contour will be retained for the patient
representation. They will appear then in the list of slices in the box for the selection of
the calculation planes.
In case of utilization of matching images, the selection box is generated from the
active series (cf.: § II.9, iSIs 3D - General Principles, Matching images)
b) Using digitizer
When the contours acquisition is done by digitizer (no image), the box for the
selection of images allows to display the set of slices previously digitized. It is then
completed with three buttons:
Digitizer which permits to acquire the contour from a new slice, by digitizer.
Cancel which permits to close the box and to cancel the current operations.
Ok which permits to close the box, after having loaded in the active window, the
current slice (i.e. that which is framed in the box for image selection).
c) Visualization and selection of images
If the contours are generated from scanned images, all the images available in the
folder previously defined (cf.: § IV.2, iSis 3D - Slices Menu, Create from images) are
displayed in the box. Maximum 99 images can be selected to perform the contouring
of the external surface and the internal contours.
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V-4 iSis 3D - V 2. 35 – March 2003
Figure V-2 : Image selection box
First is tested the coherence of:
• the examination date,
• the patient name,
• the patient position,
• the series number,
• the examination number.
A warning message is indicating if incoherence have been found. Note that the
incoherence are not blocking the process and it is still possible, even in this case, to
select the images.
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iSis 3D - V 2. 35 – March 2003 V-5
The selection of an image is done by a simple mouse click on the corresponding icon
in the selection box. Another simple mouse click on a selected images makes it
deselected.
A button select all located at the lower right part of the box permits to select all the
images of the box. It is always possible to deselect those images that we do not want
to contour.
A continuous selection of adjacent icons can be done as well sliding the cursor over
them while pressing the left mouse button. The same operation applied to neighboring
slices that were previously selected allows to deselect them. Finally, to deselect all it
is enough to update the window (for example pressing the corresponding button
(oblique arrow) situated in between the arrows that allow the passage from one slice to
another.
The selected icons are identified by a pink tablet located at the lower left corner. This
tablet changes appearance according to the status of the corresponding slice, the
largest frame is associated to selecting and the filled tablet signifies the presence of an
associated slice (containing at least a contour):
. no tablet →→→→ no contour defined, image not selected
. not filled tablet (frame) →→→→ no contour defined, image selected for
internal or external contouring
. completely filled tablet →→→→ contour(s) already defined, image not
selected
. half - filled tablet →→→→ contour(s) already defined, image selected
for internal or external contouring
. tablet replaced by a pink
cross
→→→→ the image cannot be used for one of the
following reasons:
- a slice of same Z value exists already ;
- the gantry angle overcomes +/- 2% ;
- the table angle overcomes +/- 10%.
A simple mouse click on an icon switches from a status to the other (selected/ not
selected), while the status of the other icons remains unchanged.
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V-6 iSis 3D - V 2. 35 – March 2003
The last selected image, called the “current” image is framed.
For this current image, various information are recalled and updated in real time, in
the lower part of the window. These information are referring to:
slice identification (Ci), longitudinal position of the slice Z (in cm), slice thickness
(Thick=, in mm), associated image name, position (Zi) of the initial image (Zi = , in the
coordinate system of the imaging system).
Figure V-3 : Image information
It is possible to obtain supplementary information on the current image by double
clicking on the information icon. A window called "Informations image" will be
displayed then, showing the principal characteristics of the associated image and/or
slice (Figure V-3).
The displayed data are those fund in the header of the image file and re the result of
the image conversion.
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In particular, the patient position information is given according to the DICOM
standards:
HF = Head First - Examples:
FF = Feet First
S = Supine HFS <=> decubitus dorsal DD
P = Prone
DR = Decubitus Right HFP <=> decubitus ventral DV
DL = Decubitus Left
Remark : the table angle of the imaging system is expressed as the absolute value of
the value read in the image file, modulo 180°, brought to 0° :
ex: for 355°, it will display 5°.
for 179°, it will display 1°.
for 182°, it will display 2°.
The displayed gantry angle is the absolute value of the value read in the image file.
It is not necessary to have the external contour defined before attempting to outline an
internal contour.
d) Contouring series
The scrolling menu Contour from >, allows to chose the contouring method :
threshold or interpolation
e) Contouring (external and internal) in series of images by treshold
The scrolling menu Contour from >, located at the lower right part of the window
create, in the selected images, either an external contour, or an internal contour
associated to one of the previously defined structures.
For the external contours are available two modes of work:
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V-8 iSis 3D - V 2. 35 – March 2003
- the automatic mode starts immediately the creation of external contours,
- in semi automatic mode, it is possible to specified first a starting point for the
contours and in the meanwhile it is possible to adjust the contrast. These adjustments
can be done (in the box for adjusting the contrast) before starting the contouring. A
dialog box is displayed, recalling the threshold level for the contouring and asks the
user to choose a starting point on the current image which is displayed at this moment
in “normal” size within the window creation/ modification of contours. Pressing the Ok
button validates the choice. The contouring starts by exploring the image, beginning
from the left of the starting point (cf.: § V-2-3, Procedure Creation/Modification of
contours, Automatic Contouring). Choosing this point in an adequate manner, one can
avoid the contouring of container accessories or of the scanner table.
The internal contouring is always done in semi-automatic mode.
It is enough to select from the submenus, at the rubric " internal ctrs ", the structure
for which is desired a serial contouring. The choice of the adjustments and of the
starting point are determinant for the success of the contouring process. Actually the
contrast level (the lower limit of the window) must be such that the interior (or exterior)
of the structure of interest takes the color of the background, and the position of the
starting point remain valid for the whole set of selected images.
In both modes, the contour calculations continues automatically for each of the
previously selected images. The contours obtained are displayed one by one, as they
are calculated, in the same time the frame corresponding to the current image is
moved. A dialog box is displayed in the upper left corner of the screen. This permits to
follow the progress of the operation and to stop or restart at any moment the
contouring (it is recommended to wait for a while after pressing this button since the
effect is not immediate).
The images for which a valid contour was found are identified by a pink tablet,
according to the conventions described in the previous paragraphs. In case of error,
the user can either delete the wrong contours, or modify them (cf.: § V-3,,
Procedure Creation/Modification of Contours, Display), or delete the current slice
(SLICE menu), i.e. delete all the contours associated with it (the image remains intact
and can be contoured again).
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Remark 1 : it is not necessary to have defined the external contour to perform the
internal contouring.
Remark 2 : to avoid aberrant results given by the semi-automatic contouring for the
see of slices, it is recommended to find before the best adjustments making trials on
some representative slices.
Remark 3 : In case of utilization of matching images series , the contouring by
threshold methods is done from the active series (cf : § II-9, General Principles,
Matching images)
f) Contouring (external and internal) by interpolation of the image series
The contouring by interpolation is performed on the internal structures and the external
contours. It is launched selecting by mouse a continuous image series, which accepts
“empty” slices with respect to the selected structure of interest; following select the
item of the “interpolation” menu.
The interpolation algorithm is based on the cloud of points method with recentering on
the isocentre and controlled erosion/dilatation of the existent contours. The relative
distance between the slice C where the contour of the interest structure S should be
calculated, and the neighboring slices where S exists, is taken into account according
to the following rules:
• if there are two slices C1 and C2 framing C where structure S is defined, the
generated contour is calculated by interpolation of the S contours defined in C1
and C2
• if there are contours only within the inferior slices (or the superior ones), the
interpolated contour is generated by copying the closest contour.
• If there is no contour defined for the structure S neither within the inferior slices
nor within the superior ones, the method cannot be applied.
g) Contouring (external) and loading a single image
The box for selecting images permits as well to start the automatic external contouring
in an arbitrary slice with a double click. If no contour is yet associated a dialog box
is displayed asking the user if he wants to preserve the external contour found. If the
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V-10 iSis 3D - V 2. 35 – March 2003
answer is affirmative, the contour is saved and the corresponding slice (image and
external contour included) is loaded in the active window. Otherwise, only the image is
loaded and it is possible to perform the contouring automatically or manually. (to be
detailed in later paragraphs).
To close the box for selecting images there are available two buttons:
Cancel : simply closes the box. All the contours just calculated in automatic or
semiautomatic mode (the icons are identified by a pink filled tablet) are saved.
Ok : closes the box. If a current icon is selected, the corresponding slice or image is
displayed in the active window, with a proposed contour, if it is the case.
V.1.2 Passing from a slice to another
The right arrow and left arrow located at the lower part of the active window allow to
pass to the next or previous window from the list of the defined slices (i.e. having
defined at least one external contour). These contours remain accessible even during
the procedure creation/ modification of contours (to be detailed later). At the end of the
list, the arrow corresponding to the scrolling sense disappears, thus becoming
inaccessible.
If the selection box is open (for example by clicking on the central button identified by
an arrow pointing upwards), the frame corresponding to the current image is displaced
together with the displayed slice, this allowing to know where we are. The box for
selecting the images permits as well to load any slice. It is enough to double click on
the desired image.
Remark : if the contours associated with the images do not appear within the box for
selecting the images, it is necessary to click on the box to update it. This need to
update the display is eventually signaled by a message: "display to refresh", located in
the upper left corner of the window.
V.1.3 The Slice Menu
It gives access to the following sub-menu:
- Images selection...
- Digitize
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iSis 3D - V 2. 35 – March 2003 V-11
- Kill
-----------------
- Quit
The item Kill has exactly the same function as in the principal SLICE menu
Images selection...: is accessible only if an image dossier has been previously
selected. It recalls the box for selecting images.
Digitize gives the control to the digitizer for creating a new slice. This sub-menu is not
accessible if an image dossier has been selected.
Quit validates the modifications and allows to go back to the main menu.
V.2 Contouring (slice by slice)
The contour acquisition can be performed from within the window creation/
modification of contours, in one o the following two ways. In manual mode the
contours are introduced with the mouse. In automatic mode it is enough to define a
starting point and the contour will be calculated according to the adjustments of the
contrast and the chosen starting point.
a) Contours property
Each contour has assigned a name. A colour and a density are equally assigned to
each contour. The name given by default is contour i, where i is automatically
incremented for each slice. The default color is yellow. The default density is equal to
1, except for the case of automatic densities calculation. The name, the color and the
density can be later modified (cf.: § V.4, iSis 3D - Procedure Creation/Modification
of Contours, Display).
Each contour may be considered as free marker or as belonging to a structure. In
the last case, the name , the color and the density assigned by default are those of the
structure. The names of the contours considered free landmarks appear in lower
cases, while those of the contours belonging to structures in capital letters. The fact
that a contour belongs to a structure can be specified from its creation.
Actually, the list of structures previously defined will be displayed at the right of the
active window, in both cases: automatic and manual contouring. It is enough to choose
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V-12 iSis 3D - V 2. 35 – March 2003
the structure, at the beginning or during the contouring, and the current contour will be
assigned to it. An item free marker is added to this list, as well as an item new... to
define a new structure. Moreover, it is possible to change the assignment of a contour
at posteriori in the dialog box for contours modification (Figure V-8).
Whatever the type of the considered element (free landmark, structure or bolus), it is
always possible to give the same name to many contours introduced from the same
slice.
It is possible at any moment to change the characteristics or the shape of a previously
defined contour, by going in the change mode.
b) Bolus
For a bolus structure, the introduction of the corresponding contour must necessarily
follow certain rules in order to be correctly accounted for: it is imperative that the
introduced contours be not “detached” from the external contour.
The bolus may be explicitly introduced, in which case they can “byte” largely from the
interior of the external contour. Only the external part will be considered.
It is also possible to call the function 3D expansion to define a bolus of a specified
thickness (cf.: § IV.9, iSis 3D - Slices menu, Expansion). In this case it is convenient
to define the bolus position as a line matching the shape of the external contour,
shortened at the extremities so as to account for the expansion.
Finally, in the case the images have been acquired, in the presence of bolus or the
boluses are automatically included in the “external contours” the procedure is to
"distort" the external contour so as to bring the bolus points to the skin (cf.: § V.2.4,
iSis 3D - Procedure Creation/Modification of Contours, Change) then to recreate a
bolus structure in manual and/or automatic mode. It is recommended the frequent use
of the distort function to bring the point of the bolus in the interior of the external
contour. To control if a bolus was correctly accounted for, verify in the "treatment times
sheet" the thickness (cf.: § III-8, File menu, Treatment times).
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c) Memorization of the visualization setup
In both cases, creation or modification of contours, it is possible at any moment to
change the display of the image using the functions zoom and/or level/windows.
Figure V-4 : Memorization of visualization set-up
When a satisfactory adjustment has been found for contouring a structure or an organ,
it can be useful to memorize this adjustment, so as to recall it easily for any other slice.
This function was introduced and it is possible at any moment to memorize (or to
load) a “visualization setup”. This “setup” consists in the combination: structure
name + zoom parameters + contrast parameters + characteristics of associated copy.
Up to 6 different setups can be memorized (Figure V-4).
To memorize a setup, do the adequate adjustments, and choose from the scrolling
list associated to the button Store... the number of the backup memory. The memories
already used are identified by the color of the associated structure (if there is one) as
well as by a cross placed beside the number.
To load a setup from the memory, click on the button corresponding to the number of
the setup. Only the buttons for the memorized setup are accessible. The color of these
buttons is the same with that of the associated structure(if there is one).
d) Sequence of functions
It is not necessary to quit the current mode to pass to another mode (manual,
automatic or change); it is possible to pass directly from one to another by pressing
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V-14 iSis 3D - V 2. 35 – March 2003
the corresponding button. It is possible to pass from a slice to another remaining in the
current mode, pressing on the corresponding arrows - the operations on the current
slice are then validated as by Ok.
V.2.1 Manual contouring
The function digitizing contours can be accessed with the mouse, clicking on the
button manual. To introduce manually the contour points, it is enough to place he
cursor at the desired place and to click either on the left mouse button, to produce a
contour from the continuous mouse movements, or on the central button to proceed
point by point, with a flexible position. These two modes can be alternated. The right
mouse button offers the possibility to cancel the points of the contour currently
introduced, 1 by 1, or continuously as long as the right mouse button is not released.
The list with available structures appears at the right and a series of buttons at the
lower part of the active window (Figure V-5) which recalls partially the functions found
on a digitizer table : Erase, Correct, Close, Next, Ok.
Erase deletes the contour that is being introduced at the current moment.
Correct cancels 1 by 1 the points of the contour that is being introduced at the current
moment. Keeping the finger pressed on the left mouse button leads to a continuos
cancellation of the previously introduced points.
Close links the current point to the first point of the contour, validates the contour that
is being introduced and passes to the next contour to be introduced.
Next validates the contour that is being introduced and passes to the next contour to
be introduced.
Ok validates the contour that is being introduced and ends the function. This validation
is obtained as well using the arrows for changing the slices or changing the mode
(passage to automatic or modify mode).
During the contour validation, an automatic control takes place in order to detect and
delete any overlapping segment. This verification is repeated for all structures and free
marks except of the external contour.
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Figure V-5 : Manual contouring
V.2.2 Automatic contouring
The function automatic extraction of contours is accessed by clicking on the button
automatic. The list of available structures appears at the right and a series of buttons
at the lower part of the active window (Figure V-6): Contour, Validate, Do not
validate, Ok.
After having eventually specified in the list the structure assigned to the current
contour, click on the button Contour and follow the instructions given in the dialog box
at the lower left part of the active window:
- one way to proceed further is, if necessary (as at any time), to adjust the contrast
level (level/windows) in the corresponding adjustments’ box so as to emphasize the
edges of the organ to be contoured.
- - the automatic contour calculation can be started by clicking on a point located in
the interior or at the right of the of the edge of the region to be contoured (Figure V-
7), the calculated contour appears on the screen.
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V-16 iSis 3D - V 2. 35 – March 2003
Figure V-6 : Automatic contouring
In case or troubles, the message "impossible to contour” appears in the dialog zone. It
is enough to restart the contouring by trying a new choice of the contrast value and/or
of the starting point. In case it is successful, it remains to confirm if it is desired or not
to save the contour obtained in this way.
Valid validates the contour that is being introduced and passes to the automatic
contouring of the next contour.
Do not valid cancels the calculation that has just been made and waits for the next
contouring.
Ok validates the last contour and ends the function automatic contouring. This
validation is obtained as well using the arrows for changing the slices or changing the
mode (passage to automatic or modify mode).
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Figure V-7 : Choosing the region to be contoured
Remark : the message “point outside image => restart” corresponds to the fact that
depending on the zoom factor and the image dimensions (generally square if he
display window is rectangular) a margin is added so as to “fill” the display window. Any
point specified in that margin is exterior to the image and invalid for the automatic
contouring. It is expected to introduce a new point instead.
V.2.3 Contouring - modify
Figure V-8 : Characteristic of contour
A dialog box appears if clicking on the button Change..., It allows to modify the
parameters associated to each contour, but also to reshape the contour, add or delete
points (Figure V-8).
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The contour to be modified is chosen by clicking on its name (left column) in the
dialog box. This causes the corresponding contour in the active window to be
highlighted, changing its color (pink).
Possibilities to modify an external contour: the name and the density associated to the
external contour are fixed. The external contour can be distort and kill. However an
external contour must exist in order to have the slab taken into account at the exit from
the mode creation/ modification of contours.
Possibilities to modify the internal contours or landmarks: the name of the internal
contours can be introduced from the keyboard or chosen from the scrolling list with
structures, which proposes 3 categories of choices:
- <new... > : gives access to the box for defining the structures (cf.: § IV.8, iSis 3D -
Slices Menu, Structures/Bolus),
- <free mark.> : redefine the contour as a free marker, and assigning a default name
(for example contour 1, contour 2),
- list of defined structures: It allows to link the external contour to a defined structure
from which it adopts the name, the density (except if “automatic calculation densities”
is active) and the color.
Compute : allows to start the calculation of the average density for a specified contour
(cf.: § V-2-6, Procedure Creation/Modification, Contouring, Automatic Densities
Calculation).
Distort : : offers the possibility to modify the shape of the selected contour (see
bellow).
Change : attributes to the selected contour the name, density and color specified in
the corresponding fields. The names of the free marks appear in small letters. The
names of the structure contours appear in Caps.
It is also possible to perform the same changes from the pop-up list that can be
activated on the “name” field.
Kill : deletes the selected contour.
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Cancel : cancels all the modifications, if a contour reshaping was performed it is
proposed (confirmation box) to save the deformations independently of other
modifications.
Ok : validates all the modifications and closes the dialog box corresponding to the
contour reshaping…
The appurtenance of a contour to a structure is guaranteed by its name. The
characteristics of a contour can be modified without altering this link: the density and
form remain unchanged but the name and the color may change.
The internal contours can be distorted and deleted.
Distort : allows to modify the shape of the selected contour. A series of buttons
appears in the active window when pressing on “distort” (Figure V-9) : Add - Kill -
Change - Cancel - Ok.
- Add : initiates the mode add points to the contour (in between the two closest
points).
- Kill : initiates the mode delete contour points (delete the closest point to the point
indicated with the mouse).
Figure V-9 : Modification of contour menu
- Change : initiates the mode displacement of contour points (with an effect of flexible
link with the adjacent points).
For these three functions, the cursor has to be placed, with the aid of the mouse, in the
vicinity of the region we want to modify. Click with the right mouse button to activate
the desired modification (Add, Kill or Change).
. While adding points the cursor is an arrow.
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V-20 iSis 3D - V 2. 35 – March 2003
. While deleting points the cursor is a pair of scissors, and when the scissors are in the
vicinity of a contour point, a small a small pink square shows the point.
. While modifying a contour, the cursor is an arrow, and when the arrow is in the
vicinity of a contour point, a small a small pink square shows the point.
- Cancel : retrieves the initial shape of the contour and ends the function.
- Ok : validates the new contour shape and ends the function “distort contour”.
V.2.4 The trace mode
The trace mode allows, during the contouring operation, to be guided by what was
done in adjacent slices. This function is particularly useful when introducing contours
for a structure difficult to be seen in the images. It is possible either to see the contours
from adjacent slices through transparency, or recopy one of these contours in order to
adjust it later by reshaping.
Two items from the CONTOURING menu are chosen in order to work in copy mode:
Trace and Options of tracing...
Trace starts the function copy. Actually, the name and the function of this item evolves
depending on the chosen options.
Options of tracing opens a specific dialog box (Figure V-10)
In he upper part of the box is a scrolling list containing a list of the structures and
items <-> and <all>, which allows to choose the structure to be trace (or the whole set
of internal contours if <all> is selected, <-> desnactive tracing mode).
Next should be specified if the contours to be displayed are to be taken on the upper
slice, the lower slice or on both. A slice is called “upper” if its Z is superior to the Z
of the current slice. In the opposite case it is called “lower” slice.
The option systematic trace allows to see through transparency the contour(s) of the
slice(s) specified systematically without needing to restart the function trace.
The option with re-copy of contours permits to retrieve in the current slice the
contour(s) originating form the superior or the inferior slice. This option is deactivated if
copying is asked in the same time from the two slices.
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Figure V-10 : Option of trace
The option with recalculate density is accessible only in case of recopying. It allows
to restart the calculation of the average density as a function of the Hounsfield
numbers found (cf.: § V.2.6, iSis 3D - Procedure Creation/Modification of Contours,
Automatic Densities Calculation).
The function trace is not accessible if:
• the slice where to copy do not exist (beginning or end of list),
• the chosen structure is not available in the slices where to copy,
• no structure has been selected (<->)
• in the mode systematic copy.
If the option recopy is selected, the item trace of menu is replaced by Copy.
Meanwhile it will appear in the menu the name of the structure to be trace/multiplied
(or all) and in between parentheses the slice which contains the copy (up, low or
both).
V.2.5 Automatic Densities Calculation
The density assigned to the contours is used in the procedure for heterogeneities
correction. Instead of arbitrarily defining a density value either explicitly in the box for
contours modification, or intermediately in the structure density, the program can be
asked to calculate from the information contained in the image.
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V-22 iSis 3D - V 2. 35 – March 2003
In practice, this solution is applicable only to images from an X scanner, for which the
values assigned to the pixels are expressed in the scale of Hounsfield numbers (from -
1000 to +3000). The conversion Hounsfield numbers →→→→ density is realized through
an intermediate - a curve in standard format “FIFI”, stored in the file “sc.den”. For the
moment, for a given user it is not possible to select the curve corresponding to a given
imaging device without modifying the content of this file. If the file exists, the densities
can be displayed in the box for adjusting the contrast (cf.: § VIII, iSis 3D - Display
menu), or calculated in the interior of a given contour.
The item automatic calculation of densities of the menu contouring can be switched
on or off. A tablet displayed at the left of the item indicates that this mode is active. In
this case, each time a contour is created or modified, the program starts automatically
the calculation of the average value for the pixels located in the interior of the contour.
This average value is afterwards converted to density and assigned to the contour.
The corresponding value will be displayed in the box for contour modification and in
the calculation plans where the used values will be recalled if there is a heterogeneity
correction to be performed. This mode remains active as long as the item of the menu
is not reselected.
Whatever mode is chosen, it is always possible to “force” the calculation of the
average density with the help of the compute button in the box for contour
modification.
V.2.6 Structures/Bolus
Permit to update the list of structures by opening the corresponding dialog box (cf.: §
IV.8, iSis 3D - Menu slices, Structures/Bolus).
V.3 Display
The display can be modified if this adds for contouring. The most frequent
modifications (Zoom, Restore and Level/Windows) are permanently accessible
through the corresponding buttons located in the upper part of the active window.
Other functions are accessible from under the rubric Display, of the menu bar, which
gives access to the following submenu:
- Image
- Contours
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iSis 3D - V 2. 35 – March 2003 V-23
- Current Beam
------------------------
- Grid >
- Distance Measurement
- Angle Measurement
Image et Contours allow to display or hide the image(s) and/or the contours of the
current slice (cf.: § VIII, Display Menu).
Current Beam offers the possibility to display the current beam during the contouring.
This item is not accessible if there isn’t any current beam. Furthermore, this option is
only available in the Display option if the “Current beam visualization in
creation/modification of contours” option is activated in the corresponding configuration
file
Zoom allow to enlarge or reduce the field of vision of the slice.
Restore allows to return to the previous "zoom" values.
Level/Windows allows to adjust the image contrast. It is not accessible if there is no
image.
Grid allows to display (or delete) at any moment a grid of chosen step centered on the
origin and superimposed on the active window.
Distance measurement allows to measure the real distance between any two points
specified on the screen with the mouse.
Angle measurement allows to measure the angle between any two vectors specified
on the screen with the mouse.
All these functions are similar to those used during the manipulation of the calculation
planes (cf.: § VIII, iSis 3D - Display Menu).
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V-24 iSis 3D - V 2. 35 – March 2003
CHAPTER VI - BEAMS MENU
iSis 3D - V 2. 35 – March 2003 VI-1
VI. BEAMS MENU
Proposes the following sub-menu:
- Inverse planning
---------------
- New...
- Change...
- Duplicate...
- Opposed...
- Mirror...
- Kill
- --------------
- Doses per fraction
- --------------
- Virtual simulation
This menu allows to create beams in different manners (New, Duplicate, Opposed,
Mirror) and then to modify them with Change, and to delete them with Kill.
It also gives access to " Virtual simulation ", in which the anatomical data are
projected onto a plane (“film”) according to a “point of view” which can be associated
or not to a beam. From the mode virtual simulation can be accessed interactively the
set of functions for the creation/modification of the beam.
The option "Inverse Planning" allows to launch the beam dynamic intensity modulation
optimisation. according to constrainst of dose. This optional module is described into
" ISIS3D – Inverse planning tools for IMRT "
The beams which are created are automatically named by the system B1, B2, B3,
…Bn respecting the order in which they have been created. The maximum
number of beams that can be created is 56. Beams can be imported from other
studies (cf.: § III.13.2, iSis 3D – File menu, Import beams).
Since the first beam has been created the box for selecting the beam represented in
figure VI-1 is available. It is displayed in the first plane while the window for
creation/modification of beams is closed.
CHAPTER VI - BEAMS MENU
VI-2 iSis 3D - V 2. 35 – March 2003
Figure VI-1 : Beam selection box
The description of Beam selection box is done at § II.4.3, Generale principles, beam
selection box.
VI.1 New and Change
New : This choice permits to open the window creation/modification of beams and to
display a new beam proposed by default as well as the complete list of parameters.
Change : This choice permits to modify the current beam, thus it is accessible only if
there is a current beam is designated. Another way to access this mode is to double
click on the name of the beam to be modified in the “box for selecting the beam”.
The beam to be created or modified will appear pink and overwritten on the weighting
slice (cf.: § VI.1.3 – iSis 3D, Beam menu, beam paramaters, reference point). which is
displayed in the graphic zone of the window creation/modification of beams.
VI.1.1 The window for creation/ modification of beams
All the operations concerning the beams are performed within a unique window,
having the screen size (Figure VI-2), from within which are accessible all the beam
parameters and the display options. This window is used for:
• creating new beams
• modifying the existing beams
• displaying the position and/or the shape of the field and of the structures
• creating, displaying or modifying the “views” starting from the memorized “point
of views”
The main elements of the window for creation/ modification of beams are the following:
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iSis 3D - V 2. 35 – March 2003 VI-3
• The graphic area occupies the upper left part of the screen. In this zone is
displayed either the transverse weighting slice, or a beam eye view, for the
current beam.
• The list of views and beams, and associated command buttons, located in the
lower central region of the screen, allows to select the current beam and to
confirm the modifications. A complementary button allows to bring to the front
plane the window for visualizing the list of beams (Figure III-6), to consult it or
to print it.
• The list with the parameters of the current beam is displayed in the right part
of the screen.
• The display options are grouped in the lower left part of the screen, under the
visualization zone.
• Two changing mode buttons, located at the lower part of the window enable
the user to toggle the current view between “slice mode” (“reference slice” or
“weighting slice1”) and “virtual simulation mode” (=”beam’s eye view). The
“reference slice” mode and “weighting slice” mode are alternatively accessible
by using the “slice mode” button and changing the label on it. These options are
available when the reference point and the weighing point are located on
distinct slices. The initially suggested option is the “reference slice” mode. It is
also possible to enter the virtual simulation mode from the corresponding item in
the “Beams” menu.
• A close button located in the lower right part of the screen permits to quit the
mode creation/ modification of beams.
1 The reference slice, is the transverse slice containing the reference point (isocenter for SAD or ARC
technique, entry point point for SSD technique). The wieghting slice is the transverse slice containing
the weighting point.
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VI-4 iSis 3D - V 2. 35 – March 2003
Figure VI-2 : Reference slice
Remark : Most of the operations of creation/ modification of beams can be done in
either modes (“weighting slice” or “virtual simulation”). However each of these
modes has its own particularities. In the following descriptive paragraph the operations
which are common to the two modes and those which are not. All the operations
specific to the mode “virtual simulation”, including the beam shape adjustment and the
creation of DRR ("Digital Reconstructed Radiographs"), are described in the
paragraph dedicated to virtual simulation (cf.: § VI.7, iSis 3D - Menu Beams, Virtual
Simulation).
VI.1.2 Creation and modification of the current beam
The usual method for creating a new beam consists in choosing the item New from the
BEAMS menu.
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iSis 3D - V 2. 35 – March 2003 VI-5
A beam is then generated with the technique SAD centered, in the first common
isocenter point if defined (cf.: § IV.11, iSis 3D – Slice menu, Point od Interest), if not in
the origin, for a 10 cm x 10 cm field. The chosen treatment unit is the first treatment
unit found in the library if no beam has been defined, or the last selected in the
opposite case. This beam is displayed in the reference slice which is either slice with
the common isocenter or the current slice. The weighting point is located at the
isocenter of the beam. The reference slice and weighting slice are the same. Beam
characteristics can be modified then in the list with the beam parameters or directly in
the graphical window, with the mouse.
It is important to understand that the beam generated in this manner is temporary.
Hence it does not appear in the list with beams displayed in the central part of he
window. It can be modified according to the user desire.
The already existing beams appear in the list: Beam B1, Beam B2, .… The beam to
be visualized and modified can be selected by clicking on its name which appears as
inverted video and becomes the “current” beam. Its characteristics are displayed then
in numerical form in the right part of the screen and in graphical form in the
visualization window. Since its characteristics had been modified, its “original” status
becomes “modified”. At this moment it is in a temporary status. Allowing different trials.
A box situated in the immediate proximity of the list with beam identifiers allows to
recall the current beam number and its status. A field of options allows to assign to it a
specific label (anterior, lateral).
Two buttons located in the " LIST OF VIEW AND BEAMS" part of the list containing the
beam parameters allows to generate rapidly a beam “Opposed” or “Mirror” relative to
the current temporary beam status. The exact significance of these two statuses is
specified in the descriptions of the items of the corresponding menu (cf.: § VI.3 and
VI.4, iSis 3D - Beam Menu, Opposed, Mirror).
After modifying the beam parameters, the following operations are possible by
pressing the corresponding buttons:
• Create a new beam from the current beam parameters (Create Bn+1) [n is the
first available number on the list],
• .Change the modifications of the current beam (Change Bn),
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VI-6 iSis 3D - V 2. 35 – March 2003
• Kill the current beam (Delete Bn).
Since a beam is “created” or “Changed” it goes back to its original status which will be
saved for the rest of the processes.
Remark 1 : to duplicate the current beam, it is enough to click on (Create Fn+1)
before modifying it. Then the program asks to specify its label (cf : § VI.2, iSIs 3D –
Beam menu, dupplicate),.
Remark 2 : The beam numbering order can be eventually modified, recopying the
beams placed in wrong positions (with “"create"), freeing the corresponding positions
(with "kill"), recreating in the correct order the beams from those which have been
previously recopied an finally deleting the beams which have been temporarily placed
at the list end…
Remark 3 : After the modifications, in case of changing the current beam (selected
from the list) or closing the window (Close), a warning message recalls that, if none
of the operations Create or Change was previously performed, the last modifications
made on the current beam will be lost. If the answer is Continue, this confirms the
option to continue without taking into account the modifications. If the answer is
Change or Create, this allows to validate the temporary parameters of the beam Bn
and the answer Cancel permits to return to the mode creation/ modification of the
current beam.
Remark 4 : In the case an irregular field was defined in order to protect certain
structures, most of the ballistic modifications (isocenter, gantry, table or collimator
rotation angles) risk to rise the problem of the validity of the field shape. A warning
message will appear thus on Change.
VI.1.3 Beam parameters
All the beam parameters are accessible as well in mode "slice", as in mode “virtual
simulation”. They can be modified in one of the following three ways:
• Type the numerical value of the parameter and then confirm it passing to the
next option fields pressing the Tab key or with a mouse click.
• Modify the current value acting on the buttons + and -, located on the sides.
Depending on the mouse button used: the left, the central or the right, the
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iSis 3D - V 2. 35 – March 2003 VI-7
values are incremented (or decremented) with a step of 1. cm, 0.1 cm and 0.01
cm for the coordinates, of 10. cm, 1. cm and 0.1 cm for the distances to the
source, and of 10.0, 1.0 and 0.10 for the rotations, respectively.
• Move the mouse graphically in the visualization window. The simple fact to
bring the cursor in this window makes the cursor change shape, becoming a
“hand” which indicates the elements that might be displaced by “click and drag”.
Meanwhile the value of the parameter is displayed in real time in the left part of
the visualization window and can be thus controlled. The modification type is
recalled by a message in the active window (in the lower left part).
In the mode “slice”, the elements which can be modified in these ways are:
• the reference point (isocenter or entrance point) = the cursor is an arrow,
“pointing” to the reference point (reference slice only).
• the gantry rotation angle = the cursor is an angle; in the ARC technique the
start and final angles, identified by the letters S and E (from start and end)
respectively, are alternatively modified.
• the collimator opening = the cursor is a vertical rod, “pointing” to the jaws
• the depth of the weighting point on the axis can be modified also graphically,
but first should be clicked on the corresponding "mouse" button, in the list with
the beam parameters.
Remark 1 : If the displayed slice is not the reference slice only the gantry rotation can
be graphically modified.
Remark 2 : It is also possible to modify graphically the position of “Points Of Interest”
defined as “isocenter” or “weighting point”, but any modification is performed using the
corresponding functions in the list of beam parameters described above.
The list of the current beam parameters is located in the right part of the screen. It is
compartimented in many zones, eaach of them including a group of parameters
(Figure VI-4).
These zones are:
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VI-8 iSis 3D - V 2. 35 – March 2003
BEAM IDENTIFIER (N°, LABEL, STATUS):
It appears in the beginning of the list with parameters. The
label can be modified in the case of introducing data in
the List of views and beams, located in the lower central part of the window creation/
modification of beams.
MACHINE AND TECHNIQUE:
Machine : The treatment machine, the
beam nature (photons, electrons, protons mode) and its energy can be selected from a
pop-up list containing the corresponding menus in cascade.
Each combination of machine/mode/energy is univocally referenced in the library with
a name chosen arbitrarily by the user, reminding the beam characteristics (ref.
documentation relative to the constitution and verification of the treatment machines
library). For example, SATX20 could represent a 20 MV photon beam (X) from a
SATurne treatment machine. In any case, the details of each combination can be
found in a correspondence table defined in the BIBAP2.TBL file (cf.: Appendix 1 of
Creation of the treatment unit library …, "MACHINE - UNIT" RELATIONSHIP TABLE
(BIBAP2.TBL)).
If a treatment machine has more than one particle modes (e.g. photons, electrons) and
more than one energies, then the appropriate combination can be selected from a
pop-up list with cascade menus. Depending on the selected machine, the machine
name, the beam nature ("X" (photons), "E" (electrons) or "P" (protons)) and its energy
are shown in the last item of the list.
These cascade lists have been defined based on the table of the BIBAP2.TBL file
mentioned above. The definition order of that table is kept in the creation of the lists.
Any machine defined in the BIBAP2.BIB library but not listed in the correspondence
table of the BIBAP2.TBL file, is grouped under the “Other” item. The option “None”,
corresponds to the definition of a “view” that is not attached to a particular machine
(cf.: § VI.7.1, iSIs 3D - Beams Menu, Virtual Simulation, Notion of view).
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iSis 3D - V 2. 35 – March 2003 VI-9
Remark 1: Any machine defined in the correspondence table but not defined in the
library BIBAP2.BIB, is eliminated from the list. In that case, a message appears in the
execution window.
Remark 2: The generic name of the machine, as it is listed in the first level of the
cascade list, is also used in order to handle data exportation towards an exterior
Control & Verify System. (cf.: § III.14.1, iSis 3D - File menu, Export beams.). In the
special case where more than one generic names have been associated to the same
machine code, it would be useful to be able to know which of these names has been
used. For this reason, the current name of the actually used machine, is being
highlighted in the list (note that the list can be consulted at any time).
In the special case of proton beams, one machine from the library corresponds to the
entire range of energies. It is then necessary to further clarify the proton “range”
(=depth of 90% in cm) and the modulation (= distance in cm between the 90% distal
and the 90% proximal).
Technique: exclusive buttons for selecting the SSD technique (fixed source- skin
distance), DST = source tumor distance (isocentric) or ARC (arc therapy).
SSD (cm) or DSA (cm) : introduction of the reference distance.
This field is called SSD (cm) when the adopted technique is SSD and DSA (cm)
when the adopted technique is STD = isocentric (SAD) or ARC. DSA is
automatically displayed and corresponds to the SAD previously chosen for the
treatment unit and it cannot be modified. Only the SSD value can be modified.
It is possible to pass from the SSD technique to the isocentric technique and vice
versa. The rules to apply are the following:
- SSD DST : the weighting point in mandatory on axis. The normalization depth is
preserved. The isocenter is thus placed on the beam axis at the normaization point.
The field size remains unchanged.
If weighting is not on axis, it is not possible to change technique SSD -> DST.
Weighting point has to be set on axis before to change technique.
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VI-10 iSis 3D - V 2. 35 – March 2003
- DST SSD : the normalization depth is preserved and the reference point is
brought to the skin.
It is not possible to pass directly SSD ↔ ARC. However it is possible to pass directly
SSD ↔ DST et DST ↔ ARC
REFERENCE POINT :
- Isocenter or Entry point: is displayed,
depending on the technique chosen.
Actually, the reference point of the beam is
the entrance point (intersection of the
beam axis with the external contour of the normalization slice) in the SSD technique. A
point in the interior of the contour will be the isocenter in the isocentric technique, DST
or ARC.
- X, Y, Z : correspond to the coordinates X, Y, Z of the reference point in the
radiotherapy coordinate system.
By default Z is the longitudinal position of the current slice named « reference slice »,
i.e. the (rescaled) slice which contains the normalization point. In case Z is changed,
the corresponding normalization slice is displayed again.
In the coplanar technique (without table rotation), the reference point can be moved
with the mouse in the slice windows mode or virtual simulation mode, whatever
technique used. (cf.: § VI.7.2.a, iSis 3D - Beams menu, Virtual simulation
creation/modification of beam). The X,Y and Z fields are accessible .
In the noncoplanar technique (with table rotation), the reference point can be moved
with the mouse only in “virtual simulation mode”, whatever technique used. It can be
also defined with X,Y and Z fields.
- Centering on: is a button which allows the automatic calculation of the reference
point in the center of the structure selected from the associated scrolling list “Center
on”. This “center” can be defined as the center of the smallest sphere encompassing
the structure ("Spherical centering ") or as the center of the smallest parallelepiped X,
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iSis 3D - V 2. 35 – March 2003 VI-11
Y, Z encompassing the structure ("Parallelepipedique centering"). The second option
is better adapted for treatments in coplanar mode (without table rotation).
In the case of spherical automatic centering only, the diameter of the sphere including
the structure is being reminded.
- Related point :
Only in the case of SAD or ARC techniques, the “related point” offers the possibility to
attach a beam to a common isocenter (a Point of Interest defined as “isocenter”, (cf.: §
IV.11, iSIs 3D - Slices Menu, Points of Interest) that can be either predefined or
defined during the creation/modification of beams. The modification of the position of
that point can be done in two ways:
- By acting on those points (Input box for the “Point of Interest” characteristics),
- By moving (graphically) the current reference point and then shifting the
associated Point of Interest on this new position.
The second way is probably the most convenient one.
A pop-up list allows to define the attachment option for the beam:
- « None » is being displayed if the beam is not attached to any common isocenter. In
the opposite case, selecting this option cancels the association of the beam to the
common isocenter.
-« New » offers the possibility to define a new common isocenter. The selection of this
option opens the input box for the characteristics of the Point of Interest. (cf.: § IV.11.2,
iSIs 3D - Slices menu, Points of interest,… ). An identification code and a name are
being suggested by default, such as « Ix» and « Isocentre_x, x being the first available
index. The initial coordinates (by default) of the Point of Interest are the coordinates of
the beam isocenter. Compulsory, the type of the Point of Interest is « Isocenter ».
The point type can be completed, for example defining it as a dose point as well. The
position of the Point of Interest can be modified by entering new coordinates, by
automatically centering it in a structure or by defining it graphically, either on the
“virtual simulation” view, or in the “reference view”, according to the active display
mode at the moment of the dialog box opening. While in the “reference slice” display
mode, a modification of the Z results to the display of the corresponding slice that
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VI-12 iSis 3D - V 2. 35 – March 2003
becomes the new “reference slice”. The creation of the new isocenter becomes
effective when the characteristics of the reference point are being validated using the
« OK » button. Closing the dialog using the « Cancel » button, cancels the creation of
the point associated to the beam isocenter.
By validating the Point of Interest , the coordinates of the beam reference point are
being updated according to the coordinates of the new isocenter. The menu of the
associated point shows the identification code of the new isocenter and the “Details”
button (cf .: § hereunder) becomes accessible.
- The list of beam attachment options is being completed with the list of all existing
common isocenters. Selecting an isocenter in this list offers the possibility to modify
the coordinates of the common isocenter and gives access to the « Details » button .
An information message is being displayed if, the position of the reference point or the
weighting depth have been modified.
Details opens the dialog box for the modification of the point characteristics. It is
initialized with the characteristics of the point associated to the beam isocenter.
Remark 1 : any modification of the Point of Interest, or “common isocenter”, results
to the change of the current isocenter and to the modification of all the beams
associated to this “current isocenter” ( cf : Remark 1). Match becomes accessible
when the reference point of the current beam is being moved and it is no more
superimposed to the associated point. The matching results to the modification of the
associated point or “common isocenter”, that is then placed on the reference point. If
other beams are also attached to the same “common isocenter”, then their reference
point is also modified ( ref : Remark 2)
Remark 2 : the weighting depth of the beams associated to this “common isocenter”
is being recalculated in the case of modification of its position using the Details or
Match options. If the new depth has not been validated, then the beams are being
detached from this isocenter and their Point of Interest is not being changed.
Remark 3 : canceling the modification of the current beam, also cancels the
matching of the associated “common isocenter” and as a consequence any
modification of the beams attached to this “common isocenter”.
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iSis 3D - V 2. 35 – March 2003 VI-13
GANTRY ROTATION - TABLE ROTATION :
- Gantry rotation, start (and end)” : In SSD or in isocentric technique, the gantry
rotation angle, in degrees, is specified, in agreement with the conventions of ICE. In
ARC technique are indicated the starting and the final arc angles “Clock Wise" ”
(attention to the range!). The corresponding arc is represented graphically. In all cases
the angle can be adjusted directly with the mouse in the graphic window.
- Table rotation : The angle of the table isocentric rotation is specified, in agreement
with the conventions of ICE. Thus a beam entering from the head top usually
corresponds to a combination gantry rotation angle/ table rotation angle 90°/270° or
270°/90°. Taking into account the difficulties in defining the reference point, the table
rotation is not allowed in the SSD technique when the SSD value differs from the SAD
value.
In case of table rotation (noncoplanar technique), the beam is or is not displayed in the
calculation plane or virtual simulation, according to option selected into beam box ‘
COLLIMATOR :
The information given in this zone,
concern the main collimator jaws.
- Rotation (0) : introduce the collimator rotation angle, according to the ICE norms
(positive in the counter clockwise sense looking from the source to the isocenter). A
“shortcut” allows a rapid display; one of the 4 principal positions can be found in the
proximity of the field defining the wedge filter. If there is a collimator rotation, an “R”
appears nearby the entrance point in the transverse slices.
- FX and FY (cm): Introduce or display the dimensions of the principal collimator.
These dimensions are defined (starting with ISIS3D v2.1) at the distance from the
isocenter. Hence the values of the “collimator opening” are to be displayed
directly on the treatment unit. In the case it might be an ambiguity (SSD different
from SAD), a warning message recalls the adopted convention. The user may choose
not to be shown any more this message, ("Vu, ne plus m’alerter"), for the respective
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VI-14 iSis 3D - V 2. 35 – March 2003
dossier and the message will be presented only after passing to the next dossier. This
message can also be inhibited with an option from the configuration file.
FX and FY are named according to the ICE conventions; Fx corresponds to the “width”
and FY to the “length” in the case of zero collimator rotation.
For each pair of jaws X or Y, it is possible to specify if it is used in mode symmetric,
asymmetric or multi-leaf.
- If the asymmetric mode is selected for one of the pairs of jaws, the fields for
introducing FX or FY becomes inaccessible and it should be clicked on the button
"Details" in order to introduce the individual values for X1, X2, Y1 or Y2
corresponding to each jaws pair. However it is more convenient to adjust the position
of each jaw by mousse in the graphic window (see also “virtual simulation” mode).
Note that it is possible (for the moment) to define the asymmetric mode for any pair of
jaws, even if the treatment unit does not actually permit that.
- If the treatment unit has a level of principal collimation (X or Y) equipped with a
multi-leaf collimator, this option becomes accessible having the possibility to
calculate automatically the leaves position after defining a field shape and chosen a
target (cf.: hereunder).
ADDITIONAL COLLIMATION :
The fields of options, scrolling lists and
buttons of this pop-up menu are related to
the eventual additional collimation.
Type
It is related to the trimmers, the blocks fixed on the block-trays already recorded in the
machine library as well as the leaves of the additional multi-leaf collimator. It is not
possible different combination of these elements. The selection “none” allows to
cancel all the additional collimation previously defined.
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iSis 3D - V 2. 35 – March 2003 VI-15
Number
The trimmer or tray number, if it is the case, is selected form the from a scrolling list
limited by the available record for the selected unit. The Source-Tray Distance or
Source-Trimmer Distance is also displayed, as a verification.
Remark : When a tray or multi-leaf collimator is used, automatically is proceeded
to the “virtual simulation mode” in order to define the field shape. For more details on
the possibilities offered refer to the virtual simulation mode (cf.: § VI.7, iSIs 3D - Beam
Menu, Virtual Simulation, Multi-leaf Collimator).
WEDGE FILTER :
Select the desired filter from within
the drop-down list containing the
available filters for the current machine or answer “NO” in order to cancel the filter
previously selected. The corresponding angle is recalled for verification.
The filters are always “attached” to the main collimator, meaning that they accompany
the collimator rotation. They are four types, according to the way they were defined
within the library:
• either they occupy an unique position with respect to the principal collimator
(defined in the library)
• either they have the possibility to be inserted according several orientations.
• either they are dynamic of VARIAN EDW Y1IN type
• either they are dynamic of VARIAN EDW Y2OUT type.
In the first case, the orientation is performed playing with the rotation of the collimator.
The buttons corresponding to the principal orientations allow to rapidly rotate by 90° or
180°.
In the second case, the orientation which can be right, left, gun or target has to be
specified. This label corresponds to the thicker edge of the wedge filter considering the
rotations of the collimator and of the gantry equal to 0°.
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VI-16 iSis 3D - V 2. 35 – March 2003
In the third case, there is about a Varian dynamic wedge, obtained by the
displacement of the Y2 leaf, during the irradiation, towards the target. This filter is
equivalent to a physical filter for which the orientation of the thicker edge is target
In the fourth case, is about a dynamic Varian filter, obtained by the displacement of the
Y2 leaf during the irradiation towards the target. This filter is equivalent to a physical
filter for which the orientation of the thicker edge is gun.
For these last two cases, the calculation of the monitor units is based on the value of
the Y dimension (according to the side of the equivalent square field). In any case, the
calculation of the monitor units is authorized only if the equivalent square field (or the
involved side for the dynamic filters) is part of the interval defined for the variation of
the transmission, which is function of field dimensions.
The selected orientation of the wedge filter can be checked by looking on the graphical
display area.
Remark : Do not forget to converse the length and width when the collimator is rotated
with 900 or 2700 .
COMPENSATOR / MODULATOR :
Modulators are dynamic intensity
modulation files such as those
generated by an inverse planing procedure. They concern only photon beams with
multileaf collimators.
Compensators are beam modifiers attached on the collimator that have been
previously calculated in order to compensate the patient’s irregular surface and/or
tissue heterogeneity. The COMPENSATOR/MODULATOR menu is accessible only for
photon beams with multileaf collimators and for proton beams, provided that structures
have been defined.
Actions relative to the buttons of this option depend on the type of the beam. The
procedure for photon beams is that of inverse planning and it is described in the
document entitled “ISIS3D – Inverse planning tools for IMRT”. Here, we will only
describe the application functions relative to the proton beams.
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iSis 3D - V 2. 35 – March 2003 VI-17
Utilization of compensator with photon beam is described into Appendix G.
BOLUS :
It is possible to associate a bolus to the current beam with the condition that the
property “bolus” was previously associated to one or more structures (cf.: § IV.8, iSIs
3D - Slices menu, structures/bolus).
The bolus is selected form the list with available bolus for the current case. The
eventually free-space (between bolus and skin surface) is checked and a message is
displayed if free-space was detected, then the bolus is not taken into account. If the
bolus was taken into account (no free-space available) it is required to modify its
contour by selecting the creation/modification of the contour (cf.: § V.2.4, iSIs 3D-
Procedure Creation/Modification of Contours) and then re-associate it to the beam.
BEAM WEIGHTING :
The “weight” of each beam is being
defined according to its contribution on a
specific point called “weighting point”. In
ISIS 3D, there are two different ways of beam weighting: the “theoretical weighting”
mode and the “effective weighting” mode. From ISIS3D-Version 2.3, the weighting
point can be defined either on the beam axis or off-axis on a specific point defined as
“weighting point” (cf : § II.3.4, iSis 3D - General Principles, Theoretical and effective
contribution).
A- Type of weighting
A pop-up list offers the possibility of choosing the position of the weighting point :
• on-axis is the default option of the weighting point position.
In a SAD or ARC technique, the weighting point is compulsory the isocenter. In
a SSD technique, the weighting point is being defined automatically for electron
beams as the depth of maximum dose and it cannot be modified, otherwise it is
defined as a function of the specified weighting depth. The reference slice is the
same with the weighting slice.
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VI-18 iSis 3D - V 2. 35 – March 2003
• New point offers the possibility to define a weighting point off-axis, or on-axis
but at a depth which is different than the automatically calculated one.
Selecting this option, opens an input box for the definition of the characteristics
of the point of interest. (cf.: § IV.11.2, Slices menu, Points of Interest,… ). An
identification code and a name are suggested by default, such as « Wx» and
"Weight._x", x being the first available index. The coordinates of the Point of
Interest are being initialized with the coordinates of the initial weighting point.
The “type” of the Point of Interest is compulsory the « Weighting Point » type,
and it can be further completed e.g. as a “dose point”. The position of the Point
of Interest can be modified by entering new coordinates, by automatically
centering it in a structure, or by defining it graphically, either on the “virtual
simulation” view, or in the “weighting view”, according to the active display
mode at the moment of the dialog box opening. While in the “weighting slice”
display mode, a modification of the Z results to the display of the corresponding
slice that becomes the new “weighting slice”. The creation of the new weighting
point becomes effective when the characteristics of the point are being
validated using the « OK » button.
By validating the Point of Interest, the coordinates of the beam weighting point, the
weighting depth and the weighting slice are being updated. The “Details” button (cf
hereunder) becomes accessible.
• The list of options relative to the position of the weighting point is being
completed with the list of all existing weighting points. Selecting a weighting
point in this list offers the possibility to modify the coordinates of the weighting
point, to recalculate the weighting depth, to update the weighting slice and to
access the « Details » button.
Details opens the dialog box for the modification of the point characteristics. It is
initialized with the characteristics of the weighting point.
Remark 1: any modification of the Point of Interest, results to the change of the
weighting point for the current beam but also for all the beams associated to this point.
If the new weighting depths are not correct, then following user confirmation the
weighting mode of invalid beams can be modified by removing the association and
returning to on-axis weighting mode.
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iSis 3D - V 2. 35 – March 2003 VI-19
Remark 2 : canceling the changes done on the current beam, results to the
cancellation of any possible modification of the Point of Interest and as a consequence
any modification of the beams attached to that point.
B- Depth of the weighting point
The Mouse button, is accessible for photons or protons in SSD mode with on-axis
weighting and offers the possibility to graphically define the weighting point in the
reference slice or in the weighting slice.
Depth (cm) : is used in order to input (or as a reminder of) the weighting depth,
according to the applied technique and the position of the weighting point.
- Contribution: This is the dose (relative or absolute) at the weighting point due to
the current beam. To facilitate the searching for the optimum weightings, the weighting
of each beam is also displayed in the box for selecting the beams, where it can be
modified.
- Depth (cm): allows to input or recalls the depth of the weighting point.
The weighting point is on axis :
• In SSD technique
o For photons beams, this depth is specified by the user, but never can
be smaller than the depth of maximum dose. The 0 value allows to work
change in the mode “weighting at the entrance”. The depth of maximum
dose is then automatically recomputed, (beam modifiers are not take into
account) even if field dimensions or energy has been modified. On the
other hand, if depth greater than the depth of maximum dose is explicitly
given, than this depth is a priori saved for all the cases where the depth
of maximum dose is smaller.
o For electron, the depth of the weighting point is always the depth of
dose maximum, calculated under “real” conditions, taking into account
the additional electron blocks.
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VI-20 iSis 3D - V 2. 35 – March 2003
o For proton beams, the weighting point must be placed on the
modulation plateau. The point can be placed automatically in the middle
of the modulation plateau by entering a weighting depth equal to zero.
• In SAD technique the normalization depth is automatically computed and, by
default, taken equal to the one of the isocenter. This value is not modifiable.
• In ARC technique, it is not possible to modify the normalization depth. This
depth is automatically computed and considered as equal to the “effective”
depth of the isocenter, that means at a depth which gives a TMR (Tissue-
Maximum Ratio) equal to the average TMR computed over all the area scanned
by the arc
The weighting point is associated to a point of interest :
• In SSD or SAD technique, the weighting depth displayed is the depth of point of
interest.
• In ARC technique the weighting depth displayed is the “effective” depth of point
of interest.
C- Value of contribution at weighting point :
Contribution: This is the dose (relative or absolute) at the weighting point due to
the current beam.
To facilitate the searching for the optimum weightings, the weighting of each beam is
also displayed in the box for selecting the beams, where it can be modified.
The two buttons, theor. and effect. allow to select between the modes:
- In “theoretic weighting” mode, where the dose contribution at the weighting
point is given considering the case of the semi-infinite medium and no
blocks or inhomogeneities are present.
- In “effective weighting” mode, the entire contribution at the weighting point
is effectively taken into account.
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iSis 3D - V 2. 35 – March 2003 VI-21
The “theoretic” and “effective” contributions are both computed in any case and
displayed in the summary-file on the beams list.
In case of weighting at a point of interest or forelectron beam, the mode of contribution
is mandatory “effective” and cannot be modifiable.
For more information about ”theroretical’ and ”effective” mode, cf.: § II-3-4, iSis3D –
General principles, Tearetical and effective contribution.
D- Remarks about weighting
Remark 1: the button " mouse capture” related to the weighting depth allows to
adjust in the graphic area and in real time the corresponding depth by using the
mouse. The depth validation is performed by clicking on Ok button.
Remark 2: In “theoretical weighting” is normal (in the presence of blocks,
inhomogeneities or lack of scatter volume) to obtain at the normalization point a dose
different from the prescribed contribution. Change the mode or calculate with the rule
of three simple over the contribution in order to obtain the desired result then check if it
is coherent with the method specified for treatment time calculation.
Remark 3: In all the cases, a warning message signals an incorrect technique if the
normalization depth is placed at a depth smaller than the depth of maximum dose
(case of photons and electrons) or beyond the modulation region (proton beams). For
electron beams no check is performed if the normalization depth is placed beyond the
depth of maximum dose.
Remark 4: In the case of bolus, the depth and the SSD values are always defined
relative to the real skin.
Remark 5: Although is better to avoid this situation, if the central beam passes
through air before reaching the normalization point, only the effective tissue crossed
by the beam is taken into account
ATTENTION !
The beam data restrict the calculations validity and their conformity according to
the designed and accomplished treatment plan. So, it is important that the
significance of different parameters, the adopted conventions (which can be
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VI-22 iSis 3D - V 2. 35 – March 2003
different than the ones of the machines used) be well understood. As a result, a
rigorous check of all data inputted for each study should be performed
(especially looking at the file with the beams used).
VI.1.4 Display options:
The slice mode implies a transverse view of the corresponding slice in the graphic
area. The parameters displayed are: the contours, the image (if it exists), point of
interest and the beams (with the exception of the non-coplanar beams). The current
beam is pink-colored and can be moved and adjusted by mouse (cf.: § VI.1.3, iSis 3D -
Beam Menu, New/Modify, Beam parameters).
“All cont.” or “Image” option buttons allow to select or not the contours or the images in
the objects list as well as the convenient display mode (visible or not). For other
objects included on the list, the selection of the display mode remains inaccessible for
the “weighting contour”. It can be used only in the “virtual simulation” (cf.: § VI.7, iSis
3D - Beam Menu, Virtual Simulation).
Browser bar located right under the graphic windows allows to display other slices to
check the limits of the beam.
The flag R indicate that the displayed slice is the reference slice of the selected beam.
Figure VI-3 : Browser bar
The flag W indicate that the displayed slice is the weighting slice of the selected beam.
Central button :
- If the displayed slice is not the weighting slice, this will move to weighting slice.
- If the displayed slice is the weighting slice, this will move to the previous displayed
slice.
-1 / +1 : Move backward or forward one slice (range all slices)
-5 / +5 : Move backward or forward five slice (range all slices)
|< & >| : Move backward or forward one slice (range only selected slices)
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iSis 3D - V 2. 35 – March 2003 VI-23
Remark : slices are sorted according to the Z value and not the slice number
The Print button is right-down of the graphic area and allows to have a printout after
print options validation (cf.: § III.9, iSis 3D - File Menu, Print Current Study).
The most used display options are accessible due to the buttons placed right under
the graphic area. The buttons available are: Zoom, Refresh and Level/Window. The
Tools button includes the grid display, the distance measurement and the angle
measurement functions. All these functions are presented in detailed in the paragraph
dedicated to the DISPLAY menu (cf.: § VIII, iSis 3D - Display Menu).
VI.2 Duplicate
creates a new beam identical to the current beam and leads to the display of the beam
creation/modification window. The label of the new beam is by default “dup Bi”.
Weighting, dose per fraction, beam group are kept for the new beam.
The option “Duplicate” is accessible only for the current beam.
VI.3 Opposed
permits to create a new beam opposite to the current beam, that means co-axial but
the gantry is rotated with 1800, the field shape is inverted (taking into account the
leaves position), the rotation of the collimator and the wedge filter orientation. The
table rotation is preserved.
In the SSD technique, the coordinates of the reference point are recalculated and the
weighting depth is preserved. In the SAD technique, the isocenter position is
preserved and the normalization depth is recalculated if it is positioned at the
isocenter. If the normalization point is not placed at the isocenter, the normalization
depth is preserved. In all cases, the contribution value is preserved.
In SSD technique, the coordinate of reference point are recomputed and the depth of
the weighting point is kept if the qweithing is on axis. If the weighting point is a point of
interest, this point is kept and the weighting depth is recomputed. In SAD technique,
yhe isocenter position is kept as weel as the weigthing point located either at isocenter
or at point of interest. The weighting depth is recompute. In all case th contribution,
dose per fraction, beam group are kept.
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VI-24 iSis 3D - V 2. 35 – March 2003
The label of the created beam is, by default, “opp Bi”.
The option “Opposed” is accessible only for the current beam.
VI.4 Mirror
allows to create the mirror beam of the current beam, that means symmetrical
relative to a reference sagittal plane or parasagittal (taking into account the
inversion of the field shape, the leaves position, the rotation of the collimator and the
wedge filter orientation). This reference plane crosses throughout:
• the isocenter of the current beam, in a SAD or ARC technique;
• the contour origin, in a SSD technique.
In the case of the noncoplanar beam, the rotation of the table remains unchanged.
In the SSD technique, the coordinates of the reference point are recalculated and the
normalization depth is preserved. In the SAD technique, the isocenter position is
preserved and the normalization depth is recalculated if is positioned at the isocenter.
If the weighting point is not placed at the isocenter, the weighting depth is preserved.
In all cases, the contribution value is preserved.
In SSD technique, the coordinate of reference point are recomputed and the depth of
the weighting point is kept if the qweithing is on axis. If the weighting point is a point of
interest, this point is kept and the weighting depth is recomputed. In SAD technique,
yhe isocenter position is kept as weel as the weigthing point located either at isocenter
or at point of interest. The weighting depth is recompute. In all case th contribution,
dose per fraction, beam group are kept.
The label of the created beam is, by default, “mir Bi”.
The option “Mirror” is accessible only for the current beam.
VI.5 Kill
deletes the current beam after user confirmation.
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iSis 3D - V 2. 35 – March 2003 VI-25
VI.6 Dose per fraction
opens a dialog box (Figure VI-5) which includes the list with beams previously defined,
(identified by their current number and their label) in order to see their values for dose
per fraction. These doses are used to calculate the treatment time (cf.: § III.8, iSis 3D -
File Menu, Treatment times). Theoretical or effective doses can be selected as it was
stated in the definition of the beam weighting. Only the beams for which a dose per
fraction was already defined are available to compute the treatment time.
In specific cases (electrons or protons beams) the treatment time cannot (for the
moment) be computed. An informative message is displayed and should be validated.
If more than 8 beams are defined, an arrow allows to scroll all defined beams.
Figure VI-4 : Dose per fraction definition box
ATTENTION!
The validation of the treatment time is the direct responsibility of the user. This
calculation is strongly dependent on the method of data input and analysis of
the basic data inputted in the machine library. Reference dose rate data,
collimator opening factor, the transmission of the accessories are especially
important.
VI.7 Virtual simulation and field shape
The Virtual simulation mode ( = Beam Eye View) allows to control and adjust the beam
position and the field shape according to the structures specified on the transversal
slices. This modality is obligatorily active when the field shape (additional blocks or
multi-leaf collimator). is defined.
The Beam Eye View option is accessed either by selecting the option from the
“Beam” menu, or by clicking the “Virtual simulation” button while in
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VI-26 iSis 3D - V 2. 35 – March 2003
creation/modification of beam mode, displaying the weighting slice. The switch is
automatic as soon as the functions from creation/ modification of the field shape are
accessed.
The window which is displayed is similar with the window for creation/modification of
beam, as it appears in "contour de weighting" mode. In particular we recognize the
possibility to access the set of beam parameters and the display options. On the other
hand, the graphic area represents the field as seen from the “source view”,
composed of the following graphical elements:
• the main collimator (pink),
• the shape of the additional collimation (pink),
• the contours of the anatomical structures and the marks previously
introduced in the transverse slices
• the point of interest
• the Digital Reconstructed Radiograph image.
These elements correspond to a conical projection from the source on a plane
perpendicular on the beam axis and situated at a distance from the source specified in
the field “Virtual SFD ”, located at the lower right of the zone where are specified the
display options. The graphic zone representing a “virtual film” can be printed at the
desired magnification factor.
The following elements are indented to help for an easier orientation:
• The screen’s vertical corresponds by default to the longitudinal axis of the
machine, the gantry being identified by a small fixed square. (cf.: § VI.7.6, iSis
3D - Beams Menu, Virtual Simulation, Display Option).
• While the gantry or the table are rotated, everything is taking place like we were
lying on the machine gantry, with the head towards the gantry (the fixed square)
and looking towards the isocenter. Only the projection of structures (source
view) is modified.
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iSis 3D - V 2. 35 – March 2003 VI-27
• While we rotate the collimator, we remain “lying on the gantry”. We see so, the
collimator rotating. A pink mobile square attached to the jaws Y2 (oriented
towards the gantry for zero rotation) allows to appreciate more easily the
rotation angle.
• If there is a wedge filter, its symbol is displayed in the part where is the thick
side
• A system indicating the patient orientation is displayed at the lower left of the
graphical area.
VI.7.1 The View Concept
The “ source views” for each of the beams can be completed by other views
(“Observer Views”) where the observer eye takes the source place. These views can
be named, saved and retrieved.
Three “standard” views (non changeable during the study ) are systematically
included in the list of views and beams: a profile view, a frontal view and a transverse
view, centered on the origin, at the standard source-film distance.
The non standard views are named by default "view V1", "view V2". We can rename
them informing the field of options of the label. Their new names appear in the list in
the place of "view Vi".
Figure VI-5 : List of view
The views are characterized by the fact that none of the machines are associated to
them. They are defined in an isocentric technique by the coordinates X, Y, Z of the
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VI-28 iSis 3D - V 2. 35 – March 2003
isocenter I, of the source to the point I (DSI), of the gantry rotation and of the table
rotation.
The characteristic parameters of the views are modified by using the same procedures
like for creation/modification of beams.
VI.7.2 Creation/Modification of a beam or of a view
By default the window of the virtual simulation opens presenting the first standard view
if none of the current beams is selected, or the current beam view alternatively.
According to the nature of the selected element in the list (beam or view), the right side
of the screen has more or fewer rubrics. For the views, none of the machines is
associated and only the useful parameters are preserved.
The parameters modification is done like in slice normalization mode, giving
numerical values, by using the buttons + and -, or starting the functions for automatic
placement (cf.: § VI.1.3, iSis 3D - Menu Beams, New/Modify, Beam parameters).
We can also act graphically with the mouse on the next elements:
a) Position of the reference point:
While the cursor above the center of the cross wires, takes a hand shape. We can
than move the reference point by using the mouse. First is done a translation of the
axis and than while we release the button the image is calculated and centered again
and the coordinates X,Y and Z are updated.
b) Position of the jaws of the principal collimator
While the cursor is passing above the margins of the principal collimator takes the
shape of a line or of a corner and an arrow, a hand shows the concerned side or the
corner . In symmetrical mode, according if we “grab” a side or an edge we move
symmetrically one side or two pairs of jaws. In asymmetrical mode each jaw can be
moved independently. In all the cases, the jaws positions are displayed in real time in
the left side of the graphical area.
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iSis 3D - V 2. 35 – March 2003 VI-29
c) The Collimator Rotation:
While the cursor is passing above one cross wires axes, outside of the jaws, it takes
the angle shape and a hand highlights the cross wire’s axis. We can than move the
collimator using the mouse. The rotation value is displayed in real time in the left side
of the graphical area.
If a complex field is defined, the selection of the “Fixed form in rot” (zone “DISPLAY
OPTIONS”) allows not to apply the rotation of the collimator to the field’s shape. The
choice of the default option (Fixed form in rot) can be defined within the
customization file. By combining the collimator rotations with and without the selection
of the option, one can establish according to the wish, the positions of the block with
respect to the principal collimator.
d) The Field Shape
The field shape defined while there are the additional blocks or a multi-leaf collimator
can be modified by clicking on the button “Distort” of the area ”additional collimation “
(cf.: § VI.7.3, iSIs 3D - Menu Beams, Virtual Simulation, Introducing and Adjusting the
Field Shape).
While the characteristics of the beams or of a view are updated, we can click on the
buttons Create, Change and Kill like indicated previously (cf.: § VI.1, iSIs 3D - Menu
Beams, New/Modify, Creation/ Modification of Beams).
The label of these buttons is slightly different if is about the beams or views ("Create
Bi" or "Create", ...).
VI.7.3 Introducing and adjusting the field shape
Apart of the case that the field is defined only by the main collimator (rectangular) or
by the trimmer, the field shape is always defined in “virtual simulation” mode. The
possible options are essentially regrouped in the area of the parameters named
ADDED COLLIMATION:
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VI-30 iSis 3D - V 2. 35 – March 2003
Figure VI-6 : Added collimation
A pop-up list allows to choose the type of the additional collimation used:
- “none” is displayed by default. By selecting “none” while the additional collimator was
defined, this is deleted after confirmation.
- “trimmer” allows to define the trimmer (cf.: § VI.1.3, iSis 3D - Menu Beams,
New/Modifier, Beam parameters)
- “Block-tray” allows the selection of tray number in the list with available numbers for
the current machine. We can so access the introduced field shape.
- “multi-leaf” is accessible only if the current machine allows this. The functions
relative to the definition and position modification of the leaves are described in the
paragraph “Multi-leaf collimator” (cf.: § VI.7.5, iSis 3D - Menu Beams, Virtual
Simulation, Multi-leaf Collimator).
When a tray is used, the field shape can be introduced in different manners,
depending on the choice made in the scrolling list “field shape after”:
• “Main colli.” Starts the field creation, limited by the blocks but having a form
which might be superimposed on that of the principal collimator,
• “1 film” or “2 films” permits to introduce with the digitizer 1 or 2 parts
according to the selected option. The film should be positioned in such way so
as to be seen from the source for a gantry rotation angle and collimator rotation
angle equal to zero (gantry up). The source - film distance (SFD) must be
specified, in cm, in the corresponding field with options. The user is guided by
messages appearing in the dialog box of the active window. The action of
finishing the work (fin du travail) ensures the closing of the field shape.
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iSis 3D - V 2. 35 – March 2003 VI-31
The orientation and the position of the image (or one of each parts of both) of the field
on the digitizer are provide to the system by the plot of one of this axis.
• Define, by 2 point the vertical axis
- Plot the "BOTTOM" point
You plot one point one the Y axis of the field
- Plot the "TOP" point
You plot a second point on the Y axis. This second point should be located at least
at 3 cm from the first on, in positive Y direction. Otherwise, a warning message alert
the user and ask to repeat the both points 'BOTTOM" and "TOP".
- plot the "CENTER" of the field
The point should not be off more than 3 mm from the vertical defined by the two
first point. Otherwise, a warning message alert the user and ask to repeat the three
points 'BOTTOM", "TOP" and "CENTER".
The plot of the field start with real tie display of the plotting point taking account of the
collimator rotation.
- Plot the field shape :
After the last point, do "END OF WORK"
You plot the first point of the field. The total number of plotting points should be less
or equal to 299. After the plot of each point, the coordinates (taking account the
collimator rotation) and he number of point remaining are displayed :
1 ( 7.55, -1.37) - rest 298
2 (-1.16,-7.75) - rest 297
......
When plotting from 1 film, the action on "END OF WORK" close the field shape.
When plotting from 2 films, the current part is remind when plotting the axis.
- Plot of the part 1
- Plot of the part 2 with 290 points
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VI-32 iSis 3D - V 2. 35 – March 2003
The plot of the first part is end by action on "end of work" and start the plot of the
second one, the last point plotted on the first part being linked to the first point
on the second part.
At the end of plot of the second part, the action on "END OF WORK" close the field
shape.
- “Mouse capture” permits the direct introduction in the graphic zone, eventually
using a grid displayed on the screen due to the button “tools” (cf.: § VI-1-4, Menu
Beams, New/Modify, Display Options). In mode “mouse capture” some other buttons
appear in the active window:
ERASE to restarting the current data introduction
CORRECT to going back point by point
CANCEL to quit without saving the last introduced data
OK to close the field shape and to account for the changes.
"structure" offers the possibility to automatically calculate the field shape according to
the shape of the target structure (target volume) in the “Beam’s Eye View”. A cascade
menu allows to select the structure of interest among the defined structures. Once the
structure has been selected, it is convenient to define a margin in cm around the
structure (using the pop-up list or typing a numerical value) and then create the
irregular field either “complete” or “reduced” depending on the neighboring structures,
clicking on the “Whole” or “Part” button of the “Create” menu respectively.
The Create/Whole option starts the automatic calculation of the field shape directly,
while
The Create/Part option opens the next dialog box offering the possibility to select the
structures to be avoided and to specify for each one of them a margin around them to
be respected. The automatic calculation of the “reduced” irregular field shape
according to these constraints is started using the Ok button. The Cancel buttons
allows to abandon the irregular field shape creation.
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iSis 3D - V 2. 35 – March 2003 VI-33
Figure VI-7 : Customized collimator
Once the field shape has been introduced (or computed), the main collimator is
automatically repositioned in symmetric mode within the limits of the field contour,
respecting an additional margin, given in the parameters file. Then can be adjusted the
jaws position, in symmetric or asymmetric mode. However they are constrained to
remain exterior to the field. If this is not respected the message “Beam and field
dimensions not adjusted” does not allow the beam validation.
Whatever was the mode of introducing the field shape, it is still possible to modify it a
posteriori:
- The button "Distort" leads to the display in the graphic zone of the buttons: “ADD”,
“DELETE”, “MODIFY”, “CANCEL” and “OK”. These buttons allow to modify the field shape
on the screen in the same way as for the contours.
- The button “Delete” deletes all the tray, trimmer, or irregular field associated with the
beam. The same result is obtained selecting “none” in the list with the types of
additional collimation.
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VI-34 iSis 3D - V 2. 35 – March 2003
Remark 1 : There is no preferential sense for introducing the field shape. In turn, the
data introduction should be continuos. In case there is a central block, it is necessary
to “cross” the exposed zone and then to continue introducing data in the inverse
sense, before “re-crossing” on the same way. A control on the coherence is done and
a warning message signals if the introduced shape seems abnormal.
Remark 2 : ISIS3D can distinguish between the margins delimited by the principal
collimator and those delimited by the additional blocks. It recognizes this automatically
if the irregular field shape was introduced following the jaws of the principal collimator,
there where they effectively define the beam. A graphic control can be done because
the margins delimited by the principal collimator appear with a fine line, while the
margins delimited by the additional blocks appear with a thick line.
VI.7.4 Exporting the field shape
For constructing personalized blocks (“Cerrobend”) using a computer controlled
machine for cutting polystyrene it is possible to export directly the files from ISIS3D,
respecting the format required by the cutting machine.
The exportation is done as one file per beam, clicking on the button “Export” from the
zone “additional collimation”. The graphic zone displays then the “block image” and a
new window will be opened allowing to choose the exportation parameters”
Protected area
Irradiated area
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iSis 3D - V 2. 35 – March 2003 VI-35
Figure VI-8 : Field shape exportation
- The exportation control window permits (Figure VI-8):
• to choose the appropriate exportation format (zone Exportation, "Au format"),
• to choose the exportation file location and its name. A default file name is
proposed and the file extension is imposed by the chosen format. If it was
chosen a file name already existing, a warning message informs the user that
he should specify a new name.
• to choose the visualization parameters: “Visualization plane": bottom or top
of the block, "Mirror view" or not. These two options allow to check the
fabrication quality by directly superimposing the fabricated block on the printed
“block image”
• to specify the block thickness (the default value is indicated in the parameters
file)
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VI-36 iSis 3D - V 2. 35 – March 2003
• to indicate to the cutting machine the method to be used, i.e. the wire or blade
position, if the block is ”outside“ or not.
• to modify the source to tray distance when the block should be located at
another position than on the tray (the default value corresponds to the distance
source-tray).
• to display the landmarks indicating the patient orientation relative to the
screen. These landmarks are freely chosen characters which are displayed at
the upper right part of the screen. They can be explicitly introduced from the
keyboard or selected from the associated scrolling lists, containing the usual
anatomic indications (“left”, “right”, “anterior”, “posterior”, “head”, “feet”) .
• to adjust the representation scale "Zoom",
• to print what is represented,
• to perform the exportation "Ok" or to cancel it with "Cancel"
- The graphic area presents the “block image”, taking into account the block thickness
and the different visualization parameters :
• with continuous line: image of the block and the collimator jaws at the
level of the representation plane (bottom or top) and at the specified
source - block distance.
• with dashed line: image of the block and the collimator jaws at the level
of the reciprocal of the representation plane (bottom or top).
depending on the support used for positioning the block, a clue can be specified (in the
characteristics of the cutting machine) and be plotted on the line (squares centered on
the coordinates of the clue, eventually truncated by the page margin),
the principal information related to the blocks are displayed: patient name, study,
concerned beam, name and location of the exportation file, plane and representation
mode, distance of the representation, block thickness and representation scale.
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iSis 3D - V 2. 35 – March 2003 VI-37
VI.7.5 Multi-leaf collimator
For the treatment units which permit this, the
field shape can be defined by positioning the
collimator leaves, this being integrated either in
the principal collimator, or in the additional
collimator.
In order to have the option “Multi-leaf” accessible, the treatment unit library should
have been previously updated and a file should have been defined, containing the
characteristics of the multi-leaf collimator: number and thickness of the leaves,
orientation, boundary values for the displacement. In the case there is an additional
multi-leaf collimator, the margins are as well specified for the automatic recalculation
of the principal jaws position relative to the leaves.
The leaves positions is automatically calculated starting from the shape of the field to
be irradiated, called “Basic field”. This can also be done manually, defining one by
one the leaves positions. It is not possible (for the moment) to simultaneously have a
multi-leaf collimator and additional blocks.
To compute the position of the leaves, select “multi-leaf” as the type of additional
collimation. This selection is made automatically if this mode was selected at the level
of a pair of principal jaws. The possible cases are possible following this one are:
• if a field shape was previously defined (together with the type of tray), it is
considered as basic field,
• if not, it is possible to introduce the basic field by selecting one of the
possibilities from the list “after” : film, mouse capture, structure (cf.: § VI.7.3,
iSIs 3D - Beam menu, Virtual simulation, Introducing and adjusting field
shape).
The leaves positioning is effective if clicking on the button “compute”. The positions
of the main jaws are automatically readjusted and the field shape is displayed with
thick line (except for the segments delimited by the principal collimator). The
transformation from basic field to leaves positions is done according to the selected
options , clicking on the button “Options”. The proposed options permit to choose the
mode of positioning the leaves relative to the basic field (“Conformation”) including
CHAPTER VI - BEAMS MENU
VI-38 iSis 3D - V 2. 35 – March 2003
the following: internal, middle, or external (in, half or out). It is also possible the
optimization of the collimator rotation. The optimum rotation is that which minimizes
the difference between the surface covered by the basic field and that of the multi-leaf
collimator. The chosen options are recalled beside the button that starts the
computation.
Figure VI-9 : MLC computing option
The details about the leaves positions can be obtained by clicking on the button
“Details”. A new window will open, showing in numerical format the position of each
leaf (Figure VI-11). Meanwhile, the graphic zone is refreshed and replaced by a
drawing of the collimator, showing explicitly the leaves positions. It is possible to
displace individually the leaves with the mouse by grabbing them by the “hands”
displayed when the cursor is positioned nearby the leaf top. In the same time, the
selected leaf appears as inverted video in the window “multi-leaf Collimator”. The
complete set of these data (drawing and values) can be printed by clicking on the
button “Print”. By clicking on “Ok” or on “Cancel”, the modifications are validated or
canceled, respectively and we return to virtual simulation mode.
CHAPTER VI - BEAMS MENU
iSis 3D - V 2. 35 – March 2003 VI-39
Figure VI-10 : MLC Positioning
It is also possible to create a file containing the positions of the leaves and adapted to
the format of the considered treatment unit. This file is then exported to the
treatment unit with the aim to realize the treatment. As this concerns a global
exportation of a single file for all the set of beams from the study, it is realized at the
level FILE menu (cf.: § III, File Menu).
Remark 1 : A certain number of controls are performed when displacing the leaves
one by one (numerically or graphically). It may happen that the leaves refuse to move.
This is the case when the leaves tops are tangential (one leaf must be opened in order
to be able to command another, inclusive in the opening), or when the limits of the
displacement (absolute or relative) are attained.
Remark 2 : Even when the leaves position has been modified, the basic field remains
displayed and unchanged, which may lead to confusion. The position of the leaves can
be recalculated automatically, reintroducing the data or making a modification of the
basic field and restarting then the calculation for the multi-leaf.
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VI-40 iSis 3D - V 2. 35 – March 2003
Remark 3 : In the case there is an additional multi-leaf collimator, the positioning of
the principal jaws follows the rules:
• In the sense of the leaves displacement, the jaws are positioned at a fixed
distance (can be set as parameter) to the most exterior leaves. It is not allowed
to close the jaws beyond the top of the leaves, if this happens when trying to
validate the beam will appear the message: “Beam Dimensions and complex
field shape not adjusted”.
• In the opposite sense, the jaws are positioned at a fixed distance (can be set as
parameter) to the basic field. They can be eventually modified while closing or
opening. When they are opened on the side of the non joined leaves, they are
accounting for beam limiting device.
VI.7.6 Display options and calculation of DRR
In mode “virtual simulation”, every modification is reflected graphically directly on the
visualization window in real time if the button “Display real time” is selected (lower left
corner). If not, the window updating is done by pressing the button Apply.
The objects concerned by the display options appear in a scrolling list. After selecting
one of them, the display mode should be specified, this varying according to the type
of the object. The contours and the free markers can be masked (invisible) or can
appear as complete contours (continuous line in front, dotted line in the back), as
limits as small lines (having a T shape), as solid (full filling) or cross-hashed (hashed
filling) of the same width with that of the slice. The collimator, the complex field and the
reconstructed image (if it exists) can be made visible or invisible, Two supplementary
objects permit a “global” manipulation at the level of all the objects and all the
contours. In this case the combined display mode signifies that various choices have
been made at the level of individual objects. These choices are preserved but the set
of concerned objects can be made invisible.
Remark : the structures are being displayed as 2D projections. Therefore, there is not
a notion of foreground, background or hidden side. The structures are being displayed
according to their order in the “list of structures”.
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iSis 3D - V 2. 35 – March 2003 VI-41
A supplementary button recalls the colour of the selected object. If it is a structure, the
button “color” can be pressed to open a box for creation/ modification of structures and
change its characteristics.
Figure VI-11 : Display option
Under the graphic window are found the buttons: Zoom, Restore, Gantry orientation,
Level/Window, Tools et Print described in “normalization contour” mode and “virtual
simulation” (see also the description of the Display Menu). Note that these functions
are applied to a “film” type document. As for the zoom, a scale of 1 signifies that the
printed document can be directly superimposed on a simulation film taken with the
simulator in the same geometrical conditions (centering and “virtual” source-film
distance).
A series of buttons entitled gantry orientation permits to switch with 900 the graphic
zone to choose the most “convenient” orientation according to the working habits. The
fixed square is a symbolic representation of the gantry, is located in the upper part of
the graphic zone. It is recalled on the button and can be orientated upwards, to the left,
downwards, or to the right. The button corresponding to the current orientation
appears with a high contrast.
With the condition that the date have been introduced from transverse slices, it is
possible at any moment to ask the numerical reconstruction of a radiograph (DRR)
To start the reconstruction, it is enough to select any type of DRR from the scrolling
CHAPTER VI - BEAMS MENU
VI-42 iSis 3D - V 2. 35 – March 2003
list. The time until receiving an answer is longer the first time this is asked, since a
volume reconstruction is started. The image reconstruction in the plane of the virtual
film is automatically started. The next options are available:
• Full DRR all the densities traversed by the beams are taken into account
• Soft tissues DRR only the densities inferior to a threshold (that can be put
as a parameter) are taken into account
• Dense tissues DRR only the densities superior to a threshold (that can be
put as a parameter) are taken into account
• Maximum density DRR only the highest density along each beam is
preserved.
Figure VI-12 : D.R.R caluclated
The changing from one option to another doesn’t imply the complete recalculation but
only a redisplaying.
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iSis 3D - V 2. 35 – March 2003 VI-43
The displayed image can be adjusted in contrast and luminosity by acting on the box
for adjusting the level/window which is opened by pressing the corresponding button
located in the graphic zone. The corresponding values do not have a particular
meaning but it is recommended to be in low resolution mode “low resolution” otherwise
an important part of the image might be lost.
The display of the DRR can be controlled by making visible or invisible the object
"image". If it is visible, the DRR can be printed (on a graphic printer) with the same title
with other elements from the graphic zone.
Remark : Once D.R.R. is computed, it is store in the same folder as images. It is not
recomputed until the beams or contours characteristics are changed.
CHAPTER VI - BEAMS MENU
VI-44 iSis 3D - V 2. 35 – March 2003
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-1
VII. ISODOSES MENU
presents the following submenu:
- Calculation >
- List...
- Normalization >
- ------------------
- Dose at one point...
- Profiles and exportations...
- Dose/volume Histogram...
- ------------------
- New plane...
- Kill plane
- -------------------
- New ROI
- Display ROI
- -------------------
- Import dose >
VII.1 Calculation
presents the following submenu
- All beams
- Current Beam
- Computing Options
VII.1.1 All beams
permits to start the dose calculation for all the beams belonging to the opened study,
according to the options defined for the calculation options (cf.: § VII.1.3, iSis 3D -
Isodoses Menu, Calculation, Computing options). This choice is accessible only if the
current calculation plan or the defined zone ( cf.: § VII.9, Isodose menu, New zone)
has at least one beam which is not calculated. After the calculation of all the beams,
the eventual current beam is deselected.
CHAPTER VII - ISODOSES MENU
VII-2 iSis 3D - V 2. 35 – March 2003
VII.1.2 Current beam
launches the dose calculation for the current beam. This choice is accessible only if
there is a current beam and this one is not calculated yet.
Figure VII-1 : Calculation progress
Remark : During calculation phases the "calculation Progress" box appears. It
indicates the treated calculation plan and the retained calculation options (matrix,
model and heterogeneity correction). It allows as well following up the calculation
evaluation by successively displaying the number of the beam currently calculated and
the slice where these calculations are performed. It is possible to interrupt the
calculations by clicking the "Stop calculation" button. This button becomes
subsequently “Start calculation” and makes accessible the "Ok" button. By clicking
the "Ok" button the already performed calculations are validated and continued until
the calculation phase reaches the end. By clicking the "Start calculation" button the
calculation are relaunched as if no interruption took place.
VII.1.3 Calculation options
For every new study, the selected default calculation options are depending on the
user selected parameters. Following, these options are modified as desired and are
applied "a priori" to all the beams, leading a new calculation if necessary. For every
beam, the effectively retained options are taking into account certain cases. In case of
impossibility (e.g. double cutout for electrons and heterogeneity correction) these
options are displayed down in the beam list and the treatment time form. The above
mentioned options are globally displayed at the end of every calculation plan and the
dose volume histogram form.
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-3
The selection of "Calculation option" object launches a dialog box (Figure VII-2) which
contains the following fields.
- Calculation grid : 3 exclusive buttons fine (2.0 mm), medium (4.0 mm) or Coarse
(6.0 mm) which allows the selection of the calculation grid minimal step. If necessary,
the calculation grid step is automatically adjusted in order to cover the whole external
counter. In any case, the step effectively used is calculations is displayed at the
inferior side of any calculation plan. For every grid type, the associated step can be set
as a parameter, as well as the default grid type.
Remark : Grid step concerne only the whole plane, It is not taking into account into
ROI (cf.: § VII.9, iSIs 3D – Isodose menu, New Zone)
- Model : 3 exclusive buttons Primary only, simple cutting out or Double cutting
out. Two exclusively complementary buttons allow to choose between the standard
mode and the rapid mode. The calculations are performed according the selected
option (cf.: § II.3.1, iSIs 3D - General principles, Dose calculation, Calculation options).
The "Primary only" option is reserved only for trials. Before the calculations are
launched a confirmation is asked. The PRIMARY ONLY information is displayed in
capitals over all the results
- Heterogeneity correction : 3 exclusive buttons No, Standard or Voxel/Voxel. The
calculations are performed according the selected option (cf.: § II.3.2, iSIs 3D -
General principles, Dose calculation, taking account heterogeneities).
Remark : The current calculation options concerning the calculation model and the
heterogeneity correction are saved for every study. While reopening, if these options
are not modified, the calculations are relaunched having assigned the same options.
CHAPTER VII - ISODOSES MENU
VII-4 iSis 3D - V 2. 35 – March 2003
Figure VII-2 : Computing option
At the inferior part of the option selection box, other supplementary buttons allow the
automatic or non automatic calculations:
- Automatic Calculation : 2 exclusive buttons Yes or No.
The selection of this option lead accessible the All planes option. The calculations are
automatically performed after the creation or modification of a beam, after the creation
or modification of a slice without relaunching the calculations for all the beams or the
current beam.
This option is deactivated when the file is closed and has to be explicitly reactivated
every time the file is opened.
- All planes : 2 exclusive buttons Yes or No.
The access to this option is possible only if the Calculation automatic option is
active. In this case the calculations can be systematically performed for all the
previously selected calculation plans or for the current calculation plan.
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-5
Remark : If ROI is activated into plane when selected this option, only the ROI is
calculated (not the whole plane)
This option persists after the file is closed.
- Dose type
Allows to specify the type of dose to display in calculation plane and histogram. Two
type of dose could be display : the physical doses and the equivalent radiobiological
doses (cf.: § II.3.5, iSis 3D – Generals priciples, Dose calculation, Equivalent
radiobiological dose)
The Figure VII-3 presents the result obtained after the calculation of the dose
distribution.
Figure VII-3 : Computed doses
VII.1.4 Saving the dose calculations
The calculated doses can be stored while saving a study case. It is enough to activate
the dose calculation saving option within the customization file.
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VII-6 iSis 3D - V 2. 35 – March 2003
While a study is retaken, if the dose calculation saving option is effective, every active
plane for which the calculated doses are valid is displayed, accompanied by the doses
corresponding to all the beams calculated for this plane.
The control of the validity of stored doses is based on the version number of the
“contours” file, the version number of the “beams” file, the calculation parameters, and
for the non-transversal planes, the coordinates of the points defining the plane, which
are saved in the doses file associated to the plan. If the doses calculated for some
beams are not valid any more, these beams are considered as not calculated.
The control of saved calculated dose are base on, version number of contours file,
version number of beams file, computing option and for non tranverse plane, on the
coordonates of 2 points determinig the diagonal of region, kept into dose file. If this
data are not valid beams will be consider as not computed.
The access to the “All beams” and “Current beam” options depends equally on the
validity of the stored doses.
Remark : in order to avoid occupying the disk space due to the accumulation of dose
files, a certain control procedure for the disk space can be activated after each storage
(following configuration, consult your installation).
VII.2 List
List leads to the display of the dialog box which controls the isodoses list represented
in the (Figure VII-4) : this box stays active as long as it is not explicitly closed. The box
comprises the list of Values and Colour of isodoses prolonged respectively with the
fields Value and Colour (scrolling list).
This box contains as well the following buttons:
• Add, Change et Kill
• Initial Isodoses
• Standards Isodoses
• Apply and Cancel
• Close
The list of isodoses displayed in this box is taken into account for the active window
only if it is explicitly asked (Apply button). In this case, the list is applied for all the
calculation plans.
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-7
Value : allows the definition of a new isodose value to be displayed. After the key-in
by pressing RETURN insteadðof TAB a default color appears at the level of the color
choice pop-up list.
FigureVII-4 : List of isodoses
Colour : by clicking this button, one obtains a pop-up list of available colors. Without
releasing the button, one selects the desired color by sliding in the list the mouse
cursor. Then one stops over the desired color and releases the mouse button. At this
moment, the name associated to the chosen color appears within the associated field.
Add: creates in the isodoses list a new isodose whose value and color were specified
in the key-in field.
CHAPTER VII - ISODOSES MENU
VII-8 iSis 3D - V 2. 35 – March 2003
Change: after having selected an isodose from the list of available isodoses and after
introducing a new value and color in the associated options field, clicking change
attributes to the selected isodose the value and color specified in the SAISIE field.
Kill : eliminates the selected isodose. The next isodose is immediately selected and
could be eliminated as well if one presses the kill button once again. For the
elimination of isodoses in series, one has to start from the top of the list.
Initial isodoses: calls the list of doses associated to the protocol (cf.: § III.1, iSis 3D -
File Menu, New). If this list of isodoses does not exist the button is inactive.
Standard isodoses: calculates automatically a new list of isodoses depending on the
maximum dose observed and the number of active beams for the current plan.
Apply : validates all the modifications performed and updates the isodose lines for the
current calculation plan.
Cancel: reestablishes the list of isodoses settled after the last validation.
Close: closes the dialog box. This button is active only if the list was not modified after
the last validation.
VII.3 Normalization
allows to normalize the result of dose calculation; a sub-menu allows to select the
normalization mode
• -Without
• -At maximum
• -At one point
Without : cancels all the anterior normalization. In this case, the doses are calculated
taking directly into account the values each beam contributes to the dose
At maximum : the doses of all calculation plans are expressed as percentages of the
maximum found for the current beam in current plane.
At one point : the doses of all calculation plans are expressed as percentages of the
normalization point whose coordinates are visible in an associated box (Figure VII-5)
or within the current calculation plan with the aid of the mouse. The normalization
becomes valid by clicking the Ok button of the normalization box.
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-9
Figure VII-5 : Normalisation point
The normalization mode is displayed in the legend located at the upper right side of
each window depicting the calculation plan. The same display holds for the
dose/volume histogram window.
The normalization functions are affecting all the calculation results of the current study.
The current calculation plan graphical window is updated while the other graphical
windows are updated if the corresponding calculation plan becomes current
Remark : if one has decided to normalize the isodoses, while one modifies the beams
or the weighting factors of the beams non the corresponding beam selection box, the
results are not automatically renormalized. The normalization function has to be
explicitly relaunched by choosing the corresponding sub-menu
VII.4 Dose at one point
leads to the display dialog box (Figure VII-6) in which are displayed continuously and
in real time the coordinates and the dose value corresponding to the current position of
the mouse cursor in the current calculation plan graphical window.
CHAPTER VII - ISODOSES MENU
VII-10 iSis 3D - V 2. 35 – March 2003
Figure VII-6 : Dose at one point
A click on the current calculation plan graphical window adds the point to the list of
points whose doses are continuously displayed. The points are visible on the screen
as crosses (within the graphical window of the current calculation plan) The
corresponding doses are displayed aside each point.
The Erase points button allows the calculation of the list of points defined for the
current calculation plan and the refresh of the display
The Ok button ends the function.
VII.5 Profiles and exportation
leads to the display a dialog box (Figure VII-7) which allows the display the dose
profiles and the exportation of doses calculated for the current plan.
The control window display-exportation allows:
. to choose the type of data to be exported: the whole grid or one or many particular
profiles
.
to locate the placement and the name of the export file. A default file name is
proposed, while extension is free (“D3D” by default) If a name of an existing file is
specified, a message informs the user that a new name has to be specified.
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-11
FigureVII-7 : Doses profiles and exportations (1)
In “grid” mode only the “Export grid” button is accessible, realizing the exportation
towards the specified file
In “profile” mode the “Definition of profile" zone allows to specify the following
parameters :
• Sampling step: by default equal to the calculation step of the calculation grid.
Determines the precision of the profile curve,
• Normalization at origin if this option is active, the dose at origin becomes 100,
• Type of the initially displayed: ”Profile”, profile parallel to the horizontal axis,
“Depth” profile parallel to the vertical axis or “Other”, to be specified on the
input field.
The “Mouse capture” button opens a profile visualization window and determines the
appearance of a arrow in the window of the current slice (Figure VII-8) representing
the visualization profile (pink line). This profile can be displaced using the mouse, by a
click and slide movement. The translation of the profile is realized selecting with the
name a central point of the profile while the rotation could be realized by selecting
another point (cf.: § VI.1.3.c, iSis 3D - Beam menu, New/modify, beam parameters). In
the dialog zone of the current plan are update the following: the profile type, the
CHAPTER VII - ISODOSES MENU
VII-12 iSis 3D - V 2. 35 – March 2003
distance d from the profile to the origin, the profile angle with the vertical, the
coordinates x, y and z of the profile origin. The graph representing the dose
(normalized or not) function of distance to the reference point showed within the
profile visualization window is updated in real time.
Once the desired profile is obtained, the Ok button of the current plan window allows
to validate the profile. Following, a dialog which recalls the profile parameters appears
and suggests to add the entered profile within the content of the export file. More than
one profile could be exported to the same file. The “Cancel” button allows the
visualization canceling without to export the profile.
If a profile was validated (with or without exportation) the “Print profile” button allows
to keep a copy of the profile.
The Ok and Cancel buttons are closing the dialog. In case of cancellation, all the
export files (of the grid and/or of profile’s) are destroyed
The export file is a test file containing a lot of comments. Its format is specified to the
ISIS 3D software.
The profile files can be visualized and compared with the experimental data by using
the “support of experimental files” utility.
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-13
Figure VII-8 : Doses profiles and exportations (2)
CHAPTER VII - ISODOSES MENU
VII-14 iSis 3D - V 2. 35 – March 2003
VII.6 Dose/ Volume Histogram
The dose-volume histograms (DVH) are allowing the representation of the 3D dose
distribution for different interest structures. These are giving a sort of "resume" of what
is going on with these structures (target volume or critical organs) for all calculation
plans set. Thus, one can obtain rapidly global information about the "quality" of a
treatment plan :the min dose, max., average and modal for different structures, the
proportion of an organ receiving more than a certain dose. The dose volume
histograms are presented either in differential form where on the y axis are
represented the volumes receiving a given dose (or more precisely a small interval) or
in cumulated form where on the y axis is represented the volume (cm3 or %)
receiving more than a certain dose represented on abscissa. For a finer dose
distribution analysis at the border volume it may be interesting to create a fictive
structure by using the expansion tool (cf.: § IV.9, iSis 3D - Slices Menu, Expansion)
and then to launch the DVH, excluding the initial volume in order to get only a
peripheral zone.
It is possible to calculate successively the DVH for different previously defined
structures with or without exclusion, and then to display them on the same graph,
either in differential or in cumulative form (maximum 10).
It is also possible to store the graph in order to be compare the DVH of different
studies.
ATTENTION !
The DVH are not saved. They have to be printed once are calculated. It is the user
responsibility to get assured about the coherence of saved studies and the printed
DVH (based on the name and date + time of the study). Hence it is recommended to
save systematically the studies either immediately before or immediately after the
printing of the DVH.
The calculation method chosen for ISIS is the "random points" method, inspired
basically on the work of NIMIERKO. It consists in "extracting" random points inside a
parallelepiped which contains the structure of interest, but counting only these points
located inside the structure. This method presents several advantages:
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-15
• The DVH calculation can be asked at any time without being necessary the
calculation for the slices plans to be previously launched
• The number of points necessary in order to get valuable calculations is
relatively small. NIMIERKO has shown that generally, a number of 400 points
(proposed here as default) gives coherent results.
Once a first result is obtained, it is possible to continue the extraction of points, until
the results are stabilized. It is possible to get assured that the points density is
sufficient for the dose distribution and the analyzed structure.
- The volume calculation, which is performed as well using the random points
method could be compared the result based on contours calculations (cf.: § IV.10, iSis
3D - Slices Menu, Volumes). A good agreement between the volume calculation
obtained with the two methods gives a good indication on the validity of the DVH
calculation (except for the case a structure is excluded).
For the current implementation, the choice of the random points is based on a
generator which uses as starting value the internal clock. For these conditions, two
successive calculations are susceptible to give slightly different results. The scope of
this choice is to test the validity of the result by evaluating the difference after the
same calculation restarted several times.
The performed calculations are taken into account constantly the options selected in
the calculation options box (cf.: § VI.3, iSis 3D - Isodoses Menu, Normalization).
They are realized for the whole beam set and are taking into account eventual
normalizations. In order to isolate the contribution of certain beams, the individual
weightings should be adjusted.
The selection of dose/volume histograms item opens the box represented below
(Figure VII-9).
CHAPTER VII - ISODOSES MENU
VII-16 iSis 3D - V 2. 35 – March 2003
FigureVII-9 : Dose/Volume histogram dialog box
This box is composed of three parts (Calculation, Results, Graphic).
The CALCULATION part is composed of the following fields :
• Calculate in : allows to choose the structure where the calculations should be
performed.
• Exclude : allows not to take into account one structure . A check is
performed in order to forbid the structure to be calculated within the excluded
structure.
• nb iterations : allows the user to choose the number of points to be calculated.
This number is initialized to 40, but it could be changed to the desired one.
• Begin : launches the dose/volume histograms calculation. The calculation is
performed by extracting the random points until the "nb iterations" points are
found inside the chosen structure.
• Retry : is substituting "Begin" while a first calculation was performed for a
given structure. The calculation restarts from zero.
• Continue : allows to continue an already started calculation. This new
calculation stops when "nb iterations" supplementary points are found inside the
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-17
structure of interest. Of course these points are added to the previously
calculated points which are integrally kept.
The RESULTS part presents the data of the last calculation :
• Volume (cm3) of : remembers the name of the structure for which the
calculation was performed.
• Expected : recalls the volume of the structure calculated from the entered
contours (the same as that one found in the "volume" pad)
• Computed : is the volume calculated with the random points method. It
corresponds to the structure volume minus the volume of the part to be
excluded.
Remark: Those both volumes, determined with two different way, should have similar
value. If it is not the case, the number of ramdon points chosen is probably not enough
and you have to continue calculation up to volumes value are similar. In the case of
exclusion, the expected volume is always greater than the computed volume, because
the expected volume does not take into account the exclusion.
- the four other fields are displaying respectively the values of minimum dose,
maximum, average and modal2 calculated for the considered structure.
The GRAPHIC part allows to visualize the results of several successive calculations. It is
presented as follows
- Two exclusive buttons differential and cumulated allow the chosen graph display
mode (a prior or a posteriori)
- Centered on : allows to center the curve at a particular point of the curve and to
execute a local zoom on this point
- Two exclusive buttons "volume in cm3 " and "%" allow to choose the principal
measuring unit of y axis ( a priori or a posteriori). If "%" is selected, then the reference
2 The modal dose is the most frequent found dose; it corresponds to the peak of the
differential DVH
CHAPTER VII - ISODOSES MENU
VII-18 iSis 3D - V 2. 35 – March 2003
(100 %) is the calculated volume of the structure. If there is a single DVH displayed,
both scales (cm 3 and %) are simultaneously present on the sides of the graph.
• title : allows the user to specify the name to be displayed at the top of the
graphical document (it is advised less than 18 characters)
• name : is the name to be given to the current DVH curve. ( to be calculated). By
default the name is given by the concerned structure name followed, if it is the
caase. by "sans" when another structure is excluded. The name can be
changed as desired (only the first 18 charecters are going to be displayed on
the result)
• colour : is a pop-up list which allows to choose the color of the graph (by
default is the same as the concerned structure)
create : allows to create a new graph having the title indicated in the "title" field which
displays the current curve with the specified "name" and "colour".
Erase : deletes all the present graphs from the pad after the confirmation was asked.
The main title is kept by default.
Add : adds the current curve to the curves already presented, but in the limit of
maximum to simultaneous curves. After the tenth curve is added, the button becomes
inaccessible. The user has the possibility to print before a new graphical page can be
created with Create or Erase.
Print : launches the printing process of the graphical window to the peripheral chosen
in printing options. Only the A4 "portrait" mode is supported
Ok : triggers the disappearance of the graphical window (after the confirmation and the
exit from the dose volume histograms box. The non printed graphs are lost. The
display of the curves is as indicated in Figure VII-10 ( the case of a graph in
cumulative form)
Header (the header) of the display presents a number of general information which
allow to find the characteristics of the associated study and the calculation conditions.
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-19
Cumulated Differential
Figure VII-10 : Dose / Volume histogram
The graph itself supports up to five curves. For the case of a single curve, two scales
are displayed for the y axis, corresponding to the volumes expressed in cm3 and in %.
The X axis (doses) makes directly use of the weighting factors defined for each beam.
(without taking into account eventual normalization options)
Under the traced zone, one could find, line by line, the characteristics of each curve :
name, colour and type of feature, total number of points found within the structure,
the volume corresponding to the found points, minimum dose, maximum, average,
and modal dose inside the structure, width at half height of the peak, centered on
the modal dose (calculated in differential mode).
Additionally, the minimum dose and minimum dose coordinates are indicated ( for the
moment) in the execution window of the program.
CHAPTER VII - ISODOSES MENU
VII-20 iSis 3D - V 2. 35 – March 2003
ATTENTION!
The Dose-Volume histograms calculation validity for a given dose distribution depends
strongly on the quality of the entered contour (for the associated structure) and the
number of random points extracted. It is up to the user to assure himself for this
validity
VII.7 New plane
permits to calculate the isodoses for non transversal planes. Only the planes
perpendicular to the slices are available.
These planes could be:
o Sagittal (SA) if perpendicular to the X axis
o Frontal (FR) if perpendicular to the y axis
o Sagittal Oblique (SO) or Frontal Oblique for all the intermediate positions,
with a limit arbitrarily fixed to 45°.
This function is accessible only if a current slice is selected. In fact, for this slice the
plane position is chosen.
When the function is called, a pink line representing the position of the plane (by
default sagittal median) appears within the window of the current plane (Figure VII-10).
This plane can be moved using click and slide function of the mouse. The translation is
realized by selecting with the mouse the central point of the line while the rotation by
selecting another point (cf.: § VI.I.3.c, iSis 3D - Beam menu, New/modify, beam
parameters). In the dialog zone of the window the following parameters are
permanently updated: the plane type, the distance d from the plane to the origin, the
angle of the plane to the vertical, the x, y, z coordinates of the new plane origin. It is
suitable to define the plane with regard to a slice a little but off z axis. The x and y
coordinates should be towards the center of the slice, in order to have contours
symmetrically placed around the origin, it is possible as well to prefer another origin in
order to counter the plane over the interest region.
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-21
The position of the chosen plan is validated by clicking the Ok button located towards
the right side of the working window. It is created this way a new plane which is on
one hand added to the list of calculation plans and on the other hand displayed as a
window. For the moment, the only things appearing for this plan are the contours
depicting the intersections with the external surface and with the internal structures.
The images and the beams are not represented.
The list of the free markers associated to the current plan includes on one hand the
structures cut by the plane and one the other hand, in yellow, the other structures of
the study which could play a role in the calculation, especially if it is about
heterogeneities.
The plane created this way could be manipulated the same way as the transversal
slices planes correspondent to the entered contours (selection, iconification, scaling).
As for the other plans, the functions set of the ISODOSES menu is available for
launching and controlling the dose distribution calculation.
The used dose calculation algorithm is exactly the same as for the transversal slices.
In fact, for each calculation point belonging to the "new plane", the modified
transversal slice that contains the point is searched and following, the calculation is
performed for this slice. The rendering of the structures contours and the calculations
validity are better if there is a higher number of initially introduced transversal slices.
The plane created this way could be manipulated the same way as the transversal
slices planes correspondent to the entered contours (selection, iconification, scaling).
As for the other plans, the functions set of the ISODOSES menu is available for
launching and controlling the dose distribution calculation.
The used dose calculation algorithm is exactly the same as for the transversal slices.
In fact, for each calculation point belonging to the "new plane", the modified
transversal slice that contains the point is searched and following, the calculation is
performed for this slice. The rendering of the structures contours and the calculations
validity are better if there is a higher number of initially introduced transversal slices.
In order to get the calculation and the display of the reconstructed image for the new
created plan, the image option should be selected from the DISPLAY menu. (cf.: §
VIII.1, iSIs 3D - Display Menu, Image)
CHAPTER VII - ISODOSES MENU
VII-22 iSis 3D - V 2. 35 – March 2003
Figure VII-11 : Non transverse plane axis selection
Figure VII-12 : Non transverse plane
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-23
VII.8 Kill plane
permits to destroy the calculation plans that are not going to be kept. This operation is
applied only for the plans previously created using the sub menu "New plane".
VII.9 New zone
Offers the possibility to define, inside a slice, a rectangular zone inside which the dose
calculation is performed with improved resolution that doesn’t depend on the size of
the contours. In the interior of that zone, the step of the calculation grid is the finest
one defined in the calculation options. If necessary, the calculation step will be
automatically adjusted such that the entire zone be covered.
Using this function, the rectangular zone is defined, inside the active slice or plane,
with a click-and-drag movement of the mouse along its diagonal. The creation of the
zone is validated using the OK button. Only one zone per slice or plane can be
created. The zone can be modified by defining a new zone that replaces the previous
one. The creation of a zone makes its display active.
VII.10 Zone display
Makes the zone active for, the calculation or the display of the dose distribution. Dose
calculation (automatic or using the Calculate option from the Isodoses menu) and
dose display is limited in the zone. The calculation step inside the zone is defined
using the calculation options in the bottom of each plan.
The “toggle” function is not accessible unless a zone is defined in the active slice or
plan.
Dose normalization (cf.: § VI.3, iSis 3D - Isodoses Menu, Normalization) can take
place inside the zone. The introduction of a dose point outside the displayed zone will
be without any effect and any dose point defined on the slice or plane outside the zone
will be displayed without a dose value.
The 3D Visualization option in the Display menu is not accessible while in “Zone
display” mode.
Once the “Zone display” option deactivated, the zone is erased and then the dose
distribution (if it is calculated) is displayed on the slice or plane.
CHAPTER VII - ISODOSES MENU
VII-24 iSis 3D - V 2. 35 – March 2003
VII.11 Importation of doses ( stereotactic )
VII.11.1 Generalities
The dose importation within the current plan allows overlying the dose distributions
calculated with another application to the images and/or contours defined within ISIS
3D. In order for this importation to have any meaning, it is necessarily for the
calculation performed with the external application to have been made starting from
the same anatomical data, for a patient having the same treatment position. It is also
important to having careful selected a common origin for the contours definition and
the same axes orientation. The display of the obtained doses is basically static, and
the modification of the technique, for example, should be accompanied by a
modification of the data coming from the external application, followed by a new
launch of the import function. This switch between the two applications is greatly
facilitated if they are both open on screen, on condition to taking care that after
contours, beams and calculation planes have been updated, to save the
imported study. One notices that only the dose distributions are displayed (with
superposition over the images and/or the current structures); within ISIS3D there is
neither graphical representation of beams from the imported study, nor display of their
characteristics.
For the moment, the only dose distributions that can be imported are those calculated
with the STEREO module belonging to the ISIS application chain.
VII.11.2 Launching the import
The “import doses” menu presents (as a unique item, the following sub-menu)
stereotactic
This item is accessible only if the option allowing the import of the stereotactic doses is
chosen within the customization file.
Following the selection of this item, it is checked within the menu, indicating that one
passes in import mode. The displayed doses are those of stereotactic. One can again
pass in “normal” mode by selecting the same item of the menu.
The following functions still remain accessible in import mode:
o normalization
CHAPTER VII - ISODOSES MENU
iSis 3D - V 2. 35 – March 2003 VII-25
o dose to a point
o isodoses list
and most of the display and printing functions (study or current plan).
On the contrary, the following functions are deactivated:
o calculation
o profiles and export
o dose volume histograms
The passage from normal mode to the import mode and vice-versa, suppresses any
dose normalization. The dose points, defined in one or the other modes are preserved.
The display of the stereotactic doses is triggered at the moment any plan is opened
with ISIS3D (calculation plans selection box, “open” button). If the plan is already
opened, it is suitable to close it and then to re-open it. ISIS 3D then searches if the
same plan exists within the list of those which were stored by STEREO and, if
affirmative, displays the corresponding isodoses. If not, a message appears, indicating
the absence of the associated plane and giving information (coordinates of the 3
points defining the plane) for the calculation of the same plane to be launched from the
STEREO application.
The mechanisms of associating the calculation planes is given in the following.
VII.11.3 Mechanism of associating the existent and imported planes
In order to ensure that the calculations make use of the same anatomical data, an
initial check is performed on the coherence of the “contours” files. Every contour
modification in ISIS 3D should be accompanied by the storage of the study, before the
dose calculations are performed with the STEREO software.
The ISIS 3D method of plan recognition defined under STEREO is different if one
deals with a transversal plane or any other plane.
in the case of a transversal plane, only the Z of the STEREO plane and the Z of the
ISIS 3D slice are compared. On the contrary, in X,Y, the origin of the radiotherapy ISIS
3D system can be different from the origin used by STEREO, which generally
CHAPTER VII - ISODOSES MENU
VII-26 iSis 3D - V 2. 35 – March 2003
coincides with one of the isocentres and which defines the centering of the calculation
grid (limited to 8 cm x 8 cm).
In the case of a saggital, frontal or oblique plane, the calculation planes are
completely defined by three points, which should be exactly the same under STEREO
and ISIS 3D. The implicit definition under STEREO of the saggital and frontal planes
cannot be used since the axes orientation is different from that defined under ISIS 3D.
It is necessarily to define them by explicitly specifying the coordinates of the three
reference points, copied from the values displayed in the ISIS 3D message box (see
below, VII-9-2 Launch of the import).
VII.11.4 Display and printing the results
At the bottom of the calculation planes where the stereotactic doses are displayed, the
essential elements of the calculation are remembered:
o number of the treatment plan under STEREO
o calculation step (fixed at 2 mm)
o calculation model employed (STEREO)
o absence of the heterogeneity correction
These plans can be, according to the wish, either printed individually, or globally, by
launching the printing of the whole study.
CHAPTER VIII - DISPLAY MENU
iSis 3D - V2. 35 – March 2003 VIII-1
VIII. DISPLAY MENU
permits the general control over the visualization of the current graphical window and
proposes the following options:
- Images
- Contours
- Beams
- Isodoses
- Registered images
-------------------
- Isodoses 3D
-------------------
- Level/Windows...
-------------------
- Zoom...
- Restore
-------------------
- Grid >
- Distance measurement
- Angle measurement
-------------------
- Visualization 3D (option)
VIII.1 Image
permits to display or not the image (if it exists). A button next to the item informs if
the option is selected or not.
In the particular case of the non Transversal planes previously created using "New
plane" (cf.: § VII.7, iSis 3D - Isodoses Menu, New plane), the option is by default not
selected (no images). If one selects it, it is possible to launch for the current plan an
image reconstruction from the transversal slices. The quality of the reconstruction is
better if there is a large number of close adjacent slices.
If the option is selected an appearing dialog box usage of quality improving filter. The
image is reconstructed and displayed after the confirmation was given. The
reconstruction time depends upon the power of the computer.
The different display option (Zoom, Level/Windows) are applicable.
CHAPTER VIII - DISPLAY MENU
VIII-2 iSis 3D - V2. 35 – March 2003
Remark : The reconstructed image is stored in the same directory with the transversal
slice images. If the calculation plan is not modified or deleted, upon the reopening of
an previously saved dossier, the reconstructed image is not recalculated.
VIII.2 Contours
permits to display or not the contours and points of interest, if there are any. A button
next to the item informs if the option is selected or not (maybe check box)
VIII.3 Beams
permits to display or not the active beams. A button (check box) next to the item
informs if the option is selected or not
VIII.4 Isodoses
permits to display or not the isodose curves and the points where the dose is to be
calculated. A button (check box) next to the item informs if the option is selected or
not.
VIII.5 Registered image
Allows to switch between two series of images, when this ones are available (cf.: §
II.9, iSis 3D – Generals principles, Matched Images). This option is also accessible by
the short-cut "Ctrl-r" from calculation planes.
VIII.6 Isodoses 3D
displays a 3D view of the dose distribution for the current calculation plan (where
the height represents the dose). An Ok button appearing in the graphical window
allows to return to the 2D view. An print button launches the printing.
CHAPTER VIII - DISPLAY MENU
iSis 3D - V2. 35 – March 2003 VIII-3
VIII.7 Level/Window
permits to adjust the contrast of the image by modifying the width and the center value
of the gray scale window.
The modification of the window width (Figure VIII-1) is achieved by a click and drag
action of the mouse left button towards the interior of the scale. The level
displacement is achieved by the click and slide action of the mouse central button. A
single click at the desired position (of the appropriate button) allows to modify the
width of the window or the gray level value.
Figure VIII-1 : Level / Windows adjustment box
The movements of the mouse cursor are dynamically followed by the display of the
gray level, the window width, the minimum and maximum visible levels and the
modification of the image display.
The gray level and window width numerical values could be directly modified in their
corresponding entry fields.
A predefined level/window couple linked to a particular organ and known under the
name "tissues choice" could be equally selected from the scrolling list. The list of
CHAPTER VIII - DISPLAY MENU
VIII-4 iSis 3D - V2. 35 – March 2003
names and available values is parametrizable and could be adopted to the
preferences of each user.
The mouse capture button allows to select a rectangular region of the image (by click
and slide) to which there is a special interest. Following, the contrast is automatically
adjusted so that the whole gray scale (from white to black) covers exactly the density
values of the selected region. This function is useful mainly for the passage to the high
resolution display (e.g. the brain case).
If the original image is available, once the settings are performed for a special interest
region it is possible to pass in high resolution mode. The values comprised within the
selected area are recalculated and sampled on 64 gray levels (cf.: § II.4.4, iSis 3D -
General Principles, Elements of dialog, Management of Images). This operation could
be restarted few times for areas smaller and smaller. In any moment the initial image
could be obtained by selecting the low resolution mode. The resolution mode is by
default kept for all newly displayed images
The “Grey Levels” (grey scale) option offers the possibility to choose the way the
gray levels are being distributed between the minimum and maximum gray value of
the window :
• Linear : gray levels are distributed evenly (default mode),
• Logarithmic : gray levels are distributed according to a logarithmic curve
(better contrast for the lower values),
• Exponential : gray levels are distributed according to an exponential curve
(better contrast for the higher values),
• Histogram : the distribution of gray levels is based on the image histogram
in order to enhance the contrast in the regions that are “rich” in information
(those containing more pixels),
• Black & White : using only two gray levels: all pixels with a value greater
than the minimum value are displayed in white ; the rest of the pixels are
displayed using the background color. This option offers the possibility to
better apprehend the borders detected by the “automatic contour” function
which is based on gray scale thresholding.
CHAPTER VIII - DISPLAY MENU
iSis 3D - V2. 35 – March 2003 VIII-5
The effect of the gray-level distribution functions (logarithmic, exponential and
histogram functions) could be more or less obvious according to the adjustment of the
increase coefficient using the horizontal scroll bar. The effect is grater for higher
values of the coefficient.
The densities button offers the possibility to immediately convert all the Hounsfield
values, displayed in the ‘window level/window width’ box, into density values, using the
predefined conversion curve (cf.: § III.6, iSis 3D - File Menu, List of slices and IV.1,
iSIs 3D – Header and list of slice, and IV.2.1, iSis 3D - Slices Menu, Header and list
of slices and Creating from images).
The adjustment panel does not have to be closed. However, if necessary, it can be
closed using the two buttons situated in the bottom:
The Cancel button restores the initial window level/window width settings and closes
the dialog box.
The Ok button validates the window level/window width settings and closes the dialog
box.
Tree different settings are handled and activated automatically by the system ; the title
of the window level/window width dialog box shows the current setting. The first,
concerns the visualization of the calculation planes with the series of primary images
(title : « settings »), the second affects the visualization of the calculation planes with
the series of merged images (title : « settings (register series)») and the third is
specific to the DRRs (title : « settings (DRR) »).
VIII.8 Zoom...
permits to control the scaling of the display and the graphical center of the current
graphical window. It is applicable to must of the displayed windows (slice in(
creation/modification, calculation plane, virtual simulation, ...).
The scale should be interpreted by considering as reference the printed document
paper and the reality. In order to facilitate the interpretation of the screen display, the
width and height of the displayed graphical windows have the same rations as A3 or
A4 paper sheets in landscape disposal. The display scale and the corresponding
paper format are permanently displayed in the legend. For example, 9.5/A4 means a
CHAPTER VIII - DISPLAY MENU
VIII-6 iSis 3D - V2. 35 – March 2003
half scale if the window is printed on an A4 paper sheet. In this case, the display at the
screen is the same as for a 1./A3 scale (multiplying factor and paper format multiplied
by 2)
Figure VIII-2 : Zoom adjustement box
The dialog box (Figure VIII-2) present the following fields:
- Factor : entry field for the scale + scrolling list that proposes the default scales
(parametrizable),
- Format : scrolling list (parametrizable) for the choice of the paper format to which the
display window is assimilated.
- Graphic Center : two entry fields for the window center coordinates X and Y (or U
and V) and a toggle button which allows to choose these coordinates using the mouse
cursor in the graphical window.
- Two buttons allow to mention to which window(s) the zooming is to be applied :
- Zoom kept : that all the windows that are going to be displayed from this point on
will be with the same parameters. This function is especially useful for the
creation/modification contour mode. If one would like to cancel this function while a
study is running, the "zoom" function is to be relaunched. Following one have to click
on this button again.
- Global zoom: allows to assign the zooming parameters to all the windows belonging
to the study (specially calculation plans), even if there were opened with another
zooming value.
CHAPTER VIII - DISPLAY MENU
iSis 3D - V2. 35 – March 2003 VIII-7
Remark : The "Zoom kept" and "Global zoom" functions can not be accessed in virtual
simulation mode.
The box contains as well the following buttons:
- OK and Cancel
Cancel : reestablishes the initial display conditions and closes the dialog box.
Ok : validates the display conditions, updates the graphical window and close the
dialog box.
VIII.9 Restore
permits to came back to the precedent zoom and consequently to cancel the zoom
which is supposed to be used. This function could be several times applied in order to
balance between the last two zooms used. For the calculation plans cases, this
function has an effect only on the plan to be affected by the zoom modification.
VIII.10 Grid
allows to display in the current window a calibrated grid. The choice made in the
cascade ....... allows to get the step grid or to delete a previously displayed grid
("no"). The displayed grid is every time centered on the coordinates origin.
(corresponding to the patient).
The superposition of a grid of a known step may help to have an approximation of the
distances on screen or in order to create new contours (reference to a paper
document MRI film) when in contours creation/modification phase).
VIII.11 Distance measurement
determines the appearance in the current window of a dialog zone which 2 guides the
distances measurements with the mouse. One clicks on the first point and one move
the mouse with the button pressed while the second point is positioned. The points
coordinates and the distances between them are permanently displayed. The angle
indication allow to make measurements rigorously horizontal or vertical.
CHAPTER VIII - DISPLAY MENU
VIII-8 iSis 3D - V2. 35 – March 2003
It is possible to follow consecutively the distance measurements for several segments,
but the corresponding values are not saved. In order to quit this function one have to
click on the Ok button at the right hand side of the working window.
VIII.12 Angle measurement
permits to measure the angle between two segments
As for the distance measurements, one starts by tracing a first segment. A third point
should be selected, linked in a elastic fashion to the second point. The angle taken into
account is that one whose tip is the second point.
The angles measurements could be performed consecutively for several segments,
but the corresponding values are not saved. In order to quit this function, click on the
Ok button at the right hand side of the working window.
VIII.13 Visualization 3D (option)
This mean item launches the surface representation module (optional). This module
allows to display in 3D:
• external surface of the patient
• the anatomical structures
• the beams
• an isodose surface, continuously variable.
If the Visualization 3D item is not grayed, it is accessible and is used to launch the
process which follows two steps:
1 - generation of "3D objets" of the study (allowed on all working posts).
2 - 3D display of these objects (allowed only for the authorized working post (s) )
The complete description of the 3D visualization module could be found in the chapter
X, Visualization 3D.
CHAPTER IX - WINDOWS MENU
iSis 3D - V2. 35 – March 2003 IX-1
IX. WINDOWS MENU
IX.1 Open on selection
proposes the sub option Open on selection which allows to choose or not the
opening of a graphical window after a calculation plan is selected (cf.: § II.4.2, iSIs 3D
- General principles, Elements of dialog, Calculation plane selection box).
IX.2 Store current plan
This function allows to compare on screen several studies and to pass from one to
another
When selecting Store current planes a dialog box opens (Figure IX-1) and proposes
to take a snapshot of the current calculation plan associating free comments and to
prepare an optional cliché of the beams list.
When clicking on Store the asked clichés are added to the "List of photographed
studies" of the WINDOWS menu (cf.: § IX.3, iSis 3D - Windows menu, list of
photographed studies). The "Cancel" button allows to cancel the function.
Figure IX-1 : «Store current plane » dialog box
In order to remember afterwards which study was associated to snapshot, you should
save this study. At the moment the snapshot was taken, a message warns the user
about this and proposes either to "Save" the study (cf.: § III-4, File Menu, Save) before
snapshot, or Store without saving - in which case the study could not be
remembered - or to cancel the snapshot.
CHAPTER IX - WINDOWS MENU
IX-2 iSis 3D - V2. 35 – March 2003
Figure IX-2 : Confimation demand of snapshot
IX.3 List of photographed studies
This function allows to compare on screen several studies and to pass from one to
another.
The list of the photographed STUDIES contains all the photographs taken once a study
was opened (or created) till it was closed. All the intermediate steps of the study are
included, as well as the phases when the study name was changed.
The plans and list of the photographed beams are called "Ei.J - study name : plane
..." and "Ei.J - LIST OF BEAMS 1/1", where i represents the i-th save study after the
opening (or creation) and j the j-th snapshot realized for this study (Figure IX-2).
Figure IX-3 : Plane snapshot list
Selecting one of the snapshot determines its display on screen, in a window form
which contains a comment line, a graphical area identical to that of the current plan
at the capture moment and two buttons, “Recall study” and “Close” (Figure IX-4).
CHAPTER IX - WINDOWS MENU
iSis 3D - V2. 35 – March 2003 IX-3
Figure IX-4 : Snapeshot of plane
The “Recall study” button is accessible only if the study was properly saved at the
snapshot time (cf.: § IX.2, iSis 3D - Windows menu, Store current plane). In this case
the button allows, after the validation of a confirmation question, to close the current
study (with the associated saving proposal) and to re-open the study correspondent to
the snapshot.
After successive study savings and openings, the photographs set is kept until the
explicit closing of the dossier is realized by the “File”/”Close”.
CHAPTER IX - WINDOWS MENU
IX-4 iSis 3D - V2. 35 – March 2003
CHAPTER X - 3D VISUALIZATION
iSis 3D - V2. 35 – March 2003 X-1
X. 3D VISUALIZATION
X.1 surface reconstruction
The surface reconstruction concerns all the slices (transversal) that are appearing in
the slices selection box (or the slices list) either or not are selected. Starting from this
set of slices all the anatomical “objects” are reconstructed (external surface and
structures). The reconstructed objects are keeping the names and colors previously
assigned (cf.: § IV.8, iSis 3D - Slices menu, Structures/bolus). The isolated points, the
lines and the free markers are not reconstructed.
Figure X-1 : Surface reconstruction
The beam type “objects” are displayed as a cone region whose tip is the source and
for the base, the shape of the field. The principal collimator id not displayed (except if it
has no block). The default colors assigned to the beams are arbitrarily. They have
though a transparency property. All the existent beams are by default reconstructed
and displayed.
CHAPTER X - 3D VISUALIZATION
X-2 iSis 3D - V2. 35 – March 2003
The “surface isodose” object is reconstructed from the transversal planes calculated
dose distributions. In order the surface display to be meaningful, the calculation should
be mandatory launched in all the transversal slices of the interest region. An alerting
message warns about the possibility of an erroneously reconstruction if the calculation
is not performed for all the selected slices.
The surface reconstruction of the objects set takes usually few minutes. Meanwhile
one can see on screen the progressive advance of the scene. One have to wait until
the end of this reconstruction for modifying the display of the scene.
X.2 Change zoom and the point of view
The way to present in space the displayed objects (from the observers looking point)
can be modified in real time by using the mouse. The available functions are the
following:
• rotation in space: move the mouse keeping pressed the central button
• translation in the screen plane: move the mouse keeping pressed the right
button
• zoom move the mouse keeping pressed the central button and the Maj/min key
• continuous rotation keep pressed the mouse central button and slide it
rapidly in the rotation sense before to release the button; the sliding velocity
determines the rotation speed.
One can act as well on Display using the following buttons:
• limits: if this option is active (white color button), the mouse driven
transformation acts on the rectangle which contains the set of the objects
appearing on the screen; otherwise, the mouse acts in real time on the objects
with a reaction time that depends on the hardware configuration.
• Face/Back, Profile right/Profile left, From Head/From Feet: performs a
rotation according to the choice done
• Customized is the default display mode that allows to memorize the performed
transformations. Thus, if one of the Anterior/Posterior views are selected, the
“Personalized” button allows to recall the previous state of the display change.
CHAPTER X - 3D VISUALIZATION
iSis 3D - V2. 35 – March 2003 X-3
X.3 Display or hide objects
The set of objects is grouped in a scrolling list which can be explored using the scroll
bar and the mouse central button for ascending or descending, or the left or the right
mouse buttons for ascending and descending respectively. The object is selected by
clicking on its name in the list. The object becomes current.
Whatever the current object it is, it is possible to be displayed or not by clicking on the
Visible button.
X.4 Change object representation mode, color and transparency
The anatomical “objects” representation mode, the isodoses and the beams, could be
modified by clicking one of the three buttons: surface, lines or points. The effect is
almost immediate.
The color could be as well modified but its setting is a little more delicate since it is
based on the three basic colors: red, green and blue.
Finally, the transparency of the current object could be continuously adjusted from a
zero value opacity (object completely transparent) till an unity value opacity (object
completely opaque)
X.5 Change the value of the isodose surface
If the doses were previously calculated for a sufficient number of adjacent slices, one
can display a selected isodose by moving the “ISODOSE” cursor to the desired value.
The corresponding isodose surface gets “inflated” or “deflated” according to the
selected value and the re-display is performed at the moment the mouse button is
released.
This function is particularly useful in order to see if a given isodose surface “wraps”
the target volume without containing any cold point. It is recommended to the user to
use the “surface” representation mode for the target volume and the “lines” mode for
the isodose. The “surface” mode for the isodose is equally preferably because it allows
to see the target volume exceeding, if this is the case, the wrapping isodose.
CHAPTER X - 3D VISUALIZATION
X-4 iSis 3D - V2. 35 – March 2003
X.6 Print window
The print of the scene the way it is visualized is possible in Postscript mode. It is
enough to choose the printer paper format (“A3” or “A4”), the quality of the print
(“draft”, “stand.” Or “fine”) and to introduce or confirm the name of the file (normally the
name of the study followed by the extension .PS) in the “File” entry field. The printing
is launched by pressing Return or after the mouse quits the field once the name was
modified.
The choice of the printing quality influences directly the printing time. This amount of
time can vary from a few minutes for an inferior quality to tenths of minutes for the high
quality (with an ink jet printer). The medium quality (stand.) is generally satisfactory.
X.7 Display other scenes
The set of reconstructed objects constitutes a scene which takes by default the name
of the original study. Each time a new scene is reconstructed it replaces the previous
one. The corresponding files are systematically saved and a voluntary action should
be made (at the systems level) in order to destroy them.
It is possible this way, without quitting the surface visualization module to display as
well other scenes previously build. For this one have to click on “Choose study”.
Following, a list where one could select the scene to be displayed (clicking its name,
composed with the name of the study followed by the extension “.V3D”) is displayed.
In order to display the 3D objects generated on another working place click on New dir
and introduce:
• either the full access path as “node::disk:[dir1.dir2]”
e.g.: ALPHA2::DKA0:[DOSI.USR.PHYSIQUE.VUES3D])
• or a logical name previously defined (e.g. ALPHA2$VUES3D)
X.8 Return to calculation mode
Even if the surface visualization module is operational, the initial application remains a
priori active. It is possible to pass from one to another by simply clicking inside the
corresponding window. If the display window covers all the screen, it can be useful to
CHAPTER X - 3D VISUALIZATION
iSis 3D - V2. 35 – March 2003 X-5
minimize (make it as icon) it. A double click on the icon (called “V3D - VISUALIZATION
3D”) allows to come back to the visualization module.
An often encountered case is when one decides to adjust the beam parameters after
the results of the surface representation display were seen. In order to do this, one
have to get into the dose calculation application and then, after the parameters
modification to select a new item Visualization 3D standard or Full screen from the
DISPLAY menu. Every object of the current scene is then called and replaced by the
new objects of the modified study.
By clicking the Quit button, the surface representation module is completely closed. All
the object are kept (as well the continuously variable isodose surface). Only the
representation options are lost.
CHAPTER X - 3D VISUALIZATION
X-6 iSis 3D - V2. 35 – March 2003
APPENDIX
iSis 3D - V 2.35 - March 2003 1
APPENDIX
A. Text editor
B. Description of set-up file
B1. Default set-up of application
B2. File access zones configuration file
B3. List of protocols
B4. Defaults set-up Level/Windows
B5. Color table
B6. Automatic FTP parameters
C. Conversion, of Hounsfied number to densities, curve format
D. Descriptiion of study files
D1. Slices file
D2. Beams file
D3. Administrative file
E. Export doses file format
F. Waterphantom Program
G. Photon Compensators
G1. Users’ guide
G2. Description of Compensator file "DEPTH" (.PRF)
G3. Description of Compensator file "REAL" (.CPR)
G4. Description of Compensator file "THEORETICAL" (.CPT]
G5. Description of Compensator file "HEK"
G6. Description of Compensator file "Machine file"
H. Menu summary
I. List of figures and tables
APPENDIX
2 iSis 3D - V 2.35 - March 2003
APPENDIX A – TEXT EDITOR
ISIS 3D - V 2. 35 – March 2003 A - 1
A. USING THE TEXT EDITOR
To open a text file (with a known name) in order to be modified, the following
command has to be used:
Open a Decterm and since the $ is displayed, type:
ED/EDT FILENAME.ext;n RETURN
Ex : edt/edt SATX15.DAT;1
The system replay by *, type C then RETURN.
The, the system display the beginning of the file.
The function-keys
The keys of the right-side of the keyboard became the function-key.
(ATTENTION IF YOU WANT TO INPUT NUMBERS; DO NOT USE THE RIGHT-
SIDE OF THE KEYBOARD)
The figure A3-1 presents these function-keys.
You can have displayed this figure on the screen by pressing the key PF2 and deleted
by pressing the blank space key.
Prompt placing inside the text file
* In order to pass from one character to other, use the keys:
* In order to pass from one line to other, use the keys:
Searching for a string in the file
Press on PF1 then PF3.
The system asks for: search for :
Type the string, then press on PF3.
The prompt will be placed at the beginning of the string. If the text file includes strings
of the same type, press PF3 and the system will pass at the next.
If the system does not find the string, it answers by NOT FOUND.
APPENDIX A – TEXT EDITOR
A - 2 ISIS 3D - V 2. 35 – March 2003
Character insertion
Place the cursor at the desired place, then type the character.
Character deleting
Place the cursor after the character to be deleted, then press Back Space key.
File closing
Press on the key PF1 then on the key 7 (right-side of the keyboard).
The system asks for : command
type EXIT Closing and saving the file.
Or QUIT Closing without saving the file. the modifications will not
be taken into account.
Then press on the key ENTER on the right-side of the keyboard in order to
execute the command.
TOUCHES DE FONCTION
PF1 PF2 PF3 PF4
7 8 9
1 32
0
ENTER
UP DOWN LEFT RIGHTGOLD HELP FNDNXT
FIND
PAGE COMMAND
SECTFILL
APPEND REPLACE
DEL LUND L
DEL WUND W
4 5 6 ,ADVANCEBOTTOM
BACKUP TOP
CUTPASTE
DEL CUND C
WORDCHNGCASE
EOLDEL EOL
CHARSPCINS
ENTER
SUBS
LINEOPEN LINE
SELECT RESET
APPENDIX B – SETUP FILES
iSis 3D - V 2.35 - March 2003 B - 1
B. DESCRIPTION OF SET-UP FILES
Some parameters can be defined into following files to be taken into account at the
launch of application ISIS3D.
Those files are located into DOSI$USR:[PHYSICAL.POSTES] directory.
B1. Default set-up of application ISIS2_OPTIONS.ETL
B2. File access zones configuration file ISIS2_ZONES_DEFAUT.ETL
B3. List of protocols ISIS2_STRUCTURE.ETL
B4. Defaults set-up Level/Windows ISIS2_PREREGLAGES.ETL
B5. Color table ISIS2-ANGLAIS.TBL*
B6. Automatic FTP parameters I3D_EXPORTATION.COM
* ISIS2-ANGLAIS.TBL is located into “ISIS2$EXE:” directory
APPENDIX B – SETUP FILES
B - 2 iSis 3D - V 2.35 - March 2003
APPENDIX B1 – SESSION PARAMETERS FILE
ISIS 3D - V 2. 35 - March 2003 B1 - 1
B1. SESSION PARAMETERS FILE FORMAT (ISIS2_OPTION.ETL)
This file allow to set up :
• Logical names defining studies' location
• Logical names defining images' location
• Logical name defining temporary files location
• Default state of graphic window when selecting plane
• Logical name defining color table
• List of scale factor and paper size
• Background print-out color
• Default size of graphic window when selecting plane
• Default set-up of automatic densities calculation options
• The visibility of cursor in elastic mode
• Plot type of internal contours
• Computing option
• Complex field automatic computing option
• Availability of the 3D visualization option
• DRR calculation options
• Display information message in SSD , "SSD different than SAD"
• Default block thickness
APPENDIX B1 – SESSION PARAMETERS FILE
B1 - 2 ISIS 3D - V 2. 35 - March 2003
Session parameters file example : Only blue line parameters can be modify by user
ISIS2:identification_du_fichier_de_parametrage
ISIS2
ISIS2:version_de_fichier_de_parametrage
18
MOTIF:FONT_UNIT_LARGEUR
7
MOTIF:FONT_UNIT_HAUTEUR
7
MOTIF:DUREE_DOUBLE_CLIC
500
MOTIF:Drapeau_de_demande_de_regeneration_du_trace_sur_EXPOSE
0
FICHIERS:Name_of_study_based_on_by_default_ :_0=the name__1=the_file_number
0
FICHIERS:File_number_mandatory_ :0=no__1=yes
0
FICHIERS:repertoire_des_fichiers_administratifs
ISIS2$DOSSIERS
FICHIERS:repertoire_des_fichiers_coupes
ISIS2$DOSSIERS
FICHIERS:repertoire_des_fichiers_faisceaux
ISIS2$DIRFSCX
FICHIERS:repertoire_des_repertoires_d'images
ISIS2$IMAGES
FICHIERS:repertoire_du_repertoire_d'images_temporaires___ZERO_si_aucun
ZERO
FICHIERS:default_conversion_density_curve_name
CURIE
FICHIERS:repertoire_des_fichiers_contextes
ISIS2$DIRCTX
FICHIERS:fichier_temporaire
ISIS2$DIRCTX:liste_dossiers.tmp
FICHIERS:fichier_statistiques_0=global___1=zone_par_zone
0
BOITE_COUPES:code_du_caractere_croix_de_la_boite_de_coupe
215
BOITE_COUPES:code_du_caractere_espace
32
BOITE_COUPES:default_OPEN_ON_SELECTION_value_0=NO__1=YES
1
ISODOSES:nombre_maximum_de_couleurs
16
APPENDIX B1 – SESSION PARAMETERS FILE
ISIS 3D - V 2. 35 - March 2003 B1 - 3
ISODOSES:nombre_de_couleurs_utilisees_par_defaut
16
ISODOSES:premier_indice_dans_la_table_des_couleurs
0
CALCULS:step_of_calculation_for_fine_grid
2.0
CALCULS: step_of_calculation_for_medium_grid
4.0
CALCULS: step_of_calculation_for_coarse_grid
6.0
CALCULS: default_calculation_step
4.0
CALCULS:radial_step_calculation
3.0
CALCULS:calculation_model :0=simple_cutting_out,1=double_cutting_out,2=primary_only
0
CALCULS:heterogeneity_correction :0=no;1=standar;2=vox/vox
0
CALCULS:field_grid_step
2.0
CALCULS:fast_calculation:0=no;1=yes
1
CALCULS:save_calculated_doses:0=no;1=yes
1
CALCULS_HDV:display_and_save_DVH:0=no;1=dispay;2=save;3=display+save
3
COMPENSATEUR:pas_de_la_grille_de_calcul_des_profondeurs_en_U:PAS_GRILLE_COMP_U
0.1075
COMPENSATEUR:pas_de_la_grille_de_calcul_des_profondeurs_en_V:PAS_GRILLE_COMP_V
0.0931
DURCISSEMENT_FAISCEAU:prise_en_compte:0=non,2=primaire
0
CONTOURS:nombre_maximum_de_couleurs
16
CONTOURS:premier_indice_dans_la_table_des_couleurs
0
COULEURS:fichier_table_des_couleurs
ISIS2$TABLECOULEURS
WAVE:taille_allouable_pour_le_code
30000
WAVE:taille_allouable_pour_les_donnees
30000
ZOOM:formats_papier:nombre_puis_nom-dimensions-utiles-x-yy__5_format_maximum
5
A6 14.85 10.5
A5 21. 14.85
APPENDIX B1 – SESSION PARAMETERS FILE
B1 - 4 ISIS 3D - V 2. 35 - March 2003
A4 29.7 21.
A3 42. 29.7
A2 59.4 42.
ZOOM:facteurs_d'echelle:nombre_puis_valeurs___10_echelles_maximum
9
0.25 0.5 0.75 1. 1.5 2. 3. 4. 5.
IMPRESSION:couleur_du_fond:0=couleur_standard,blanc_sinon
1
AFFICHAGE:tailles_des_fenetres:nombre(0/n-1)_puis_dimensions-utiles-x-y__5_tailles_max
4
869 614
340 240
724 512
996 704
AFFICHAGE:taille_de_fenetre_par_defaut:1=petite,2=moyenne,3=grande
2
AFFICHAGE:largeur_des_icones_en_pixels
80
AFFICHAGE:hauteur_des_icones_en_pixels
80
AFFICHAGE:largeur_virtuelle_des_icones_en_centimetres
30.
AFFICHAGE:hauteur_virtuelle_des_icones_en_centimetres
30.
CONTOURS:automatic_density_calculation:0(zero)=no,1=yes
0
CONTOURS:mouse_visible_in_elastic_mode_while_modifying_contours :0=no,1=yes
1
CONTOURS:line_style:0=line,1=points,2=dashs,3=dash-points,4=dash-pt-pt-pt,5=long_dashs
2
IMAGES:zoom_avec_interpolation_des_images:0=non,oui_sinon__[defaut=1]
1
SIMULATION_VIRTUELLE:marge_ajustement_colli_apres_saisie_champ_complexe_en_cm
0.5
SIMULATION_VIRTUELLE:marge_expansion_et_champ_complexe:nombre,valeurs_en_cm__6_valeurs_max
6
0.5 1. 1.5 2. 2.5 3
MULTILAMES:conformation_auto_par_défaut:1=interne,2=externe,3=moyenne
3
MULTILAMES:optimisation_par_rotation_collimateur:1=OUI,0=NON
0
MULTILAMES:pas_d'optimisation_en_degres
5.0
DRR:valeur_seuil_entre_tissus_mous_et_denses_en_Hounsfield__[defaut=+350]
350
DRR:valeur_des_tissus_denses_dans_DRR_tissus_mous_en_Hounsfield__[defaut=0]
APPENDIX B1 – SESSION PARAMETERS FILE
ISIS 3D - V 2. 35 - March 2003 B1 - 5
0
DRR:valeur_min_des_tissus_dans_DRR_tissus_denses_en_Hounsfield__[defaut=-950]
-950
VOXEL_PAR_VOXEL_et_DRR:pas_d'echantillonnage_en_cm__[defaut=0.2]
0.15
MODULES_OPTIONNELS:visualisation3D:0=NON,1=OUI,2=OUI_sur_autre_poste
1
INFORMATION:Alert_if_SSD_different_of_SDA:0=no,1=yes
1
CACHE: Default_block_thickness_cm
7.0
IMPORTATION_DOSES_STEREOTAXIQUES:0=NON,1=OUI
1
COEFFICIENT_RADIOBIOLOGIQUE_DES_STRUCTURES_PAR_DEFAUT
3.0
DOSE_PAR_FRACTION
2.0
Equivalent radiobiological dose value "2.0" Gray
APPENDIX B1 – SESSION PARAMETERS FILE
B1 - 6 ISIS 3D - V 2. 35 - March 2003
APPENDIX B2 – ACCESS ZONES FILE
ISIS 3D - V 2. 35 - March 2003 B2 - 1
B2. ACCESS ZONES FILE (ISIS2_ZONES_DEFAUT.ETL)
Line Content Format Commentaries
1 Identification A4 ISIS2
2 File version number I1 2
3 Comment
4 Number of defined Zones I2 NBZ
5 Comment
6 Comment
7 Comment
For each defned zones
+1 Index of zone I2
+1 Name A20 Name display into scroll list
Key A20 DISQUE
Key A15 ISIS
Path A64
End of zones definition
8 + (NBZ*2) Comment
+1 Number of zone association I2 7
For each association
+1 Comment
+1 Key
+1 Comment
+1 Number of zones associated I2 NBZA
+1 to +NBZA Index for zone associated I2
End of association
DO NOT MODIFY UNDER THIS LINE
APPENDIX B2 – ACCESS ZONES FILE
B2 - 2 ISIS 3D - V 2. 35 - March 2003
ONLY BLUE LINES CAN BE MODIFIED
ISIS2
2
ISIS2:Number_of_defined_zones
5 Number of zones defined
ISIS2:pour_chaque_zone
ISIS2:numero_de_la_zone
ISIS2:nom_sur_20_CAR;Vecteur_sur_20_CAR;Format_sur_15_CAR;Chemin_sur_64_car_max
1 index of zone
ISIS Dossiers disque ISIS ISIS2$DISKDOSS:[DOSI.USR.PHYSIQUE.DOSSIERS] definition of zones
2 index of zone
ISIS Dossiers DEMO disque ISIS ISIS2$DISKDOSS:[DOSI.USR.DEMO] definition of zones
3 index of zone
ISIS Images disque ISIS ISIS2$DISKIMG:[DOSI.USR.IMAGES] definition of zones
4 index of zone
Images DEMO disque ISIS ISIS2$DISKIMG:[DOSI.USR.IMAGES_DEMO] definition of zones
5 index of zone
Export disque ISIS ISIS2$DISKDOSS:[DOSI.USR.EXPORT] definition of zones
ISIS2:nombre_d_affectation_possible_des_zones_(fixe)
7
ISIS2:nom_source_of_studies
source_études
ISIS2:nombre_de_zones_pour_l_affectation_suivi_des_numeros_des_zones
2 Number of associated zones
1 index of zone
2 index of zone
ISIS2:nom_destination_of_studies
destin_études
ISIS2:nombre_de_zones_pour_l_affectation_suivi_des_numeros_des_zones
2 Number of associated zones
1 index of zone
2 index of zone
ISIS2:nom__sources_of_importations
source_import
ISIS2:nombre_de_zones_pour_l_affectation_suivi_des_numeros_des_zones
2 Number of associated zones
1 index of zone
2 index of zone
ISIS2:nom_destination_of_exportations
destin_import
ISIS2:nombre_de_zones_pour_l_affectation_suivi_des_numeros_des_zones
2 Number of associated zones
1 index of zone
2 index of zone
ISIS2:nom_sources_of_images
source_images
ISIS2:nombre_de_zones_pour_l_affectation_suivi_des_numeros_des_zones
2 Number of associated zones
3 index of zone
4 index of zone
APPENDIX B2 – ACCESS ZONES FILE
ISIS 3D - V 2. 35 - March 2003 B2 - 3
ISIS2:nom_zones_where_it_is_allowed_to_kill_studies
zones_destr
ISIS2:nombre_de_zones_pour_l_affectation_suivi_des_numeros_des_zones
2 Number of associated zones
1 index of zone
2 index of zone
ISIS2:nom_zones_for_exportation_of_block_mlc_data_beam_data
zones_export
ISIS2:nombre_de_zones_pour_l_affectation_suivi_des_numeros_des_zones
1 Number of associated zones
5 index of zone
DO NOT MODIFY UNDER THIS LINE
ISIS2:nombre_d_objets_ISIS2
9
ISIS2:nom_de_l_objet::contour
CONTOURS
ISIS2:nombre_de_formats_associes_à_l_objet_suivi_des_noms_de_format_plus_format
1
ISIS *.ctr
ISIS2:numero_de_la_zone_associee_par_defaut_a_l'objet__0_pour_aucune
0
ISIS2:nom_de_l_objet::faisceau
FAISCEAUX
ISIS2:nombre_de_formats_associes_à_l_objet_suivi_des_noms_de_format_plus_format
1
ISIS *.fsc
ISIS2:numero_de_la_zone_associee_par_defaut_a_l'objet__0_pour_aucune
0
ISIS2:nom_de_l_objet::etude
ETUDE
ISIS2:nombre_de_formats_associes_à_l_objet_suivi_des_noms_de_format_plus_format
1
ISIS *.isx
ISIS2:numero_de_la_zone_associee_par_defaut_a_l'objet__0_pour_aucune
0
ISIS2:nom_de_l_objet::repimage
REP_IMAGES
ISIS2:nombre_de_formats_associes_à_l_objet_suivi_des_noms_de_format_plus_format
1
ISIS *.dir
ISIS2:numero_de_la_zone_associee_par_defaut_a_l'objet__0_pour_aucune
0
ISIS2:nom_de_l_objet::compens
COMPENSATEURS
ISIS2:nombre_de_formats_associes_à_l_objet_suivi_des_noms_de_format_plus_format
2
ISIS *.cpr
ISIS *.dlc
ISIS2:numero_de_la_zone_associee_par_defaut_a_l'objet__0_pour_aucune
0
APPENDIX B2 – ACCESS ZONES FILE
B2 - 4 ISIS 3D - V 2. 35 - March 2003
ISIS2:nom_de_l_objet::mlc
Faisceaux/MLC
ISIS2:nombre_de_formats=4,Automatique/RTP_Lantis(inutilise)/RTP_Varis/RTP_Isis
4
Automatique .
RTP_Lantis .RTP
RTP_Varis .RTP
RTP_Isis .RTP
ISIS2:numero_de_la_zone_associee_par_defaut_a_l'objet__0_pour_aucune
1
ISIS2:nom_de_l_objet::champ
FORME_DU_CHAMP
ISIS2:nombre_de_formats_associes_à_l_objet_suivi_des_noms_de_format_plus_format
0
ISIS2:numero_de_la_zone_associee_par_defaut_a_l'objet__0_pour_aucune
1
ISIS2:nom_de_l_objet::doses
DOSE
ISIS2:nombre_de_formats_associes_à_l_objet_suivi_des_noms_de_format_plus_format
0
ISIS2:numero_de_la_zone_associee_par_defaut_a_l'objet__0_pour_aucune
1
ISIS2:nom_de_l_objet::CopieFenetre
Copie_de_Fenetre
ISIS2:nombre_de_formats_associes_à_l_objet_suivi_des_noms_de_format_plus_format
1
BMP .bmp
ISIS2:numero_de_la_zone_associee_par_defaut_a_l'objet__0_pour_aucune
0
ANNEXE B3 – LISTE DES PROTOCOLES
iSis 3D - V 2.35 - March 2003 B3 - 1
B3. FORMAT DU FICHIER DES PROTOCOLES
Identification : ISIS2_STRUCTURES.ETL
Location : DOSI$USR :[PHYSICAL.POSTES]
Line Content Format Commentaries
1 Identification A4 ISIS2
2 File version number I1 4
3 Number of protocol I2 NBP
4 Comments A64
5 Number of type of POI I1 5
For each protocol
+1 Index I2 IP
+1 Name A20 Name display into scroll list
End of protocol name and index definition
For each protocol
6 + (NBP*2) Index of protocol I2 IP
+1 Number of structure I2
For each structure
+1 Index I2 Right justify
Name A12 Right justify
Density F(6.2) Right justify
Color I4 Right justify
Index for zone associated I2 Right justify
End of structure definition
+1 Number of point of interest I2
+1 Comment
For each Point of interest
+1 Code A2 Mandatory (no space)
Name A16
Color I2 Right justify
Flag type 5 x I2 00=false, 01=true (only one of five flags can set to true)
Coordinates X Y Z 3 x F(6.2) Right justify (99.99 99.99 99.99 means cordonates not defined)
End of point of interest definition
For each isodose
+1 Value I or F(x.1) Free lenght
Separator A1 ,
Color I2
End of isodose
+1 End of list -1, 0
End of Protocol
ANNEXE B3 – LISTE DES PROTOCOLES
B3 - 2 iSis 3D - V 2.35 - March 2003
Color index for : Structures and point of interest
Isodoses
white 0 1 blue_1 1 2 red 2 3 green_2 3 4 orange_1 4 5 cyan 5 6 green_1 6 7 yellow 7 8 blue_2 8 9 orange_2 9 10 purple 10 11 pink 11 12 blue_3 12 13 brown 13 14 green_3 14 15
gray 15 16
ANNEXE B3 – LISTE DES PROTOCOLES
iSis 3D - V 2.35 - March 2003 B3 - 3
Example of structures file : ISIS2 4 7 !!! nombre de types de point ISOC(Is) POND(Po) DOSE(Do) REPERE(Re) BILLE(Bi) 5 1 DEFAUT 2 SEIN 3 CRANE BENIN 4 CRANE MALIN 5 PROSTATE 6 GYNECO 7 UROLOGIE VESSIE 1 6 1VOLUME CIBLE 1.00 0 5 2VOL. TUMORAL 1.00 0 1 3MOELLE 1.00 0 4 4POUMON GAUCH 1.00 0 3 5POUMON DROIT 1.00 0 3 6OS 1.00 0 6 0 !!! Types IsPoDoReBi -1, 0 2 2 1POUMON 1.00 0 3 2VOL CIBLE 1.00 0 2 5 !!! Types IsPoDoReBi AACMI 3 LM 5 0 0 1 0 0 99.99 99.99 99.99 ABCMI 1,5 LM 6 0 0 1 0 0 99.99 99.99 99.99 ACsus clav 10 0 0 1 0 0 99.99 99.99 99.99 ADsous clav 11 0 0 1 0 0 99.99 99.99 99.99 AEaxillaire 2 0 0 1 0 0 99.99 99.99 99.99 5, 16 10, 5 20, 6 30, 7 40, 8 42, 12 45, 3 47, 11 50, 9 52, 4 60, 10 70, 11 80, 12 -1, 0 3 13 1/00/540 1.00 0 2 2VCA/00/ 1.00 0 5 3OEIL-G 1.00 010 4OEIL-D 1.00 0 6 5TRONC CEREB 1.00 0 9 6CERVELET 1.00 0 8 7LOB.TEMP-G 1.00 0 3 8LOB.TEMP-D 1.00 011 9REG.CHIASMA 1.00 0 7 10ENCEPHALE 1.00 0 4 11HYPOPHY/THAL 1.00 014
ANNEXE B3 – LISTE DES PROTOCOLES
B3 - 4 iSis 3D - V 2.35 - March 2003
12DENTURE 1.00 013 13MOELLE 1.00 015 0 !!! Types IsPoDoReBi -1, 0 4 11 1VT GLIOME 1.00 0 2 2VP/00/60 1.00 0 5 3OEIL-G 1.00 010 4OEIL-D 1.00 0 6 5TRONC CEREB 1.00 0 9 6CERVELET 1.00 0 8 7REG.CHIASMA 1.00 0 7 8ENCEPHALE 1.00 0 4 9HYPOPHY/THAL 1.00 014 10DENTURE 1.00 013 11MOELLE 1.00 015 0 !!! Types IsPoDoReBi -1, 0 5 13 11.PROSTATE 1.00 0 2 22.PROSTAT+VS 1.00 012 3REF-GANG/ 1.00 011 4RECTUM-EXT 1.00 013 5VESSIE-EXT 1.00 0 7 6T.FEMUR-G 1.00 0 1 7T.FEMUR-D 1.00 0 6 8SACRUM/SYMPH 1.00 0 3 9S12/ILI/ISCH 1.00 010 101.VP/105/ 1.00 0 5 112.VP/105/ 1.00 0 9 121.ETUDE/5MM 1.00 014 132.ETUDE/5MM 1.00 014 0 !!! Types IsPoDoReBi -1, 0 6 13 11.VT/TUMEUR 1.00 0 2 2VESSIE 1.00 0 7 3URETRE-PROST 1.00 015 41.VP/150/XX 1.00 0 5 52.VP/I50/XX 1.00 0 9 6RECTUM-EXT 1.00 013 7GGILIA-G/XX 1.00 0 6 8GGILIA-D/XX 1.00 0 1 9SYMPH/ISCHIO 1.00 010 10FEMUR-G 1.00 0 1 11FEMUR-D 1.00 0 6 12E:VESSIE+10 1.00 0 0 13PAROI RECTUM 1.00 0 4 0 !!! Types IsPoDoReBi -1, 0
APPENDIX B4 - LEVEL/WINDOWS PRE-SETUP FILE
ISIS 3D - V 2. 35 - March 2003 B4 - 1
B4. LEVEL/WINDOWS PRE-SETUP LIST
Identification : ISIS2_PREREGLAGES.ETL
Location : DOSI$USR:[PHYSICAL.POSTES]
Line Content Format Commentaries
1 Number of pre-set-up I
+1 Label A15
Level I8 Left justify
Windows I8 Left justify
Pre-set-up file example : 5 soft_tissus 0 500 lungs_displ -700 500 lungs_ctrs 0 500 bones_displ 675 1200 bone_ctrs 300 120
APPENDIX B4 - LEVEL/WINDOWS PRE-SETUP FILE
B4 - 2 ISIS 3D - V 2. 35 - March 2003
APPENDIX B5 – COLOR TABLE
ISIS 3D - V 2. 35 – March 2003 B5 - 1
B5. COLORS TABLE FILE FORMAT
Identification : ISIS2-ANGLAIS.TBL
Location : ISIS2$EXE:
Line Content Format Commentaries
1 Number grey I2 64
+1 R V B 3 x I3 0 to 255
Name A8 Gray
66 Number of color I2 16
+1 R V B 3 x I3 0 to 255
Name A8 Display into scroll list
83 Not used
Remark : About gray
• the first "triplet" correspond graphic windows background ((67, 72, 74) default)
• Next "triplets" define a regular gradation from black (dark gray) to white
Remark : About color
• The first "triplet" (default: white) define the axis, legend, not current and not computed beam color
• The third "triplet" (default: red) define current beam color
• The fourth "triplet" (default: green_1) define computed beam color
• The eighth "triplet" (default: yellow) define default contours color
APPENDIX B5 – COLOR TABLE
B5 - 2 ISIS 3D – 2.35 – March 2003
64 Number of grey level
67 72 74 gray 165 165 165 gray
4 4 4 gray 170 170 170 gray
8 8 8 gray 174 174 174 gray
12 12 12 gray 178 178 178 gray
16 16 16 gray 182 182 182 gray
20 20 20 gray 186 186 186 gray
24 24 24 gray 190 190 190 gray
28 28 28 gray 194 194 194 gray
32 32 32 gray 198 198 198 gray
36 36 36 gray 202 202 202 gray
40 40 40 gray 206 206 206 gray
44 44 44 gray 210 210 210 gray
48 48 48 gray 214 214 214 gray
52 52 52 gray 218 218 218 gray
56 56 56 gray 222 222 222 gray
60 60 60 gray 226 226 226 gray
64 64 64 gray 230 230 230 gray
68 68 68 gray 234 234 234 gray
72 72 72 gray 238 238 238 gray
76 76 76 gray 242 242 242 gray
80 80 80 gray 246 246 246 gray
85 85 85 gray 250 250 250 gray
89 89 89 gray 254 254 254 gray
93 93 93 gray 16 Number of colors
97 97 97 gray 255 255 255 white
101 101 101 gray 0 146 255 blue_1
105 105 105 gray 255 0 0 red
109 109 109 gray 0 239 23 green_2
113 113 113 gray 255 185 109 orange_1
117 117 117 gray 0 255 255 cyan
121 121 121 gray 0 255 168 green_1
125 125 125 gray 254 249 0 yellow
129 129 129 gray 0 0 255 blue_2
133 133 133 gray 255 113 0 orange_2
137 137 137 gray 165 2 186 purple
141 141 141 gray 225 8 193 pink
145 145 145 gray 5 59 199 blue_3
149 149 149 gray 146 0 0 brown
153 153 153 gray 0 177 4 green_3
157 157 157 gray 222 190 190 gray
161 161 161 gray 5 Not used
APPENDIX B6 – I3D_EXPORTATION FILE SETUP
iSis 3D - V 2.35 - March 2003 B6 - 1
B6. I3D_EXPORTATION FILE SETUP
This file will allow to export automatically MLC, RPT and block-cutter files, throught
FTP connection. FTP server service on destination system must be activate and
configured.
Three kinds of object file can be configured for exportioon :
Type MLC, will manager exportation of MLC and RTP file
Type DECOUPEUSE, will manage exportation of block-cutter file
Name : i3d_exportation.com
Localization : DOSI$USR:[PHYSICAL.POSTES]
2
1
TYPE MLC
IPADR xxx.xxx.xxx.xxx (IP address of ftp server)
USERNAME login_name (username to login)
PASSWORD password (password to login)
REMOTE_DIR c:\\ path to access to remote directory*
MODE IMAGE
NB_EXTENSIONS 2
EXTENSION_1 MLC
EXTENSION_2 RTP
2
TYPE DECOUPEUSE
IPADR
USERNAME
PASSWORD
REMOTE_DIR
MODE ASCII
NB_EXTENSIONS 0
* According to the ftp-server OS, the path has to be define with double "\" or not, also drive could or
clould not be define into the path.
The easyest way is to define FTP account accessing directly into destination directory, in this case path
is "."
APPENDIX B6 – I3D_EXPORTATION FILE SETUP
B6 - 2 iSis 3D - V 2.35 - March 2003
If file doesn't exist create it, with following command :
$ SET DEF DOSI$USR:[PHYSICAl.POSTES]
$ copy i3d_exportation.cfg_modele i3d_exportation.cfg
to modify the file use following command :
$ edit i3d_exportation.cfg
(to exit from edit mode, press execute key, then key-in exit at command prompt)
Exemple :
2
1
TYPE MLC
IPADR 192.167.114.32 (IP address of ftp server)
USERNAME anonymous (login-name to login)
PASSWORD pass (password to login)
REMOTE_DIR c:\\rtpfile path to access to remote directory
MODE IMAGE
NB_EXTENSIONS 2
EXTENSION_1 MLC
EXTENSION_2 RTP
2
TYPE DECOUPEUSE
IPADR
USERNAME
PASSWORD
REMOTE_DIR
MODE ASCII
NB_EXTENSIONS 0
APPENDIX C – CONVERSION HOUNSFIELD / DENSITIES CURVE
iSis 3D - V 2.3 – Septembre 2001 C - 1
C. CONVERSION, OF HOUNSFIED NUMBER TO DENSITIES, CURVE FORMAT
The conversion curve of Hounsfile number to densities allow to calibrate scanner.
IDENTIFICATION : name.DEN
Remark : ^ means space charater
Line Data Format Comments
1 A3 ___ (par défaut)
Image device A7 Name of device
A5 CTDEN
I2 1
Comments A72
2 A5 ^DENS
F7.2 0.00
A8 ^^^^^^^u
A5 ^^^CT
F7.2 ^^^0.00
A8 ^^^^^^^u
A5 ^^^^ ̂
F7.2 ^^^0.00
A8 ^^^^^^^ ̂
Number of points I2 50 points maximum
3 Couple of data (F5.1, F6.3) 12 couples maximum by line
4 Couple of data (F5.1, F6.3) 12 next (if neccessary)
5 Couple of data (F5.1, F6.3) 12 next (if neccessary)
6 Couple of data (F5.1, F6.3) 12 next (if neccessary)
7 Couple of data (F5.1, F6.3) 2 last (if neccessary)
Remark: Curve containts densities as abscissa and “Hounsfiel number/1000” as
ordinate.
Example of file : sc.den
___SC^^^^^CTDEN^1Correspondance entre l'echelle des nombres Houndsfield et les densites
^DENS^^^0.00^^^^^^^u^^^CT^^^0.00^CT/1000^^^^^^^^0.00^^^^^^^^^^^^^^^^0.00^^^^^^^^^^^^^^^^0.00^^^^^^^^4
^^0.0-1.000^^1.0^0.000^^1.2^0.200^^2.2^2.000
Remark: This curve is defined by 4 points : (0.0 ; -1000), (1.0 ; 0.0), (1.2 ; 200) et (2.2
; 2000)
APPENDIX C – CONVERSION HOUNSFIELD / DENSITIES CURVE
C - 2 iSis 3D - 2.35 - March 2003
APPENDIX D – STUDY FILES
iSis 3D - V 2.35 – March 2003 D - 1
D. DESCRIPTION OF STUDY FILES
D1. Slices file *.CTR
D2. Beams file *.FSC
D3. Administrative file *.ISX
APPENDIX D – STUDY FILES
D - 2 iSis 3D - V 2.35 – March 2003
APPENDIX D1 – SLICE FILE
iSis 3D - V 2.35 - March 2003 D1 - 1
D1. SLICES FILE FORMAT
IDENTIFICATION: name.CTR
The name length is up to 20 characters.
STRUCTURE: sequential ASCII file
FORMAT:
Line Content iSis3D Variable Format Commentaries
File header:
1 file format version number
'**VERSION13**'
NVERSION A20
keyword '~~CPEIMAGE~~' A12
2 version number of slices definition
version_contours I5 increased at each saving
date of last saving date_fich_contour I2-I2-I2 dd-mm-yy
time of last saving heure_fich_contour I2 :I2 hh :mm
3 patient's name ADM_NMAL A20
file number NUMDOS A10
examination date IDAT 3I2
examination number NUMEX A16
number of slices NBCOUP I3 99 max MAXCONT
number of structures KR I2 40 max NMAXR
number of points of interest PTI_NB I4 50 max NMAXPTI
4 provider code PROV A2
DI=digitizer SC=images
serial number SERIE A12
patient's position POSPAT_REEL
A6
HFS, HFP, HFDR, HFDL
FFS, FFP, FFDR, FFDL
HF=Head First
FF=Feet First
DL=Decubitus Left
DR=Decubitus Right
S = Supine
P =Prone
patient's side / right of image ORIEDR A6
LEFT,RIGHT,ANTER,POST
patient's side / top of image ORIEHA A6
LEFT,RIGHT,ANTER,POST
longitudinal anatomical origin ORIGAN A6 commentary
APPENDIX D1 – SLICE FILE
D1 - 2 iSis 3D - V 2. 35 - March 2003
note COMMEN A72
5 images' directory NOMIM_SAV A16
NOMIM_SAV_R A16
origin of Radiotherapy XORMAT F6.2 cm
coordinate system related to YORMAT F6.2 cm
Images coordinate system ZORMAT F6.2 cm
For each structure:
+1 structure's index NCODE_STR (1:KR) I2
structure ID STR_ID (1:KR) A1
structure's name STRUCT (1:KR) A12
structure's density DENSTR (1:KR) F6.2
structure's type STRTYPE (1:KR) I3 0=organ, 1=bolus,
2=vector (brachyt.)
alpha / beta coefficient COEFSTR(1 :KR) F6.2
color, red value STR_CLR_R (1:KR) I3
color, green value STR_CLR_V (1:KR) I3
color, blue value STR_CLR_B (1:KR) I3
range: from 0 to 255
-1=not defined
DICOM color of the structure
Implemented for future use
For each point of interest (POI):
+1 POI’s index NP I4
POI ID PTI_ID A2 Ix,default for isocenters
Px, default for weighting points
POI’s name PTI_NOM A16
POI’s coordinates PTI_X F7.2
PTI_Y F7.2
PTI_Z F7.2
cm, scale 1
99.99 if not defined
POI’s type PTI_TYPE I5 combination of types
0 not specified
2° isocenter
21 weighting point
22 prescription point
23 dose point
24 marker point
25 referential point
POI can be edited PTI_EDITABLE L1 T=yes, F=no
color, red value PTI_CLR_R I3
color, green value PTI_CLR_V I3
color, blue value PTI_CLR_B I3
range: from 0 to 255
-1=not defined
Implemented for future use
number of additional lines of values
nb_ligne_valeurs I2
APPENDIX D1 – SLICE FILE
iSis 3D - V 2.35 - March 2003 D1 - 3
note PTI_COMMENT A64
For each slice:
+1 slice's index nc I3 indices might be not contiguous
+2 longitudinal position Z POSCOU (nc) F7.2
min longitudinal position Z CPE_ZMIN (nc) F7.2
max longitudinal position Z CPE_ZMAX (nc) F7.2
cm
Provides the ability to import asymmetrical slices
The actual Z position is, at the moment, recalculated as the middle of min and max positions and the thickness as the difference between max and min
tilt INCLIN (nc) I3 degrees
vertical scale of plot ECHRELV (nc) F4.2 for memory
horizontal scale of plot ECHRELH (nc) F4.2 for memory
name of associated image file NIMAG_SAV(nc)
A16
reserved A16
origin of contour related to NPXORMAT (nc) I5 pixels
image NPYORMAT (nc) I5 pixels
slice label CPE_LIBELLE A16
key word '~~CPEIMAGE~~' A12
+3 DICOM: image SOP Instance UID
CTR_IMG_UID A64 DICOM tag (0008, 0018)
+4 DICOM: image SOP Class UID CTR_IMG_CLASS A64 DICOM tag (0008, 0016)
+4 DICOM: image Frame of Reference UID
CTR_IMG_FRAME A64 DICOM tag (0020, 0052)
+5 nb of points of external contour NPXY (nc) I3 100 max MAPTCE
external cont. color, red value CTREXT_CLR_R I3
external cont. color, green value CTREXT _CLR_V I3
external cont. color, blue value CTREXT _CLR_B I3
range: from 0 to 255
-1=not defined
DICOM color of the external contour
Implemented for future use
+6 external contour coordinates XREL(1:NPXY,nc) F6.2 cm, scale 1
..
YREL(1:NPXY,nc) F6.2 1 pair by ligne
+6+NPXY number of internal contours NREP(nc) I2 40 max MAREPC
APPENDIX D1 – SLICE FILE
D1 - 4 iSis 3D - V 2. 35 - March 2003
For each internal contour:
+1 internal contour’s name NOMREP
(1:NREP,nc)
A12
index of related structure KOREP (1:NREP,nc)
I2 0=no related structure
internal contour’s density REP_DENS (1:NREP,nc)
F4.2
internal cont. color, red value REP_CLR_R I3
internal cont. color, green value REP _CLR_V I3
internal cont. color, blue value REP _CLR_B I3
range: from 0 to 255
-1=not defined
DICOM color of the contour
Implemented for future use
For each internal contour +1:
+1 index of first point of the internal contour
NPREP(1:NREP+1,nc)
I4
.. in the table of all coordinates
998 max MAPTRP
for all internal contours
-> the last value is the total number of points in the table plus one
if no internal contour
1 line with “1”
+ coordinates of all internal contours
XREP(1:NPREP-1,nc)
F6.2 cm, scale 1
.. YREP(1:NPREP-1,nc)
F6.2 1 pair by ligne
APPENDIX D2 - BEAMS FILE
iSis 3D - V 2.35 - March 2003 D2 - 1
D2. BEAMS FILE FORMAT
IDENTIFICATION: name.FSC
The name length is up to 20 characters.
STRUCTURE: sequential ASCII file
FORMAT :
Information type Format Description
File Version
vers_fich_faisc I2 file format version number (13)
Header
ver_faisc I2 version number of beams definition
date_fich_fais A8 date of last saving (dd-mm-yy)
heure_fich_fais A5 time of last saving (hh:mm)
code_centre A3 center code
adm_nmal A20 patient's name
nb_max_faisc I2 number of beams
comment_faisc A40 free commentaries
For each beam
Unit definition nf I2 beam’s index (might be not contiguous)
descript_faisc A12 beam’s description
nomapp A7 unit name
machine A20 treatment machine name
modalite I2 modality: 1=photons, 2=electrons, 3=protons
energie F6.2 energy (MV if modality=1 or else MeV)
parcours F6.2 proton range, 0. if modality is not « proton », (cm)
modulation F6.2 proton modulation, 0. if modality is not « proton », (cm)
Technique definition technique A3 technique: « DSP »=SSD, « DST »=SAD,
« ARC »
dsp F6.2 SSD value if tech=« DSP », SAD value otherwise, (cm)
xe F6.2 point of reference coordinates: isocenter or
APPENDIX D2 - BEAMS FILE
D2 - 2 iSis 3D - V 2.35 - March 2003
ye F6.2
ze F6.2
entry point (SSD technique), (cm)
dsproj F6.2 source - projection plane distance, (cm)
code_tech_3D L1 « T » if table angle not null, « F » otherwise
code_mod_fais L1 « T » if wedge filter, trimmer, block tray or MLC
Point of reference characteristics
pos_point_ref I2 point of reference type:
1=free, 4=linked to common isocenter
Id_pti_or blank characters A2 common isocenter ID
struct_ptref A12 name of the structure used to define the position of the point of reference
Rotations
angle (fi ou akb) F6.2 gantry rotation DSP/DST, start if ARC, (°)
ake F6.2 end ARC, (°)
followed by, only if code_tech_3D true « T » - i.e. table angle not null
nb_sect I2 always 0
ang_tab F6.2 table angle, (°)
Main collimator
code_asym L1 « T » if asym./mlc, « F » if symmetric
psi F6.2 collimator rotation, (°)
enw1 F6.2 width of collimator at SAD, (cm)
enw2 F6.2 height of collimator at SAD, (cm)
half-dimensions (if code_mod_fais true « T ») collipal_lax I1 « la » jaws : 0=Sym, 1=Asym, 2=MLC
collipal_lby I1 « lb » jaws : 0=Sym, 1=Asym, 2=MLC
demi_larg_D F6.2 right half-width, psi=0, (cm)
demi_larg_G F6.2 left half-width, psi=0, (cm)
demi_haut_H F6.2 top half-height, psi=0, (cm)
demi_haut_B F6.2 down half-height, psi=0, (cm)
Modificators (if code_mod_fais true « T ») nfilt A10 « 0 » or name of wedge filter
iwig A1 thick edge side
nom_comp A20 empty or name of compensator
nom_bolus A20 empty or name of bolus
type_pcp I1 1=Block-T, 2=Trimmer, 3=MLC, 0=void
kcache I2 0 or block-tray number
iprol I2 0 or trimmer number
dsf F6.2 source film distance of field shape
dsf_film F6.2 source film distance of plot
APPENDIX D2 - BEAMS FILE
iSis 3D - V 2.35 - March 2003 D2 - 3
Shape of reference (if multileaf collimator, type_pcp=MLC) Number of points of shape of reference
base_npoin I3 number of points shape of reference
Coordinates of shape of reference at dsf_film, 5 pairs at most by line (if base_npoin > 0) base_xch(1..base_npoin) F6.2 X coordinate of the nth point, (cm)
base_ych(1..base_npoin) F6.2 Y coordinate of the nth point, (cm)
Characteristics of shape of reference (if base_npoin > 0)
orig_ch_base I2 defined after :
0=Main Collimator,
1=Digitization on 1 film,
2=Digitization on 2 films,
3=Mouse,
4=Contour,
5=Structure(s),
6=Importation
nom_str_ch_base A12 empty or structure name if defined from structure
marge_ch_base F6.2 margin around structure if defined from structure, (cm)
ch_base_modif I2 1 if field has been modified since its creation, 0 if not
Multileaf collimator data (if type_pcp=MLC)
Number of leaf pairs
mlc_nleav I3 number of leaf pairs
Leaves position, 5 pairs at most by line
MLC_X1(1..mlc_nleav) F6.2 position of leaf 1 of the nth pair, (cm)
MLC_X2(1..mlc_nleav) F6.2 position of leaf 2 of the nth pair, (cm)
MLC informations
LEAF_L I3 first opened pair of leaves
LEAF_H I3 last opened pair of leaves
LEAF_M I3 number of opened pairs of leaves
MLC_MAX_Y F6.2 position of the pair of free jaws
MLC_MIN_Y F6.2 in case of integrated MLC, (cm)
Irregular field
Number of points of irregular field npoin I3 number of points of irregular field
Coordinates of irregular field at dsf_film, 5 pairs at most by line (if npoin > 0) xch(1..npoin) F6.2 X coordinate of the nth point, (cm)
ych(1..npoin) F6.2 Y coordinate of the nth point, (cm)
code_bord_champ(1..npoin) l1 « T » if nth-(n+1)th side is limited by block
APPENDIX D2 - BEAMS FILE
D2 - 4 iSis 3D - V 2.35 - March 2003
Irregular field informations, (if npoin > 0) origine du champ I2 defined after :
0=Main Collimator,
1=Digitization on 1 film,
2=Digitization on 2 films,
3=Mouse,
4=Contour,
5=Structure,
6=Importation
nom_str_champ A12 empty or structure name if defined from structure
marge_champ F6.2 margin around structure if defined from structure, (cm)
champ_modif I2 1 if field has been modified since its creation, 0 if not
Weighting tp F6.2 weithing depth, (cm)
t (if theoretical) or fh (if effective) F6.2 weigth
code_pond_theo L1 « T » if theoretical ponderation, « F » otherwise
weighting mode pos_point_pond
code_pond_entree
code_pond_isoc
I1 weighting mode :
1= at axis
2= SSD, at the depth of maximum
3= SAD or ARC, at isocenter
5= at a point of interest (POI)
pti_id(ind_pti_pond) or empty A2 POI ID if weighting at a POI
X_ptpond F6.2
Y_ptpond F6.2
Z_ptpond F6.2
weighting point coordinates, (cm)
Treatment time dose_seance F6.2 0. or dose by fraction, (Gy)
tt_unit I1 Treatment time units :
0=monitor units, 1=minutes
tt_duree F6.2 0. or monitor units if tt_unit=0
0. or minutes if tt_unit=1
tt_date A10 empty or calculation date if tt_unit=1, (dd-mm-yyyy)
fsc_numgrp I2 beam group number
APPENDIX D3 - ADMINISTRATIVE FILE
ISIS 3D - V 2. 35 - March 2003 D3 - 1
D3. ADMINISTRATIVE FILE
IDENTIFICATION : name.ISX
The maximum length of administrative file is 20 characters
STRUCTURE : sequential ASCII file
FORMAT :
Line Contain Variable iSis3D Format Commentaries
File header:
1 version number of administrative file format
adm_versfich I2 Version 27
date of file adm_datefich A8
patient's name adm_nmal A20
file number adm_ndos A10
center code adm_codectre A3
file version nvers I4
commentaries adm_comment A72
Study date
2 date ct_date A8
hour ct_heure A5
software version version A7
Software name Prog A10
Images directory
3 Image directory name ISIS2_DIRIMGS A64
4 current slice ct_cpecur I12
current beam ct_fsccur I12
5 number of planes ct_nbpdc I12
For each plane
+1 plane index I12
+1 plane type ct_codepdc A2
plane number ct_numpdc I3
Selected plane
+1 number of selected planes I12
for each selected plane
+1 selected plane index I12
Current protocol code
+1 current protocol code ct_code_protcur I12
APPENDIX D3 - ADMINISTRATIVE FILE
D3 - 2 ISIS 3D - V 2. 35 - March 2003
Isodoses
+1 number of isodoses ct_ntabiso I12
+1 isodose value (ct_ntabiso) ct_tabiso F15
isodose color (ct_ntabiso) ct_tabisoclr I12
Normalization
+1 normalization type ct_typenorm I
normalization point abscissa ct_normx F
normalizationpoint ordinate ct_normy F
normalization slice ct_normcpe A12
normalization value ct_normval F
normalization factor ct_normval F
Display
+1 Current series of image Ct_nivfen_modecur I 0=main, 1=register
+1 Number of different setting NIVFEN_NBMODES I 3 : main series, register series, DRR
For each setting
+1 window level ct_niveau I Hounsfield number
window width ct_fenetre I Hounsfield number
+1 range type ct_type_plage I
density mode ct_modedensites I
+1 resolution type
(high/low)
ct_hteres I
low resolution limit ct_hteres_bornemin I
high resolution limit ct_hteres_bornemax I
+1 Curve of grey level conversion
Ct_tab_tabcol() I 0=linear
1=logarithmic
2=exponential
3=by histogram
4=blck & white
Conversion coefficient Ct_tab_tabcol_param() F
Calculation Parameters
+1 heterogeneities correction ca_houi I
Calculation model ca_modele I 0=primary,
1= simple cutting out,
2= double cutting out
automatic calculation ca_auto I
automatic calculation every slices
ca_autottes I
calculation step ca_pascalc F
fast calculation or not ca_calcul_rapide I
type of dose displayed ca_type_dose I 0 : physical dose
1 : radiobiological dose
APPENDIX D3 - ADMINISTRATIVE FILE
ISIS 3D - V 2. 35 - March 2003 D3 - 3
Options for voxel volume, DRR, voxel/voxel calculation Options
reducing factor Fact_reduc I
number of voxel (Z) vox_nbvox_w I
no crossing for DRR vox_pas_traverse_drr F
no crossing for voxel/voxel calculation
vox_pas_traverse_vpv F
threshold soft tissue/hard tissue for DRR
Drr_seuil_mou_dur I
Sharpness factor of DRR Fact_finesse F
Structures Colors
+1 Max number of structures NMAXR I 40
+1 structures color nkclrs I
State of beam inside plane
+1 Max number of planes NB_PLANS_MAX() I 119
Max number of beams NFMAX I 56
for each plane
+1 lice number I
+1 flag active beam inside slice cs_fsc_actif I
+1 flag calculated beam inside slice
cs_mcalc I
+1 calculation step inside slice cs_etatcalc I
automatic density calculation
+1 flag automatic density calculation
ct_densauto I
zoom and virtual simulation options
+1 zoom virtual simulation ct_sim_zoom F
paper format ct_sim_fmtpapier A12
graphic center abscissa ct_sim_cgx F
graphic center ordinate ct_sim_cgy F
+1 display option ct_sim_optionsaff I
number of option for
structures
MARPC+1 I
+1 displ. option structures ct_sim_affstruct I*(MARPC+1)
number of non transverses planes
+1 number of non transverses planes
nb_plans I
view data
APPENDIX D3 - ADMINISTRATIVE FILE
D3 - 4 ISIS 3D - V 2. 35 - March 2003
+1 number of view nb_vue I
number of fixed view nbvues_fixes I 3
for each view
+1 view index I
+1 view description vue_descrip A12
source isocentre distance vue_dsi F6.2
source distance film vue_dsf F6.2
X isocenter position vue_xe F6.2
Y isocenter position vue_Ye F6.2
Z isocenter position vue_Ze F6.2
gantry rotation vue_rotbras F6.2
table rotation vue_rottab F6.2
image name associated to view
vue_nimag A16
DRR
+1 number of beams nbfscx I
for each beam
+1 beam index I
+1 image name associated to view
fsc_nimag A16
Other
+1 option message dimensions colli
ct_option_colli_dsp I
+1 Name of scanner file setup Fich_houndens-cour A64
APPENDIX E – EXPORTATION DOSE FILE
iSis 3D - V 2.35 – March 2003 E - 1
E. EXPORT DOSES FILE FORMAT
IDENTIFICATION : free name, extension .D3D by default
Les fichiers d’exportation de doses sont des fichiers auto-documentés qui comportent
les informations suivantes :
• identification de l’étude dont ils sont issus,
• indice et nature du plan de calcul concerné,
• identification des faisceaux pris en compte,
• un ou plusieurs profils de dose et/ou la grille de calcul complète.
Les fichiers d’exportation de doses sont relus par le programme CUVE qui permet
ainsi de comparer des profils calculés et mesurés (cf.: Appendix F, Waterphantom
program).
example of file :
ISIS2
DEXPORT:Numero_de_version
1
DEXPORT:Nom_du_patient
EXEMPLE
DEXPORT:Numero_de_dossier
LD0001
DEXPORT:Nom_etude
EXEMPLE
DEXPORT:Date_etude
3-09- 1
Identification of study
DEXPORT:Plan_concerne
C1
DEXPORT:Type_de_plan_C=1_PS=4_PF=8_PSO=16_PF0=32
1
DEXPORT:Origine_du_plan
0.00 0.00 -5.74
DEXPORT:Caracteristiques_du_plan_distance_inclinaison
0.00 0.00
Index and type of plane:
C = Slice,
PS = Sagittal,
PF = Frontal,
PSO,PFO = PS or PF Oblique
DEXPORT:Nombre_de_faisceaux
2
DEXPORT:Indices_des_faisceaux
1
identification of beam
APPENDIX E – EXPORTATION DOSE FILE
E - 2 iSis 3D - V 2.35 – March 2003
2
DEXPORT:DEBUT_COURBE Start of curve
DEXPORT:volume=3_ou_grille=2_ou_profil=1
1
DEXPORT:Type_de_courbe
Traversee
DEXPORT:Commentaires
Type of data
DEXPORT:Taille_du_tableau
85 0 0 0
Number of point
then X,Y size (grid)
and Z size ( volume)
DEXPORT:Coordonees_premier_point_dose
-17.00 -1.70 -5.74 9.50
DEXPORT:Coordonees_dernier_point_dose
16.60 -1.70 -5.74 99.32
Start and End coordinates
X Y Z Dose
DEXPORT:Normalisation_a_l_origine_du_profil
1
DEXPORT:Coordonnees_point_normalisation_du_profil
13.40 -1.70 -5.74
DEXPORT:Dose_au_pt_de_normalisation
103.12
Coodinates of normalization point and dose at this point.
DEXPORT:Tableau_X_Y_Z_DOSE_DISTANCE_A_L'ORIGINE
-17.00 -1.70 -5.74 9.50 -30.40
-16.60 -1.70 -5.74 9.72 -30.00
-16.20 -1.70 -5.74 9.95 -29.60
-15.80 -1.70 -5.74 10.18 -29.20
-15.40 -1.70 -5.74 10.41 -28.80
-15.00 -1.70 -5.74 10.65 -28.40
-14.60 -1.70 -5.74 10.89 -28.00
-14.20 -1.70 -5.74 11.37 -27.60
-13.80 -1.70 -5.74 11.68 -27.20
-13.40 -1.70 -5.74 11.95 -26.80
-13.00 -1.70 -5.74 12.22 -26.40
-12.60 -1.70 -5.74 12.51 -26.00
-12.20 -1.70 -5.74 12.87 -25.60
-11.80 -1.70 -5.74 13.23 -25.20
………………………………………………………………………………………………………
15.00 -1.70 -5.74 107.48 1.60
15.40 -1.70 -5.74 109.15 2.00
15.80 -1.70 -5.74 110.52 2.40
16.20 -1.70 -5.74 110.93 2.80
16.60 -1.70 -5.74 99.32 3.20
data
DEXPORT:FIN_COURBE End of curve
APPENDIX F - WATERPHATOM
ISIS 3D - V 2. 35 - March 2003 F - 1
F. WATER PHANTOM PROGRAM
Introduction This program deals with data files directly acquired from the water phantom tank. The recognized systems are: POSEIDON PRECITRON MP3 PTW MP2 PTW RFA 300 SCANDITRONIX WP700 WELLHOFER WP600 WELLHOFER Data files imported from the floppy disk The importation of the files is performed by using PCDISK. On a DECterm, since the $ sign is displayed, type :
mcr PCDISK PCDISK> USE A: <name the floppy disk reading system> (this name is given while
installing your ISIS system) A:> EXPORT A:*.* [directory name where the data will be saved] A:> EXIT
In the utilization example, will be described :
The floppy disk reading system is DVA0; The directory name where the files will be saved is CUVE; The name of the acquisition system is PTW.
On a DECterm, since the $ is displayed, type :
mcr PCDISK PCDISK> USE A: DVA0: A:> EXPORT A:*.* [.CUVE]
A:> EXIT All the above commands copy all the files from the diskette in the directory CUVE. Note: If the directory does not exists, it can be created. Checking the existence of the directory : Type DIR CUVE.DIR If the system reply :
If the system reply :
Directory DOSI$USR:[PHYSIQUE] %DIRECT-W-NOFILES, no files found CUVE.DIR;1 Total of 1 file.
the directory exists the directory does not exists Directory creation: $ CREAT/DIR [.CUVE]
APPENDIX F - WATERPHATOM
F - 2 ISIS 3D - V 2. 35 - March 2003
EXEMPLE OF UTILISATION 1 MAIN MENU
0- Selection of the acquisition system 1- Open an experimental file
5 - Creation of a new FIFI file
8 - Comparison of two curves 9 - Option
99 - End
Your selection : 0ˆ̂̂̂ 2 1ˆ̂̂̂ 10 5ˆ̂̂̂ 50 8ˆ̂̂̂ 80 9ˆ̂̂̂ 90 10ˆ̂̂̂ 100
2 Source of the experimental files : 1 - PTW 2 - WP700 3 - RFA300 4 - POSEIDON 5 - PROFILS ISIS3D 6 - COURBES FIFI N°ˆ̂̂̂ 10 10 Directory where the file is located ( [] for the current directory ) [.CUVE] ˆ̂̂̂ 11 11 File name (with extension) Give the filename with the extension the same as the one on the diskette. xxxxx.yyyˆ̂̂̂ 20 If the file can not be open, the following message is displayed: "Impossible to open the specified file !" 1 20 MAIN MENU
0- Selection of the acquisition system ( PTW ) 1- Open an experimental data file 2- Summary display 3- Display one curve from the summary 4- Print one curve from the summary 5 - Creation of a new FIFI file
8 - Comparison of two curves 9 - Option
99 - End
APPENDIX F - WATERPHATOM
ISIS 3D - V 2. 35 - March 2003 F - 3
Your choice: 0ˆ̂̂̂ 2 1ˆ̂̂̂ 10 2ˆ̂̂̂ 25 3ˆ̂̂̂ 30 4ˆ̂̂̂ 40 5ˆ̂̂̂ 50 8ˆ̂̂̂ 80 9ˆ̂̂̂ 90
99ˆ̂̂̂ END 25 File PTW-Freiburg Mephysto Export V.5.0 Created on 2-JUN-1995 12:33
Curves list N° Machine Type X/e En. SSD LX LY depth
Correct? Mev (mm) (mm) (mm) (cm) Y/N
1 STANDARD ELECTRONS CAX e 20.0 1000 100 100 0.0 NO 2 STANDARD ELECTRONS CAX e 18.0 1000 100 100 0.0 NO 3 STANDARD ELECTRONS CAX e 15.0 1000 100 100 0.0 NO 4 STANDARD ELECTRONS CAX e 12.0 1000 100 100 0.0 NO 5 STANDARD ELECTRONS CAX e 10.0 1000 100 100 0.0 NO 6 STANDARD ELECTRONS CAX e 8.0 1000 100 100 0.0 NO 7 STANDARD ELECTRONS CAX e 6.0 1000 100 100 0.0 NO
The curve number to be displayed ( RETURN if none) ? ˆ̂̂̂ 20
N°ˆ̂̂̂ display the curve, then 20 30 The curve number to be displayed ( RETURN if none) ? ˆ̂̂̂ 20 N°ˆ̂̂̂ display the curve, then 20 40 The number of the recorded curve ( RETURN if none) ? ˆ̂̂̂ 20 N°ˆ̂̂̂ Display the curve, then 20 or 55 or 65 ˆ̂̂̂ 20 or 55 or 65 50 INPUT OF THE FIFI FILE CHARACTERISTICS Center name (max 3 char) : CURˆ̂̂̂ Machine name (max 7 char ) : SATE12ˆ̂̂̂ Photon or electron ( X / e) : eˆ̂̂̂ Energy ( in MV if X, in Mev if e ) : 12ˆ̂̂̂ Dose on-axis or profiles(o/p ) :
oˆ̂̂̂ pˆ̂̂̂ 1 - Normalized depth dose ( NDD ) Open field profile ( TRAV) 2 - Tissue-Maximum Ratios ( TMR ) 3 - Tissue-Phantom Ratios ( TPR ) NDDˆ̂̂̂ SSD ( cm ) SSD (cm) 100ˆ̂̂̂ 100ˆ̂̂̂
Do you want to modify any characteristics of FIFI file ( Y / N ) ? Yˆ̂̂̂ 50 Nˆ̂̂̂ 55
APPENDIX F - WATERPHATOM
F - 4 ISIS 3D - V 2. 35 - March 2003
55 MAIN MENU 0- Selection of the acquisition system ( PTW ) 1- Open an experimental data file 2- Summary display 3- Display one curve from the summary 4- Print one curve from the summary 5- Creation of a new FIFI file 6- Add curve to FIFI file 7- Save FIFI file 8 - Comparison of two curves 9 - Option
99 - End
Your choice: 0ˆ̂̂̂ 2 1ˆ̂̂̂ 10 2ˆ̂̂̂ 25 3ˆ̂̂̂ 30 4ˆ̂̂̂ 40 5ˆ̂̂̂ 50 6ˆ̂̂̂ 60 8ˆ̂̂̂ 80 9ˆ̂̂̂ 90
99ˆ̂̂̂ END 60 File PTW-Freiburg Mephysto Export V.5.0 Created 2-JUN-1995 12:33
Curves list N° Machine Type X/e En. SSD LX LY depth.
Correct? Mev (mm) (mm) (mm) (cm) Y/N 1 STANDARD ELECTRONS CAX e 20.0 1000 100 100 0.0 NO 2 STANDARD ELECTRONS CAX e 18.0 1000 100 100 0.0 NO 3 STANDARD ELECTRONS CAX e 15.0 1000 100 100 0.0 NO 4 STANDARD ELECTRONS CAX e 12.0 1000 100 100 0.0 NO 5 STANDARD ELECTRONS CAX e 10.0 1000 100 100 0.0 NO 6 STANDARD ELECTRONS CAX e 8.0 1000 100 100 0.0 NO 7 STANDARD ELECTRONS CAX e 6.0 1000 100 100 0.0 NO
The curve number to be displayed ( RETURN if none) ? ˆ̂̂̂ 55
N°ˆ̂̂̂ display the curve, then 62 62 The curve is displayed on the screen as well as a dot curve. The initial curve (full line) includes too many points. Do you accept the corrected curve? (dot curve) Y / N ? :
Yˆ̂̂̂ recording the curve then, 65 ( or 63 )
Nˆ̂̂̂ 65, without recording the curve
APPENDIX F - WATERPHATOM
ISIS 3D - V 2. 35 - March 2003 F - 5
63 The following messages can be displayed in the cases: The curve type in not the same as the one of the FIFI file The radiud is not the same as the one in the FIFI file The energy is not the same as the one in the FIFI file The SSD is not the same as the one in the FIFI file. Do you want to adjust the curve from FIFI file (Y / N ) ? :
Yˆ̂̂̂ recording the curve then, 65 Nˆ̂̂̂ 65, without recording the curve 65 MAIN MENU
0 - Selection of the acquisition system ( PTW ) 1 - Open an experimental data file 2 - Summary display 3 - Display one curve from the summary 4 - Print one curve from the summary 5 - Creation of a new FIFI file 6 - Add a curve to FIFI file 7 - Save FIFI file 8 - Comparison of two curves 9 - Option
10 - End Your choice: 0ˆ̂̂̂ 2
1ˆ̂̂̂ 10 2ˆ̂̂̂ 25 3ˆ̂̂̂ 30 4ˆ̂̂̂ 40 5ˆ̂̂̂ 50 6ˆ̂̂̂ 60 8ˆ̂̂̂ 80 9ˆ̂̂̂ 90
99ˆ̂̂̂ 100 70 Filename without extension (max 6 characters) : SATE12ˆ̂̂̂ 65
so, the file is recorded in the [PHYSIQUE] directory with the following name:
SATE12.RPF, SATE12.TRV, SATE12.RTM or SATE12.RTF next option choose in 50 80 THE FIRST EXPERIMENTAL FILE : Source of the experimental file: 1 - PTW 2 - WP700 3 - RFA300 4 - POSEIDON 5 - PROFILS ISIS3D 6 - COURBE FIFI N°ˆ̂̂̂ 81
APPENDIX F - WATERPHATOM
F - 6 ISIS 3D - V 2. 35 - March 2003
81 Directory where the file is saved ( [] for the current directory) [.CUVE] ˆ̂̂̂ 82 82 Filename ( with extension ) Give the same filename as the one used to save it on the diskette.
xxxxx.yyyˆ̂̂̂ 83 If the specified file can not be openned, the following message is displayed: "Impossible to open the specified file!" 1
83 THE SECOND EXPERIMENTAL DATA FILE : Source of the experimental file: 1 - PTW 2 - WP700 3 - RFA300 4 - POSEIDON 5 - ISIS3D 6 - COURBE FIFI N°ˆ̂̂̂ 84 84 Directory whre the file is located ( [] for the current directory ) [.CUVE] ˆ̂̂̂ 85 85 Filename ( with extension ) Give the same filename as the one used to save it on the diskette..
xxxxx.yyyˆ̂̂̂ 86 If the specified file can not be opened, the following message is displayed: "Impossible to open the specified file!" 1
86 FILE : [.ptw]test (here is displayed the filename defined at 82) The curve number to be displayed (return if no) ? ˆ̂̂̂ 55 or 65
N°ˆ̂̂̂ display the curve, then 87 87 FICHIER : [.ptw]test (here is displayed the filename defined at 85) The curve number to be displayed (return if no) ? ˆ̂̂̂ 55 or 65
N°ˆ̂̂̂ display the curve, then 88 88 Normalize the comparison ? : [N] Oˆ̂̂̂ normalization of curves then 88b Nˆ̂̂̂ 88b 88b Change the scale of curve N° 2 ? : [N] Oˆ̂̂̂ Scale ? : enter a value (e.g. : .1 = 1/10) 89 Nˆ̂̂̂ 89 89 Print the comparison ? : [N] Nˆ̂̂̂ 86 Yˆ̂̂̂ printout the curves, then 86
APPENDIX F - WATERPHATOM
ISIS 3D - V 2. 35 - March 2003 F - 7
90 In an exceptional, this dialog is reserved to the personnel from Technologie Diffusion
1 - Printer parameters 2 - Display parameters
10 - Quitter options Your choice: 1ˆ̂̂̂ 91 2ˆ̂̂̂ 95 10ˆ̂̂̂ 1 or 20 or 55 or 65 91 Queue of printing : [CUVE$PRINT] name of a queue for printing ˆ̂̂̂ 92 ˆ̂̂̂ 92 92 Printer type : [PS] 1 - PS 2 - HPGL 1ˆ̂̂̂ or 2ˆ̂̂̂ or ˆ̂̂̂ 93 93 Exit file : [CUVE_IMP.PS] filename ˆ̂̂̂ 90 ˆ̂̂̂ 90 95 Normalize curves ? : [N] Nˆ̂̂̂ 90 Yˆ̂̂̂ 90 100 Do you really want to quit ? [O/N] : Nˆ̂̂̂ 1 or 20 or 55 or 65 Yˆ̂̂̂ end of program
APPENDIX F - WATERPHATOM
F - 8 ISIS 3D - V 2. 35 - March 2003
APPENDIX G – PHOTON COMPENSATORS
iSis3D - V 2.35 - january 2003 G - 1
G. PHOTON COMPENSATORS (available from version v2.35)
G1. Users' guide
G2. Description of Compensator file "DEPTH" (.PRF)
G3. Description of Compensator file "REAL" (.CPR)
G4. Description of Compensator file "THEORETICAL" (.CPT]
G5. Description of Compensator file "HEK"
G6. Description of Compensator file "Machine file"
APPENDIX G – PHOTON COMPENSATORS
G - 2 iSis3D - V 2.35 - january 2003
APPENDIX G1 – PHOTON COMPENSATORS
iSis3D - V 2.35 - january 2003 G1 - 1
G1. USERS' GUIDE
G1.1 General principle
The compensators are modifiers attached to the collimator, designed in order to
compensate for the surface irregularities and/or for the inhomogeneities. The ISIS
version 2.35 allows for compensators interposed in proton and photons beams. For
proton beams, compensators are used to modulate the depth of penetration as a
function of the position in the field, whereas for photon beam, it is the fluence (or
intensity) which is modulated. Photon fluence is handled differently if a MLC is present
or not :
• if an MLC is present, the compensation is assumed to be performed with
appropriate movement of the leaves, as for Intensity Modulated Radiation
Therapy (IMRT).
• if no MLC, the compensation is performed by interposition of appropriate
thickness of suitable material.
The compensator computation is a two steps process :
• the first step is the calculation of the theoretical compensator
• the second step is the calculation of the real compensator and the creation of
the associated drilling (or milling) files.
In case of photons beam, the theoretical compensator is calculated by using intensity
modulation matrix F(x,y) generated (exclusively for v.2.35) by Konrad inverse planning
module. One way to compensate an individual beam in order to obtain a uniform
distribution in one plane is to create a flat virtual structure (typically 0.5 cm thick)
perpendicular to the beam axis and to ask Konrad to compute the fluence resulting in
a uniform dose within this structure. The theoretical compensator is then a matrix of
transmission factors Tr(x,y)
The transmission factor Tri(xi,yi) at point (xi, yi) is calculated as the ratio of the fluence
Fi(xi,yi) to the maximum fluence Fmax(xmax,ymax).
APPENDIX G1 – PHOTON COMPENSATORS
G1 - 2 iSis3D - V 2.35 - january 2003
If no MLC, the manufactured compensator is defined by a material thickness matrix
Th(x,y) calculated from the transmission factor matrix Tr(x,y) according to the following
expression:
Log(Tri(xi,yi)) Thi(xi,yi) = - —————— µ
where Thi is the thickness in cm and µ is the attenuation coefficient in cm-1.
G1.2 User interface
G1.2.1 Access to compensator dialog in the virtual simulation mode
In the ‘Virtual Simulation’ mode (or beam modification) the < Compensator /
Modulator > box of the current beam displays the following pull-down menu :
• None
• New
• Open
None : Is the default option. If a compensator has been previously defined, it allows to
remove the compensator from the current beam.
New : launches the theoretical compensator calculation. As soon as this option is
selected, the Konrad – Inverse planning window appears.
Figure G1-1 : Associating an intensity ‘Modulator’ to a beam
Fill-in the name given to the Konrad’s plan created by KonRad in the field <
Konrad’s plan name >.
Click the < ok > button.
APPENDIX G1 – PHOTON COMPENSATORS
iSis3D - V 2.35 - january 2003 G1 - 3
The transmission matrix of the theoretical compensator, is calculated and displayed in the graphic zone.
Note : The name of the theoretical compensator is obtained by the concatenation of
the Konrad’s plan name with the beam number and cannot be modified.
Open : this option gives access to the selection of a theoretical compensator file in a
list located in a specific directory ("zone") predefined for this purpose.
A message is displayed if the beam parameters are inconsistent with the compensator
data .
The button <Manufacture> becomes accessible after computing or selecting a
theoretical compensator.
Note : If a multi-leaf collimator is selected for the current beam, a dynamic intensity
modulation will be applied and the button <Manufacture>will not be sensitive.
Manufacture :
By clicking the button Manufacture a dialog box appears to define the manufacturing
parameters (see G1.2.2).
Details :
The button Details becomes sensitive after a compensator has been computed or
when an existing one is selected. It gives access to a dialog box where the main
characteristics of the compensator are displayed (see G1.2.3).
G1.2.2 Launching the manufacture of a real compensator
After clicking on <manufacture>, box is displayed (Figure G1-2).
The upper part of the box permits to choose:
• the type of machine used for compensator realisation (“Manufacturing
options”).
• the location and the name (8 characters at most) of the file to be exported to
the computer driven milling machine.
APPENDIX G1 – PHOTON COMPENSATORS
G1 - 4 iSis3D - V 2.35 - january 2003
A default file name is proposed and the file extension is imposed according to the
chosen export format. If the chosen file name already exists, a warning message
prompt the user to give a new name.
Figure G1-2 : Compensator manufacture box
The second part of the box permits to specify the compensator properties.
The items and the layout could be slightly different according to the milling machine.
The following description refers to the HEK machine.
• S-base of comp. Dist. : distance from source to base of the compensator in
cm
APPENDIX G1 – PHOTON COMPENSATORS
iSis3D - V 2.35 - january 2003 G1 - 5
• Attenuation coefficient : attenuation coefficient of compensator material in
cm¹
• Tool size : the tool size, specified in cm, defines the step along FY of the
calculation grid. The resolution of the calculation grid along FX is defined in the
session parameters file (see 3, associated files).
• Maximum thickness : upper limitation of the compensator thickness in cm.
(not used for the HEK machine).
• Height of cut. loop : this parameter is defined in the default parameters file
of HEK machine and cannot be changed. It is used to calculate the number of
requisite cutting loops.
• Additional thickness : this thickness refers to the whole field area (in cm)
• Safety margin : specified in cm. In the safety margin region the compensator
is extended with a thickness equal to the maximum calculated thickness.
The lower part of the box contains two buttons :
• Ok : to start the computation of the real compensator.
• Cancel : to close the dialog box without calculating the compensator.
At the end of the calculation the dialog box is closed.
G1.2.3 Accessing to the details of the compensator characteristics
After clicking on <Details>the following window appears, which describes the
parameters of the compensator and the parameters of the associated beam.
Note : The required block thickness includes the additional thickness.
The required length and width of the compensator include the lateral safety
margin.
APPENDIX G1 – PHOTON COMPENSATORS
G1 - 6 iSis3D - V 2.35 - january 2003
In this window five buttons are accessible.
• Redefine : displays the Konrad – Inverse planning window to calculate a new
theoretical compensator.
• Profiles display : starts the plotting program CONTROL. A dialog window is
opened to define the profiles to plot and to print if necessary.
• Matrix display : displays the transmission matrix in the graphic zone.
• Print… : prints the parameters of the beam and compensator.
• Close : closes the window.
Figure G1-3 : Compensator characteristic box
G1.3 Associated files
Some of the parameters used for the computation of the compensators are stored into
specific files. In addition, the compensator process generates new files which are
described below.
When a milling machine is used, it is considered as part of the ISIS environment and
therefore defined through a specific file : “name of the milling machine”.ETA located in
APPENDIX G1 – PHOTON COMPENSATORS
iSis3D - V 2.35 - january 2003 G1 - 7
the directory ISIS2$DIRETAETL (i.e. HEK_SE_70.ETA for the Hek machine SE 70)
which contains its main characteristics (cf.: Appendix G6, Description of machine
parameters file HEK_SE_70.ETA).
Some other fixed parameters are fixed in the “session parameter file” :
ISIS2_OPTIONS.ETL, which is described in the appendix of the ISIS brochure :
“SET-UP and PARAMETERS FILE DESCRIPTION”.
In particular, the step of the grid for the theoretical compensator calculation is defined
in this file.
After the compensator module has been launched, three
files can be computed :
• the theoretical compensator file (.CPT)
• the real compensator file (.CPR)
• the milling compensator file (according to specifications of the milling
machine)
The theoretical and real compensator files are created for all types of compensation .
In case of planning inverse compensation, these files have the name of Konrad’s plan
specified by the user.
The theoretical compensator file has the extension “.CPT”.and contains the matrix
of transmission factors. It is described in the appendix : “Theoretical compensator file
format”
The real compensator file has the extension “.CPR” in case of static compensator
(for an MLC it is replaced by the sequencing file of the MLC). It contains the matrix of
material thickness. This matrix is calculated from a theoretical thickness matrix ( cf.: §
G1.1 general principle) according to the tool size and it is used for the dose
calculation. It is described in the appendix : “Real compensator file format” )
The milling file(s) is (are) created only for a static compensator.
APPENDIX G1 – PHOTON COMPENSATORS
G1 - 8 iSis3D - V 2.35 - january 2003
For the HEK milling machine, two milling files are created. Only the name of these
files is specified by the user, the extension of header information file « iii » and the
extension of data file « ddd » are imposed (cf.: Appendix G6, Description of machine
parameters file HEK_SE_70.ETA).
The detailed format of these two files is described in the appendix : “HEK compensator
file format”. It should be noted that part of the header file could be customized through
an ISIS file (the name of which is defined in HEK_SE_70.ETA as
ISI$REALCOMP_C_PARAMDEF) that is copied at the appropriate position (“copied
from *.mas file”) in the header information file.
APPENDIX G2 – DEPTH COMPENSATOR FILE
iSis 3D - V 2.35 - March 2003 G2 - 1
G2. DEPTH COMPENSATOR FILE
IDENTIFICATION: name.PRF
The name length is up to 20 characters.
STRUCTURE: sequential ASCII file
FORMAT:
Line Element description ISis Variable Format Notes
1 Revision ID NVERSION A20 "**version02**
2 Information line A60 "Nom fichier patient dossier Ident pl trait Date Heure"
3 File Name (.PRF) NOMFIC A20
Patient Name NOM_FICH A20
File ID NUM_DOSS A10 File ID of the patient within the hospital
Plan ID PLAN_TRAIT A10
Free A5
Plan Date IDAT_CREAT() 3 x I2 ddmmyy
Plan Time HEURE_CREAT A8 hh :mm:ss
4 Information line A60 "N faisc Descriptif faisc"
5 Beam ID NUM_FAISC I2
Free A5
Beam description DESCR_FAISC A12
6 Information line A60 "POSPAT X_ISO Y_ISO Z_ISO ANGBRA ANGTAB ANGCOL DSA Co/VCIBLE"
7 Patient Position POS_PATIENT A6 Position of the patient relative to to the imaging equipment space. Defined terms (see DICOM [0018,5100]) :
HFS,HFP,HFDR,HFDL,FFP,FFS,FFDR,FFDL
Beam isocentre X_ISO
Y_ISO
Z_ISO
3 x F6.2 Isocentre coordinates in the radiotherapy coordinate system
Free A5
Gantry rotation ANGBRA F6.2 gantry rotation angle, in degrees, ICE conventions
Free A5
Table rotation ANGTAB F6.2 Isocentric table rotation angle, in degrees, ICE conventions
Free A5
Collimator rotation ANGCOL F6.2 collimator rotation angle, in degrees, ICE conventions
Source-calculation plan Dist_S_COMP F6.2 cm
APPENDIX G2 – DEPTH COMPENSATOR FILE
G2 - 2 iSis 3D - V 2. 35 - March 2003
distance
Source axis distance D_S_AXE F6.2 cm
Target volume ID NCOD_VCIB I2 Index of target volume in iSis tables
Not used for intensity or fluence maps
Target volume name NOM_VCIB A12 Name of target volume
Not used for intensity or fluence maps
Heterogeneity correction
CO_HETERO I2 0=No 1=Yes
8 Information line A60 NP_TOTU,NP_TOTV"
9 Number of values in U direction
NP_TOTU I3
Free A5
Number of values in V direction
NP_TOTV I3
10 Information line A60 Coordonnées des trois points du plan du compensateur
11 Plan origin XPL(1)
YPL(1)
ZPL(1)
3 x F6.2 Origin coordinates in the radiotherapy coordinate system
12 Point in U direction XPL(2)
YPL(2)
ZPL(2)
3 x F6.2 coordinates in the radiotherapy coordinate system
13 Point in V direction XPL(3)
YPL(3)
ZPL(3)
3 x F6.2 coordinates in the radiotherapy coordinate system
14 Information line A60 « PAS_GR_INI_U , PAS_GR_INI_V »
15 Grid step in U direction PAS_GR_INI_U F8.6
Grid step in V direction PAS_COMP_V F8.6
16 Information line A60 S U_GRI V_GRI prof_min, prof_max dsp
17 Boolean true if the point is inside the structure
NUAGE_STR(I,J) L1 ‘T’ if the point is inside the target structure
Coordinates of the point U_GRILL(I)
V_GRILL(J)
2 x F10.6 I from 1 to NP_TOTU
For I constantI ,J =1, NP_TOTV
Free A5
Minimum Depth PROF_MIN_STR(I,J) F10.6 Cm
Free A5
Maximum Depth PROF_MAX_STR(I,J) F10.6 Cm
Free A5
Source_skin Distance at the point
DIST_SP (I,J) F10.6 Cm
APPENDIX G3 – "REAL" COMPENSATOR FILE
iSis 3D - V 2.35 - March 2003 G3 - 1
G3. "REAL" COMPENSATOR FILE
IDENTIFICATION: name.CPR
The name length is up to 20 characters.
STRUCTURE: sequential ASCII file
FORMAT:
Line Element description ISis Variable Format Notes
1 Keyword to identify the content
CODEFIC A20 "COMP. REALISE" or
Revision ID NVERSION A20 "**version04**
2
3
Information line
Compensation type
NTYPE A60
I2
« TYPE : 1 : Forme de compensation »
INVERSE PLANNING = 16
4
5
Information line
Compensator format
MODE_REA A60
I2
« MODE : 1 :Mode de réalisation / format
HEK manufacturing = 1
6 Information line A60 "Nom patient N dossier Ident pl trait Date Heure"
7 Patient Name NOM_FICH A20
File ID NUM_DOSS A10 File ID of the patient within the hospital
Plan ID PLAN_TRAIT A10
Free A5
Plan Date IDAT_CREAT() 3 x I2 ddmmyy
Plan Time HEURE_CREAT A8 hh :mm:ss
8 Information line A60 "N faisc Descriptif faisc"
9 Beam ID NUM_FAISC I2
Free A5
Beam description DESCR_FAISC A12
10 Information line A60 "POSPAT X_ISO Y_ISO Z_ISO ANGBRA ANGTAB ANGCOL DSA Co/VCI"
11 Patient Position POS_PATIENT A6 Position of thepatient relative to to the imaging equipment space. Defined terms (see DICOM [0018,5100]) :
HFS,HFP,HFDR,HFDL,FFP,FFS,FFDR,FFDL
Beam isocentre X_ISO
Y_ISO
Z_ISO
3 x F6.2 Isocentre coordinates in the radiotherapy coordinate system
Free A5
Gantry rotation ANGBRA F6.2 gantry rotation angle, in degrees, ICE conventions
APPENDIX G3 – "REAL" COMPENSATOR FILE
G3 - 2 iSis 3D - V 2. 35 - March 2003
Free A5
Table rotation ANGTAB F6.2 Isocentric table rotation angle, in degrees, ICE conventions
Free A5
Collimator rotation ANGCOL F6.2 collimator rotation angle, in degrees, ICE conventions
Source axis distance D_S_AXE F6.2 cm
Target volume ID NCOD_VCIB I2 Index of target volume in iSis tables
Not used for intensity or fluence maps
Target volume name NOM_VCIB A12 Name of target volume
Not used for intensity or fluence maps
Heterogeneity correction
CO_HETERO I2 0=No correction 1=Standard correction
2=Voxel/voxel correction
12 Information line A60 Coordonnées des trois points du plan du compensateur
13 Plan origin XPL(1)
YPL(1)
ZPL(1)
3F6.2 Origin coordinates in the radiotherapy coordinate system
14 Point in U direction XPL(2)
YPL(2)
ZPL(2)
3F6.2 coordinates in the radiotherapy coordinate system
15 Point in V direction XPL(3)
YPL(3)
ZPL(3)
3F6.2 coordinates in the radiotherapy coordinate system
16 Information line A60 "DIST_S_COMP /U_MIN,U_MAX/V_MIN,V_MAX/NP_CMPU,NP_CMPV/ PAS_U_V"
17 Source – calculation plan distance
DIST_S_COMP F6.2 Source compensator distance, in cm or
Free A6
ROI limits U_MIN_UTIL
U_MAX_UTIL
V_MIN_UTIL
V_MAX_UTIL
4 x F6.2 Limits of the Region Of Interest:
Limits of the structure (compensator)
Free A5
Number of values in U direction for compensator
NP_COMP_TOTU I3
Free A5
Number of values in V direction for compensator
NP_COMP_TOTV I3
Grid step in U direction for compensator
PAS_COMP_U F6.4
Grid step in V direction for compensator
PAS_COMP_V F6.4
18 Information line A60 "PAS_GR_INI_U(V)/TYPE_GRILLE/NP_TOTU(V)"
19 Grid step in U direction PAS_INI_U F6.4
Grid step in V direction PAS_INI_V F6.4
APPENDIX G3 – "REAL" COMPENSATOR FILE
iSis 3D - V 2.35 - March 2003 G3 - 3
Free A5
Type of grid ITYPE_GR I1 = 1 aligned grid, =2 alternated grid
Free A5
……
Number of values in U direction for grid
Free
NP_TOTU I3
A5
Number of values in V direction for grid
NP_TOTV I3
20 Information line A60 "Taille de l’outil en CM / Coef. d’atténuation » or
RAYON FRAISEUSE en CM /Densité plexi "
21 Tool size or
Drill Radius
RAYN_FRAISE F6.4 If MODE_REA = 1 (HEK)
Free A5
Attenuation coefficient or
Material density
COMP_COEFF_ATT
DENS_MAT_COMP F6.4 If MODE_REA = 1 (HEK)
22 Information line A60 "EP_COMP_MAX UMAX VMAX EP_COMP_MIN UMIN VMIN"
23 Maximum value EPAISS_COMP_MAX F6.2 Maximum thickness for compensator
Free A5
Coordinates of maximum value
U_COMP_MAX_ERR V_COMP_MAX_ERR
2 x F6.2
Minimum value EPAISS_COMP_MIN_ERR F6.2 Minimum thickness for compensator
Free A5
Coordinates of minimum value
U_COMP_MIN_ERR
V_COMP_MIN_ERR 2 x F6.2
24 Information line A60 « NUL,NUL,NUL,MARGE DE SECURITE » if MODE_REA=1 (HEK) or
MARG_PROX MARG_DIST M_ERR_DSC ,M_ERR_DSA"
25 Proximal margin
Distal margin
DSC error margin
Safety margin
VMARG_PROX
VMARG_DIST
VMARG_ERR
VMARG_LAT
F6.2 0.if MODE_REA=1
0. if MODE_REA=1
0. if MODE_REA=1
Safety margin
26 Information line A60 "EPAIS_SUP_COMP,EPAIS_MAXI_COMP,LONG_FY_COMP, LARG_FX_COMP if MODE_REA=1 or
EPAIS_MIN_PLEXI,EPAIS_MAX_PLEXI,DIAM_MIN_PLEXI"
27 Additional thickness
Maximum compensator thickness
Compensator length or
Compensator diameter
EPAISS_MIN_PLEXI
EPAISS_MAX_PLEXI
LONG_U_NECESS
DIAM_MIN_PLEXI
LARG_V_NECESS
4 F6.2
APPENDIX G3 – "REAL" COMPENSATOR FILE
G3 - 4 iSis 3D - V 2. 35 - March 2003
Compensator width If MODE_REA=1
If MODE_REA=1
28 Information line A60 If MODE_REA=1 this record is not defined
PAR_SC,PMOD_SC,PARC_AC,PMOD_AC_ERR"
29 Practical range without compensator
Modulation without compensator
Practical range with compensator
Modulation with compensator
PARC_SC
PMOD_SC
PARC_AC
PMOD_AC
4 x F6.2
30 Information line A60 "FICHIER COMPENSATEUR THEORIQUE"
31
32
Number of files
File name of theoretical compensator
I2
A20
Number of files = 1
33 Information line A60 « FICHIER MACHINE
34
Number of files
Name of drilling files
(NB_FICH_MACH next lines)
NB_FICH_MACH I2
A75
Number of drilling files
30 Information line A60 T U_GRI V_GRI EP_COMP
31 Boolean true if the point is inside the compensation area
Coordinates of the point
Compensator thickness
Source_skin distance
NUAGE_MACH(I,J)
U_GRILL(I)
V_GRILL(J)
EPAISS_COMP_MACH(I,J)
DIST_SP(I,J)
L1
4 x F6.2
0. if inverse planning
APPENDIX G4 – "THEORETICAL" COMPENSATOR FILE
iSis 3D - V 2.35 - March 2003 G4 - 1
G4. "THEORETICAL" COMPENSATOR FILE
IDENTIFICATION: name.CPT
The name length is up to 20 characters.
STRUCTURE: sequential ASCII file
FORMAT:
Line Element description ISis Variable Format Notes
1 Keyword to identify the content
CODEFIC A20 "COMP. REALISE" or
Revision ID NVERSION A20 "**version04**
2 Information line A60
3 Compensation type NTYPE I2 « TYPE : 1 : Forme de compensation »
INVERSE PLANNING = 16
4 Information line A60
5 Compensator format MODE_REA I2 « MODE : 1 :Mode de réalisation / format
HEK manufacturing = 1
6 Information line A60 "Nom patient N dossier Ident pl trait Date Heure"
7 Patient Name NOM_FICH A20
File ID NUM_DOSS A10 File ID of the patient within the hospital
Plan ID PLAN_TRAIT A10
Free A5
Plan Date IDAT_CREAT() 3 x I2 ddmmyy
Plan Time HEURE_CREAT A8 hh :mm:ss
8 Information line A60 "N faisc Descriptif faisc"
9 Beam ID NUM_FAISC I2
Free A5
Beam description DESCR_FAISC A12
10 Information line A60 "POSPAT X_ISO Y_ISO Z_ISO ANGBRA ANGTAB ANGCOL DSA Co/VCI"
11 Patient Position POS_PATIENT A6 Position of thepatient relative to to the imaging equipment space. Defined terms (see DICOM [0018,5100]) :
HFS,HFP,HFDR,HFDL,FFP,FFS,FFDR,FFDL
Beam isocentre X_ISO
Y_ISO
Z_ISO
3 x F6.2 Isocentre coordinates in the radiotherapy coordinate system
Free A5
Gantry rotation ANGBRA F6.2 gantry rotation angle, in degrees, ICE conventions
Free A5
Table rotation ANGTAB F6.2 Isocentric table rotation angle, in degrees, ICE ti
APPENDIX G4 – "THEORETICAL" COMPENSATOR FILE
G4 - 2 iSis 3D - V 2. 35 - March 2003
ICE conventions
Free A5
Collimator rotation ANGCOL F6.2 collimator rotation angle, in degrees, ICE conventions
Source axis distance D_S_AXE F6.2 cm
Target volume ID NCOD_VCIB I2 Index of target volume in iSis tables
Not used for intensity or fluence maps
Target volume name NOM_VCIB A12 Name of target volume
Not used for intensity or fluence maps
Heterogeneity correction CO_HETERO I2 0=No correction 1=Standard correction
2=Voxel/voxel correction
12 Information line A60 Coordonnées des trois points du plan du compensateur
13 Plan origin XPL(1)
YPL(1)
ZPL(1)
3F6.2 Origin coordinates in the radiotherapy coordinate system
14 Point in U direction XPL(2)
YPL(2)
ZPL(2)
3F6.2 coordinates in the radiotherapy coordinate system
15 Point in V direction XPL(3)
YPL(3)
ZPL(3)
3F6.2 coordinates in the radiotherapy coordinate system
16 Information line A60 "DIST_S_COMP /U_MIN,U_MAX/V_MIN,V_MAX/NP_CMPU,NP_CMPV/ PAS_U_V"
17 Source – calculation plan distance
DIST_S_COMP F6.2 Source compensator distance, in cm or
Free A6
ROI limits U_MIN_UTIL
U_MAX_UTIL
V_MIN_UTIL
V_MAX_UTIL
4 x F6.2 Limits of the Region Of Interest:
Limits of the structure (compensator)
Free A5
Number of values in U direction for compensator
NP_COMP_TOTU I3
Free A5
Number of values in V direction for compensator
NP_COMP_TOTV I3
Grid step in U direction for compensator
PAS_COMP_U F6.4
Grid step in V direction for compensator
PAS_COMP_V F6.4
18 Information line A60 "PAS_GR_INI_U(V)/TYPE_GRILLE/NP_TOTU(V)"
19 Grid step in U direction PAS_INI_U F6.4
Grid step in V direction PAS_INI_V F6.4
Free A5
Type of grid ITYPE_GR I1 = 1 aligned grid, =2 alternated grid
Free A5
Number of values in U di i f id
NP_TOTU I3
APPENDIX G4 – "THEORETICAL" COMPENSATOR FILE
iSis 3D - V 2.35 - March 2003 G4 - 3
……
direction for grid
Free
A5
Number of values in V direction for grid
NP_TOTV I3
20 Information line A60 "Taille de l’outil en CM / Coef. d’atténuation » or
RAYON FRAISEUSE en CM /Densité plexi "
21 Tool size or Drill Radius RAYN_FRAISE F6.4 If MODE_REA = 1 (HEK)
Free A5
Attenuation coefficient or
Material density
COMP_COEFF_ATT
DENS_MAT_COMP
F6.4 If MODE_REA = 1 (HEK)
22 Information line A60 "EP_COMP_MAX UMAX VMAX EP_COMP_MIN UMIN VMIN"
23 Maximum value EPAISS_COMP_MAX F6.2 Maximum thickness for compensator
Free A5
Coordinates of maximum value
U_COMP_MAX_ERR
V_COMP_MAX_ERR
2 x F6.2
Minimum value EPAISS_COMP_MIN_ERR F6.2 Minimum thickness for compensator
Free A5
Coordinates of minimum value
U_COMP_MIN_ERR
V_COMP_MIN_ERR
2 x F6.2
24 Information line A60 « NUL,NUL,NUL,MARGE DE SECURITE » if MODE_REA=1 (HEK) or
MARG_PROX MARG_DIST M_ERR_DSC ,M_ERR_DSA"
25 Proximal margin
Distal margin
DSC error margin
Safety margin
VMARG_PROX
VMARG_DIST
VMARG_ERR
VMARG_LAT
F6.2 0.if MODE_REA=1
0. if MODE_REA=1
0. if MODE_REA=1
Safety margin
26 Information line A60 "EPAIS_SUP_COMP,EPAIS_MAXI_COMP,LONG_FY_COMP, LARG_FX_COMP if MODE_REA=1 or
EPAIS_MIN_PLEXI,EPAIS_MAX_PLEXI,DIAM_MIN_PLEXI"
27 Additional thickness
Maximum compensator thickness
EPAISS_MIN_PLEXI
EPAISS_MAX_PLEXI
4 x F6.2 If MODE_REA=1
Compensator length or
Compensator diameter
Compensator width
LONG_U_NECESS
DIAM_MIN_PLEXI
LARG_V_NECESS
If MODE_REA=1
28 Information line A60 If MODE_REA=1 this record is not defined
PAR_SC,PMOD_SC,PARC_AC,PMOD_AC_ERR"
29 Practical range without compensator
PARC_SC 4 x F6.2
Modulation without compensator
PMOD_SC
Practical range with compensator
PARC_AC
Modulation with compensator
PMOD_AC
APPENDIX G4 – "THEORETICAL" COMPENSATOR FILE
G4 - 4 iSis 3D - V 2. 35 - March 2003
30 Information line A60 "FICHIER COMPENSATEUR THEORIQUE"
31 Number of files I2 Number of files = 1
32 File name of theoretical compensator
A20
33 Information line A60 « FICHIER MACHINE
34
Number of files
Name of drilling files
(NB_FICH_MACH next lines)
NB_FICH_MACH I2
A75
Number of drilling files
35 Information line A60 T U_GRI V_GRI EP_COMP
36 Boolean true if the point is inside the compensation area
NUAGE_MACH(I,J) L1
Coordinates of the point
Compensator thickness
Source_skin distance
U_GRILL(I) V_GRILL(J)
EPAISS_COMP_MACH(I,J)
DIST_SP(I,J)
4 x F6.2 0. if inverse planning
APPENDIX G5 – "HEK" COMPENSATOR FILE
iSis 3D - V 2.35 - March 2003 G5 - 1
G5. "HEK" COMPENSATOR FILE
IDENTIFICATION: name.mas
STRUCTURE: sequential ASCII file
FORMAT:
HEK Medizintechnik
HEK Compensator File Format for DOS-based software
Unit :HEK SE 70
Version D 1.0X.X asp 01.2002
This document describes the file format for the compensator files used for the HEK cutting software.
Each compensator consist of two files :
Header - information [extension must III]
data file [extension must ddd]
A compensator can hold max: 99 profiles ( runs)
Each run max 150 coordinates
At the end of the Header file a copy of the default parameter set ( files with the extension *.mas) is add
to the file.
So it is possible to do some changes in the cutting parameters only for this compensator.
due to the dos-operating system you can only use 8 letters or numbers for the filenames
Description Format File Output sample
Header Information- File
number of adjustment holes integer 0
in case number of holes is <> 0 then loop for all holes
x and y – Coordinates of hole [cm*1000] 2 x integer 5000 -5000
....................
number of profiles ( runs) integer 34
number of necessary heights integer 2
not used integer
width of the tools [cm *1000] integer 400
maximum height of the compensator [cm *1000] integer 2800
distance focus compensator [cm *100] ( integer) integer 5400
distance center point to start of compensator [cm *1000] integer -844
additional height [cm *1000] ( integer) integer 0
savety border [cm *100] ( integer) integer 0
APPENDIX G5 – "HEK" COMPENSATOR FILE
G5 - 2 iSis 3D - V 2. 35 - March 2003
loop for all profiles
maximum height of this profile [cm *1000] integer 1800
number of points of this profile integer 130
Name of CT-serie ( not used) 0
No of first CT-image ( not used) 0
No of CT images ( not used) 0
Patid of CT-images (not used) 0
Patname of CT-images (not used) 0
Date of CT-images (not used) 0
Pixel size (mm) (not used) 0
Min and max positions of images (not used) 0
Distance source to midplane (not used) 0
First image for calculation (not used) 0
Last image for calculation ( not used) 0
Center image ( not used) 0
Loop over all images with distance to next image (not used) 0
Row where calculation starts (not used) 0
Row where calculation ends (not used) 0
Col where calculation starts (not used) 0
Col. where calculation ends (not used) 0
Direction flag : up or down ( 0 or 1) ( not used) 0
Calculation flag ( not used) 0
Distance midplane skin in center ( not used) 0
Row of centerpoint (not used) 0
Col of centerpoint (not used) 0
First CT 0
Last CT 0
Flag for interpolation (not used) 0
Total width (cm) Real 21.
Min width (cm) Real -9.
Max width (cm) Real 12.
Total length (cm) Real 12.3
Min length (cm) Real -5.1
Max length (cm) Rea 7.2
Ct diameter (not used) 0
Half-value thickness used for calculation (not used) 0
Thickness in centerpoint (not used) 0
APPENDIX G5 – "HEK" COMPENSATOR FILE
iSis 3D - V 2.35 - March 2003 G5 - 3
now a copy of the parameters is following, you have to copy this information from a *.mas file:
Masch-Id string maschid HEK _ Default
type of unit string Ger„tetyp HEK SE 70
date of changes string „nderung 12.3.1997 15:27
Source tray dist. [cm] real fbu 51.00
source –film dist [cm] real ffa 120.00
cutting speed for holes real gescw1 2.50
cutting speed for wire real geschw2 2.50
height of cutting loop [cm] real schlho 2.20
width of cutting loop [mm] real schlbr 4.00
attention coefficient for modi-area real HWS 1.75
flag for external frame integer ikreis 0
flag for cutting –Tool ( Wire or Pin) integer idraht 2
filename for external frame string form.FOR
flag for cutting way string . . 1
distance rectangle irreg field [cm] real . . 1.00
diameter of cutting tools [cm] real . . 0.44
speed cutting real . . 0.40
speed fast movement real . . 5.00
flag for display field integer .feldflag . 0
reference distance [cm] real .feldref . 100.00
field edges xmin [cm] real .xmin . -15.00
field edges xmax [cm] real .xmax . 15.00
field edges ymin [cm] real .ymin . -15.00
field edges ymax [cm] real .ymax . 15.00
flag for cutting irreg field integer . . 0
distance of rectangle around [cm] integer . . 1.00
irreg filed integer
absolute xmin coordinate [cm] real . . -14.00
absolute xmax coordinate [cm] real . . 14.00
absolute ymin coordinate [cm] real . . -14.00
absolute ymax coordinate [cm] real . . 14.00
flag for symmetry of rectangle around integer . . 1
speed real Geschwpin 0.10
diameter real srad1 1.40
height of loop[cm] real Schlho 2.20
width of loop [cm] real Schlbr 4.00
not used real leer 0.00
not used real leer 0.00
not used real lee 0.00
APPENDIX G5 – "HEK" COMPENSATOR FILE
G5 - 4 iSis 3D - V 2. 35 - March 2003
Data - File
loop for all profiles ( number in Header )
loop for all points of profile ( number in Header )
"x Position [cm *1000] ;z Position ( depth) [cm *1000] " integer 5620 2735
the y- position is calculated from informations in the header file :
width of the tools and distance of central point to start of compensator
APPENDIX G6 – MACHINE PARAMETERS FILE
iSis 3D - V 2.35 - March 2003 G6 - 1
G6. MACHINE PARAMETERS FILE
IDENTIFICATION: Machine.ETA
Location : DOSI$DAT:[PERIPHS]
FORMAT:
HEK_SE_70.ETA
HEK cutting machine parameters file
ISI$DECOUP_C_MODELE HEK_SE_70
ISI$DECOUP_C_FILEFORMAT 2
ISI$DECOUP_C_FILEEXT HEK0????.HEK
ISI$DECOUP_C_DETROMP 0.92!0.10
ISI$DECOUP_C_PARAMDEF HEK_DECOUPEUSE Default parameters file for blocks
ISI$REALCOMP_C_MODELE HEK_SE_70
ISI$REALCOMP_C_FILEFORMAT 1
ISI$REALCOMP_C_FILEEXT_1 HEK0????.iii
ISI$REALCOMP_C_FILEEXT_2 HEK0????.ddd
ISI$REALCOMP_C_PARAMDEF lucknow Default parameters file for compensators (.mas)
APPENDIX G6 - MACHINE PARAMETERS FILE
G6 - 2 iSis 3D - V 2. 35 - March 2003
IDENTIFICATION: lucknow.MAS
Location : DOSI$DAT:[PERIPHS]
LUCKNOW.MAS
Masch-Id string maschid linac
type of unit string Ger„tetyp HEK SE 70
date of changes string „nderung 8-14-2001 9:20
Source tray dist. [cm] real fbu 56.00
source –film dist [cm] real ffa 80.00
cutting speed for holes real gescw1 2.50
cutting speed for wire real geschw2 2.50
height of cutting loop [cm] real schlho 2.20
width of cutting loop [mm] real schlbr 4.00
attention coefficient for modi-area real HWS 1.60
flag for external frame integer ikreis 1
flag for cutting –Tool ( Wire or Pin) integer idraht 1
filename for external frame string form.FOR
flag for cutting way string . . 2
distance rectangle irreg field [cm] real . . 1.00
diameter of cutting tools [cm] real . . 0.40
speed cutting real . . 4.00
speed fast movement real . . 5.00
flag for display field integer .feldflag . 0
reference distance [cm] real .feldref . 100.00
field edges xmin [cm] real .xmin . -15.00
field edges xmax [cm] real .xmax . 15.00
field edges ymin [cm] real .ymin . -15.00
field edges ymax [cm] real .ymax . 15.00
flag for cutting irreg field integer . . 0
distance of rectangle around [cm] integer . . 1.00
irreg filed integer
absolute xmin coordinate [cm] real . . -14.00
absolute xmax coordinate [cm] real . . 14.00
absolute ymin coordinate [cm] real . . -14.00
absolute ymax coordinate [cm] real . . 14.00
flag for symmetry of rectangle around integer . . 1
speed real Geschwpin 1.50
diameter real srad1 0.80
height of loop[cm] real Schlho 2.20
width of loop [cm] real Schlbr 4.00
not used real leer 0.00
not used real leer 0.00
not used real lee 0.00
APPENDIX H – MENU SUMMARY
ISIS 3D - V 2.35 – March 2003 H - 1
H- MENU SUMMARY
MAIN MENU
FILE
New.. Patient data input box
Open... Patient's study selection box
Close... Study save management box
Save... Study save management box
Kill... Destruction confirmation box
List of slices... Slices data display form
List of beams... Beams data display form
Treatment Time… Treatment times data display form
Dose/volume Contributions Contribution of each beam at defined point display form
Print current plane… Paper output control box
Print study… Paper output control box
Eject sheet
Import > Import box
Import contours… contours file
Importer faisceaux beams file
Export >
Beams> Export box
to Varian's MLC … MLC data to Varian's "MLC file"
to Elekta's MLC … MLC data to Elekta's "MLC fle"
to Lantis… Beams data to Lantis RTP Link file
to Varis RTP file Beams data to Varian's "RTP Exchange" file
to ISIS RTP file Beams data to ISIS's "RTP IEC" file
Contours/beams DICOM RT Exportation menu to DICOM RT server
Quit... Study save management box
SLICES
Header and list... Slices data display form
Create from >
Images... Image's study selection box and Creation of contours menu
Digitizer... Digitizer parameters input box
Change... Modification of contour Menu
Duplicate / Adjust...: Slice position adjustment box
Kill
Origin... Modification of the origin box
Z opposed
Structures / Bolus … Structures/Bolus management box
Expansion... Structures/Bolus expansion options box
Volumes... Volumes and Structures/Bolus data display form
Points of Interest… Point of Interest management box
APPENDIX H – MENU SUMMARY
H - 2 ISIS 3D - V 2.35 – March 2003
BEAMS
Inverse Planning launch dialog of inverse planning
New "Slice" management window
Change... "Slice" management window
Duplicate... "Slice" management window
Opposed... "Slice" management window
Mirror... "Slice" management window
Kill... Destruction confirmation box
Doses per fraction Beams dose definition box
Virtual simulation "Virtual simulation" management window
ISODOSES
Calculation >
All beams Calculation progression box
Current beam Calculation progression box
Computing option... Calculation parameters set-up box
List... Isodoses parameters set-up box
Normalization >
Without Annulation de la normalisation éventuelle
At maximum Dose normalization at maximun of dose into the plane
At one point Dose normalization at defined point
Dose at one point Doses value position box
Profiles et exportations…
Dose / Volume Histogram Dose/volume histogram calculation box
New plane...
Kill plane...
New ROI... Enhanced calcultion resolution region definition
Display ROI ON/OFF ROI calculation display
Import doses > Import stereotactic calculated dose
DISPLAY
Image ON/OFF images display
Contours ON/OFF contours display
Beams ON/OFF beams display
Isodoses ON/OFF isodose display
Registered Images Switched between CT and MRI images
Isodose 3D 3D dose distribution visualization
Level / Window... Level / Window adjustment box
Zoom...: Scale set-up and Graphic center control box
Restore
Grid > ON/OFF grid display
None
…..
Distance measurement Distance measurement tool
Angle measurement Angle measurement tool
3D Visualization > Launch 3D visualization
standard
full screen
APPENDIX H – MENU SUMMARY
ISIS 3D - V 2.35 – March 2003 H - 3
WINDOWS
Open on selection ON/OFF automatic opening plane when selected
Store current plane Snapshot option box
List of STUDIES' snapshot: Snapshot visualization window
CREATION / MODIFICATION OF CONTOURS MENU
SLICES
Images selection… Images selection box
Digitize New slice from digitizer
Kill Kill current slice
Quit
CONTOURING
Trace Tracing option
Option of tracing Option of trace set-up box
Automatic densities calculation Toggle switch
Structures / Bolus Structures / Bolus selection box
Points of Interest Point of interest management box
DISPLAY
Image ON/OFF images display
Contours ON/OFF contours display
Curent Beam ON/OFF current beam display
Registered images Switched between CT and MRI images
Grid ON/OFF grid display
Distance measurement Distance measurement tool
Angle measurement Angle measurement tool
ASSOCIATED BUTTONS
IMAGE SELECTION
Left arrow
Selection arrow
Right arrow
CONTOURING
Manual Control button
Automatic Automatic contouring control button
Change Modification of contours box
ZOOM
Restore Scale set-up and Graphic center control box
Level / Windows Level / Window adjustment box
APPENDIX H – MENU SUMMARY
H - 4 ISIS 3D - V 2.35 – March 2003
APPENDIX I – LIST OF FIGURES AND TABLES
ISIS 3D - V 2.35 - March 2003 I - 1
I. LIST OF FIGURES AND TABLES
List of Figures :
Figure I-1 : Launch menu ..................................................................................................................I-3 Figure I-2 : iSis3D main menu...........................................................................................................I-3 Figure II-1 : Reference coordinate system ......................................................................................II-2 Figure II-2 : Calculation planes selection box ...............................................................................II-18 Figure II-3 : Beams selection box (1) .............................................................................................II-19 Figure II-4 : Beams selection box (2) .............................................................................................II-20 Figure II-5 : Coplanar beams into a transverse plane (1) .............................................................II-22 Figure II-6 : Coplanar beams into a transverse plane (2) .............................................................II-23 Figure II-7 : Wedge representation.................................................................................................II-24 Figure II-8 : Intensity Modulation with Compensator or MLC ......................................................II-24 Figure II-9 : Plane perpendicular to the beam axis of an anterior beam.....................................II-25 Figure II-10 : Non coplanar beam into transverse plane ..............................................................II-26 Figure II-11 : Gray level selection...................................................................................................II-27 Figure II-12 : Level / Windows adjustment box .............................................................................II-28 Figure II-13 : Isodose management box ........................................................................................II-29 Figure II-14 : DRR and Voxel options box .....................................................................................II-31 Figure III-1 : New study creation box .............................................................................................III-2 Figure III-2 : Object selection box ..................................................................................................III-4 Figure III-3 : Study selection box ...................................................................................................III-7 Figure III-4 : Save study box ...........................................................................................................III-9 Figure III-5 : Deletion studies box ................................................................................................III-11 Figure III-6 : List of beams ............................................................................................................III-12 Figure III-7 : Treament time...........................................................................................................III-14 Figure III-8 : Dose Volume contribution table .............................................................................III-17 Figure III-9 : Printing box ..............................................................................................................III-18 Figure III-10 : Demand of confirmation of structures importation (1) .........................................III-21 Figure III-11 : Demand of confirmation of structures importation (2) .........................................III-21 Figure III-12 : Information about structures importation..............................................................III-22 Figure III-13 : Demand of confirmation of beams importation.....................................................III-23 Figure III-14 : Beams exportation box............................................................................................III-24 Figure III-15 : Dicom RT object exportation box ...........................................................................III-28 Figure IV-1 : Header and list of slices ........................................................................................... IV-4 Figure IV-2 : Set of image selection box ....................................................................................... IV-7 Figure IV-3 : Image selection box .................................................................................................. IV-7 Figure IV-4 ; Characteristic of plot box ....................................................................................... IV-10 Figure IV-5 : Duplicate / Adjust a slice ........................................................................................ IV-11 Figure IV-6 : Origin for all slices .................................................................................................. IV-12 Figure IV-7 : Structures / Bolus management box ..................................................................... IV-13 Figure IV-8 : 3D expansion of structure or bolus box................................................................ IV-15 Figure IV-9 : Geometric characteristics of structures ............................................................... IV-17 Figure IV-10 : Point of Interest management box......................................................................... IV-19 Figure IV-11 : Creation / Modification point of interest box ........................................................ IV-21 Figure V-1 : Creation / Modification of slice ................................................................................. V-2 Figure V-2 : Image selection box ................................................................................................... V-4 Figure V-3 : Image information ...................................................................................................... V-6 Figure V-4 : Memorization of visualization set-up...................................................................... V-13 Figure V-5 : Manual contouring ................................................................................................... V-15 Figure V-6 : Automatic contouring .............................................................................................. V-16 Figure V-7 : Choosing the region to be contoured .................................................................... V-17 Figure V-8 : Characteristic of contour......................................................................................... V-17 Figure V-9 : Modification of contour menu................................................................................. V-19 Figure V-10 : Option of trace.......................................................................................................... V-21 Figure VI-1 : Beam selection box................................................................................................... VI-2 Figure VI-2 : Reference slice .......................................................................................................... VI-4
APPENDIX I – LIST OF FIGURES AND TABLES
I - 2 ISIS 3D - V 2.35 - March 2003
Figure VI-3 : Browser bar.............................................................................................................. VI-22 Figure VI-4 : Dose per fraction definition box............................................................................. VI-25 Figure VI-5 : List of view............................................................................................................... VI-27 Figure VI-6 : Added collimation ................................................................................................... VI-30 Figure VI-7 : Customized collimator ............................................................................................ VI-33 Figure VI-8 : Field shape exportation .......................................................................................... VI-35 Figure VI-9 : MLC computing option ........................................................................................... VI-38 Figure VI-10 : MLC Positioning ...................................................................................................... VI-39 Figure VI-11 : Display option.......................................................................................................... VI-41 Figure VI-12 : D.R.R caluclated ...................................................................................................... VI-42 Figure VII-2 : Computing option..................................................................................................... VII-4 Figure VII-3 : Computed doses ...................................................................................................... VII-5 Figure VII-5 : Normalisation point.................................................................................................. VII-9 Figure VII-6 : Dose at one point ................................................................................................... VII-10 FigureVII-7 : Doses profiles and exportations (1)...................................................................... VII-11 FigureVII-9 : Dose/Volume histogram dialog box...................................................................... VII-16 Figure VII-10 : Dose / Volume histogram ...................................................................................... VII-19 Figure VII-11 : Non transverse plane axis selection..................................................................... VII-22 Figure VIII-1 : Level / Windows adjustment box ........................................................................... VIII-3 Figure VIII-2 : Zoom adjustement box ........................................................................................... VIII-6 Figure IX-1 : «Store current plane » dialog box............................................................................ IX-1 Figure IX-2 : Confimation demand of snapshot............................................................................ IX-2 Figure IX-3 : Plane snapshot list.................................................................................................... IX-2 Figure IX-4 : Snapeshot of plane ................................................................................................... IX-3 Figure X-1 : Surface reconstruction .............................................................................................. X-1
List of Tables
Table II-1 : Possibilities and system verification – Summary ..................................................II-12 Table II-2 : Example of calculation with theoretical and effective contribution......................II-13