Pinnacle planning system

Manufactured by Philips

Sourced in United States

The Pinnacle planning system is a medical imaging software solution developed by Philips. It is designed to assist healthcare professionals in the planning and management of radiation therapy treatments. The system provides tools for importing, visualizing, and analyzing patient data from various imaging modalities, enabling healthcare providers to develop customized treatment plans.

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Lab products found in correlation

Clinac ix, by Agilent Technologies (2 mentions) Eclipse proton therapy treatment planning system, by Agilent Technologies (2 mentions) Artiste linear accelerator, by Siemens (1 mentions) Paraformaldehyde (pfa), by Merck Group (1 mentions) C57bl 6n mice, by Charles River Laboratories (1 mentions) Linear accelerator, by Agilent Technologies (1 mentions) Clinac 6ex, by Agilent Technologies (1 mentions) Eclipse planning system, by Agilent Technologies (1 mentions) Clinac 2100c, by Agilent Technologies (1 mentions) Clinic 9, by Agilent Technologies (1 mentions)

14 protocols using pinnacle planning system

IMRT Planning Techniques for Head and Neck Cancer

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IMRT was delivered using a linear accelerator producing 6 MV photons. The initial IMRT planning system, Corvus system (North American Scientific, Inc, Cranberry Township, PA) was used from 2000 to 2003. In 2003, we transitioned to the Pinnacle planning system (Philips Medical Systems, Andover, MA).
Treatment was delivered with a static gantry approach. The IMRT fields generally consisted of 9 static gantry beams with the following angles: 0, 40, 80, 120, 160, 200, 240, 280, and 320 for patients treated to both sides of the neck and 7 beams equidistant through a 190° arc for patients treated to only 1 side of the neck. No patient was treated with volumetric modulated arc therapy. General treatment strategies included defining 3 clinical target volumes (CTVs): CTV1 (which included gross nodal disease with a margin, or in postoperative situations the preoperative tumor bed with margin), CTV2 (neck volume at high risk of harboring microscopic disease but without clinical, radiographic, or pathologic evidence of nodal disease), and CTV3 (nodal volume and mucosa deemed at low risk of harboring subclinical disease).

Kamal M., Mohamed A.S., Fuller C.D., Sturgis E.M., Johnson F.M., Morrison W.H., Gunn G.B., Hutcheson K.A., Phan J., Volpe S., Ng S.P., Phan J., Cardenas C., Ferrarotto R., Frank S.J., Rosenthal D.I, & Garden A.S. (2020). Patterns of Failure After Intensity Modulated Radiation Therapy in Head and Neck Squamous Cell Carcinoma of Unknown Primary: Implication of Elective Nodal and Mucosal Dose Coverage. Advances in Radiation Oncology, 5(5), 929-935.

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Image-Guided IMRT for Lung Cancer

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All patients received image-guided IMRT with 6-MV photo beam. Patients underwent computed tomography (CT)-based treatment simulation in the supine position while immobilized in an upper body. Then, the CT images were transmitted to the Pinnacle planning system (version 9.2, Philips), where the target volume and critical normal organs were delineated. The total lung volume was then calculated as lung volume minus the tumor volume. Afterwards, the IMRT plan was generated and optimized using the Pinnacle planning system, and the doses were calculated using the collapsed cone convolution dose algorithm. Plans for each patient were optimized by direct parameter optimization, based on target volume and locations of the organs at risk. Volume of lung areas receiving radiation of > 20 Gy (V20) was limited to 25-35% of the total lung volume. The image-guided IMRT was delivered using the two predefined linear accelerators (Elekta Synergy and Varian Clinac iX). A total dose of 30-72 Gy, at a rate of 1.8-3 Gy per fraction, was given once per day, five per week.

Du L., Yu W., Huang X., Zhao N., Liu F., tong F., Zhang S., Niu B., Liu X., Xu S., Huang Y., Dai X., Xie C., Chen G., Cong X, & Qu B. (2018). GSTP1 Ile105Val polymorphism might be associated with the risk of radiation pneumonitis among lung cancer patients in Chinese population: A prospective study. Journal of Cancer, 9(4), 726-735.

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Whole-Body Irradiation in C57BL/6-N Mice

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C57BL/6-N mice (2-month-old) were purchased from Charles River Laboratories (Sulzfeld, Germany) and housed in pathogen-free rooms to minimize infection risks, and supplied with a standard laboratory diet and water ad libitum. For whole-body irradiation (6-MV photons; dose-rate, 2 Gy/min) using an Artiste™ linear accelerator (Siemens, Munich, Germany), the animals were placed in an 18 cm-diameter Plexiglass cylinder covered by 1.5 cm thick plastic to improve dose homogeneity. Computed-tomography-based three-dimensional dose calculations were made with the Pinnacle planning system (Philips Radiation Oncology Systems, Fitchburg, WI, USA). Animals were irradiated with single-doses (10 Gy or 2 Gy) or with fractionated IR (once daily from Monday to Friday: 5 × 2 Gy, 20 × 0.1 Gy). At defined time-points after the last IR exposure, mice were anesthetized, perfused, and the lungs were removed, fixed overnight in 4% paraformaldehyde (Sigma-Aldrich Chemie GmbH, Munich, Germany), and processed for further analysis. At least three biological (experimental animals) and three technical (whole lung slices) replicates were examined for each irradiation regimen. The experimental protocol was approved by Medical Sciences Animal Care and Use Committee of Saarland University.

Abd Al-razaq M.A., Freyter B.M., Isermann A., Tewary G., Mangelinck A., Mann C, & Rübe C.E. (2023). Role of Histone Variant H2A.J in Fine-Tuning Chromatin Organization for the Establishment of Ionizing Radiation-Induced Senescence. Cells, 12(6), 916.

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Postoperative IMRT for Cervical Cancer

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All patients underwent Intensity-Modulated Radiation Therapy (IMRT) according to their postoperative pathology. The target area for radiotherapy was delineated according to the consensus of the target area for RTOG cervical cancer. The IMRT plan was designed using the Pinnacle planning system (Philips, Netherlands, version 9.7).

Li W., Xiong L., Zhu Q., Lu H., Zhong M., Liang M., Jiang W., Wang Y, & Cheng W. (2021). Assessment of retroperitoneal lymph node status in locally advanced cervical cancer. BMC Cancer, 21, 484.

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Mapping of Non-Reconstructed Breast Tumor Recurrences

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All cases of NR were mapped manually using CT imaging of a female patient who had undergone left-sided mastectomy and sentinel node biopsy without reconstruction. Her CT scan of the chest with intravenous contrast acquired with both arms abducted overhead and uploaded onto the Pinnacle planning system (Philips Health Care).
The spatial locations of the NRs were transferred to the template CT. The epicenter of each NR was identified as the center of a 5-mm circle. Transferred recurrences were centrally reviewed by the study radiation oncologists (C.D. and A.H.) and radiologist (J.T.). A red circle represented NR cases in patients who received RT as part of primary treatment, and a yellow circle represented those who did not.

DeSelm C., Yang T.J., Cahlon O., Tisnado J., Khan A., Gillespie E., Powell S, & Ho A. (2018). A 3-Dimensional Mapping Analysis of Regional Nodal Recurrences in Breast Cancer. International journal of radiation oncology, biology, physics, 103(3), 583-591.

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Radiation Therapy for Oropharyngeal Cancer

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The standard processes and sequence of treatment for patients with OPC at MD Anderson Cancer Center have been reported elsewhere [47] , [48] , [49] . At least two radiation oncologists examined all patients and target volumes were peer-reviewed for quality assurance purposes. Gross tumor plus margins were prescribed a dose of 66 Gy for small-volume disease and 70 Gy for more advanced disease, and elective regions received 54–63 Gy. For IMPT patients, a relative biological effectiveness (RBE) value of 1.1 was used. Planning for IMPT was done with an Eclipse proton therapy treatment planning system (version 8.9, Varian Medical Systems, Palo Alto, CA, USA). Planning for IMRT was done with a Pinnacle planning system (Philips Medical Systems, Andover, MA, USA). Treatment was delivered with a static gantry approach. IMRT was delivered with a Varian Medical Systems (Palo Alto CA) linear accelerator as 6-MV photons with daily image guidance [50] (link).

Jensen G.L., Blanchard P., Gunn G.B., Garden A.S., David Fuller C., Sturgis E.M., Gillison M.L., Phan J., Morrison W.H., Rosenthal D.I, & Frank S.J. (2017). Prognostic impact of leukocyte counts before and during radiotherapy for oropharyngeal cancer. Clinical and Translational Radiation Oncology, 7, 28-35.

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Lumpectomy Cavity Delineation and IMRT Planning

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Based on the planning CT scan, both breasts, both lungs, and the heart were contoured. The lumpectomy cavity was contoured independently both on planning CT and planning 3D-US. CT images were contoured on the treatment planning system (Pinnacle; Philips Medical Systems, Cleveland, OH, USA) and 3D-US images were contoured on the Clarity Workstation using semi-automatic contouring tools. Two separate observers contoured the cavities on the two different modalities without reference to each other. Based on the planning CT, the clinical target volume (CTV) was defined as the excision cavity + 1.0 cm (5 mm from the skin surface and pectoralis muscle). The planning target volume (PTV) was a 0.5 cm expansion around the CTV. The final PTV was modified to exclude the first 5 mm of tissue from the skin surface as well as any portion extending into the lung. Intensity-modulated radiation therapy was the treatment technique used for planning via the Philips Pinnacle planning system. Ten fractions of 4 Gy were delivered once daily, 5 days per week, for a total dose of 40 Gy.

Sayan M., Vergalasova I., Hard D., Wrigth H., Archambault J., Gagne H., Nelson C, & Heimann R. (2019). Daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging. Radiation Oncology Journal, 37(4), 259-264.

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Non-Contrast CT Simulation for Radiotherapy

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All patients underwent non contrast-enhanced computed tomography simulation in the immobilization devices as described previously.[21 (link)] At least 2 experienced radiation oncologists examined all patients and reviewed all the contours for quality assurance [21 (link), 22 (link)]. In patients receiving IMRT, the Gross tumor volume plus margins received 70 Gy in 33 fractions. A relative biological effectiveness value of 1.1 was prescribed for IMPT patients. IMPT cases were planned with an Eclipse proton therapy treatment planning system (version 8.9, Varian Medical Systems, Palo Alto, California). IMRT planning was performed with a Pinnacle planning system (Philips Medical Systems, Andover, MA).

A Prospective Longitudinal assessment of MRI Signal Intensity Kinetics of Non-Target Muscles in Patients with Advanced Stage Oropharyngeal Cancer in Relationship to Radiotherapy Dose and Post-Treatment Radiation-Associated Dysphagia: Preliminary findings from a Randomized Trial. (2018). Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 130, 46-55.

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Multimodal Radiation Therapy for MPM

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The 3DCRT group was treated between 1999 and 2005. These patients were treated with 25 × 1.8 Gy = 45 Gy to the hemithorax and subsequently, in a second series, a boost of 7 × 1.8 Gy = 12.6 Gy was given to the incompletely resected area (total dose 57.6 Gy). Dose calculation was performed on Pinnacle planning system (Philips Medical Systems) for a linear accelerator (Clinac 2100C, Varian Medical Systems). Details of the treatment technique have previously been published [7 (link)].
HCRT has been used at our institution since 2005 for the treatment of MPM patients. Of the 14 patients treated with HCRT, 11 were treated with conventional static field IMRT and 3 patients with rotational IMRT (volumetric arc radiotherapy, i.e. Rapid Arc® in the present series).
IMRT and VMAT plans achieved similar dose distributions [9 (link),10 ]. In the case of HCRT only one series was applied with 26 × 1.75 Gy = 45.5 Gy delivered to the hemithorax with a simultaneous integrated boost of 26 × 2.15 Gy = 55.9 Gy delivered to the R1/R2 region. Planning and dose calculation was performed on the Eclipse planning system (Varian Medical Systems, Palo Alto, CA) for a linear accelerator (Clinac 6EX or Trilogy, Varian Medical Systems). The treatment technique and dose-volume constraints have been previously published [7 (link),10 ,11 (link)].

Krayenbuehl J., Dimmerling P., Ciernik I.F, & Riesterer O. (2014). Clinical outcome of postoperative highly conformal versus 3D conformal radiotherapy in patients with malignant pleural mesothelioma. Radiation Oncology (London, England), 9, 32.

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Multimodal Treatment for Head and Neck Cancer

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Multidisciplinary treatment strategy was previously described by Garden, et al.¹⁶ Surgery before radiation was generally used for diagnosis only, while neck dissection after radiation was done for patients who did not have a complete clinical response. Concurrent chemoradiation was recommended for patients with more advanced T-stage or bulky adenopathy, and induction chemotherapy recommended for patients with advanced nodal disease. In terms of radiation, 66 Gy was prescribed for patients with small volume primary disease, and 70–72 Gy for more advanced disease. Patients were planned using the Pinnacle planning system (Philips Medical Systems, Andover, MA) and IMRT was used to treat the primary tumor and upper neck nodes using Varian (Varian Medical Systems, Palo Alto, CA) linear accelerators delivering 6-MV photons.

Perni S., Mohamed A.S., Scott J., Enderling H., Garden A.S., Gunn B., Rosenthal D, & Fuller C.D. (2016). CT-based Volumetric Tumor Growth Velocity: A Novel Imaging Prognostic Indicator in Oropharyngeal Cancer Patients Receiving Radiotherapy. Oral oncology, 63, 16-22.

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