All patients underwent enhanced CT scan at 2.5-5 mm slice thickness for IMRT planning. Patients were immobilized by vacuum molds or thermoplastic body films in the supine position with free quiet breathing mode. Gross tumor volume (GTV) was identified as tumor focus. The GTV and organs at risk were contours in the Pinnacle 3 system (Philips, Netherlands) or MIM 6.8 system (MIM, USA). Whenever conditions permitted, CT-positron emission tomography (PET-CT) fusion for the extrahepatic sites and CT-magnetic resonance imaging (MRI) fusion for intrahepatic lesions were performed. For patients with multiple lesions, 1–5 lesions were selected for IMRT at the discretion of the radiation oncologists. IMRT plans were designed using the Monaco treatment planning system (version 5.1) or Pinnacle 3 system (Philips, Netherlands). The final median biologically effective dose used α/β ratio = 10 was 67.2 Gy (IQR, 60–78 Gy). The RT was received using a 6 MV X-ray linear accelerator daily over five fractions per week.
Pinnacle 3 system
Manufactured by Philips
Sourced in Netherlands
The Pinnacle 3 system is a laboratory equipment product offered by Philips. The core function of the Pinnacle 3 system is to provide analytical capabilities for various applications. However, a detailed description of its features and intended use cannot be provided while maintaining an unbiased and factual approach.
Automatically generated - may contain errors
Lab products found in correlation
5 protocols using pinnacle 3 system
1
IMRT Planning for Extrahepatic and Intrahepatic Lesions
2
IMRT Dosimetry for Liver Cancer
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The contrast-enhanced computed tomography (CT) scans for the dose calculation plans were underwent by positioning the patients in supine with their arms overhead during free quiet breathing. Gross tumour volume (GTV) including macrovascular invasion (MVI) was clearly delineated using the contrast-enhanced CT and CT–magnetic resonance imaging fusion. The GTV was expanded to 4–5 mm to establish the clinical target volume (CTV). The planning target volume included the CTV plus a 5–10 mm margin, implemented to account for respiratory motion and setup uncertainty. All target areas and organs at risk were contoured using the Pinnacle 3 system (Philips, Netherlands) or MIM 6.8 system (MIM, USA). IMRT plans were designed using the Monaco treatment planning system (version 5.1) or the Pinnacle 3 system (Philips, Netherlands). Among the 75 patients, the median total GTV dose was 53.24 Gy ± 7.26 Gy (mean ± standard deviation), with a median of 2.96 Gy ± 0.84 Gy per fraction; each fraction was 3 to 5 days a week. IMRT was administered to all patients using a linear accelerator with 6 MV X-rays (ELEKTA Versa-HD or ELEKTA Synergy, Sweden).
3
IMRT for Liver Tumors with Macrovascular Invasion
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The main indication for IMRT included liver tumors with macrovascular invasion; distant metastasis treated with palliative IMRT. For patients with bilobar multiple HCCs, as many lesions as possible were chosen for IMRT without exceeding the tolerance limits of the organs at risk. All patients underwent enhanced computed tomography (CT) scan at 2.5–5 mm slice thickness for IMRT planning. CT-positron emission tomography fusion and magnetic resonance imaging fusion were performed for identifying extrahepatic metastasis and intrahepatic lesions, respectively. Gross tumor volume (GTV) was defined as the tumor focus. The GTV and at-risk organs were contoured using the Pinnacle 3 system (Philips, Netherlands) or the MIM software (version 6.8; MIM, USA). The planned target volume (PTV) was defined as the GTV plus an asymmetrical dilation of 1 cm in the craniocaudal direction and 5 mm in the axial direction to set the uncertainty and respiratory movement. The IMRT plans were designed using Pinnacle 3 or the Monaco treatment planning system version 5.1. The final median biologically effective dose, which used α/β ratio = 10 according to the linear-quadratic model, was 51 Gy (interquartile range, 40–51 Gy). IMRT was delivered via a 6 MV X-ray linear accelerator (ELEKTA Synergy or ELEKTA Versa-HD, Sweden) using cone-beam CT to correct the positions.18 (link)
4
IMRT Planning for Pelvic Radiotherapy
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In treatment planning, 3D CT images were used as the reference (pCT). The primary clinical target volume (CTV1), which included the surgical bed, was delineated on the pCT images using a Pinnacle3 system (v.9.10; Philips Medical Systems, Fitchburg, WI, USA). Pelvic lymphatics were delineated as the secondary clinical target volume (CTV2) in 12 patients. A setup margin (SM) of 3–5 mm was added to the CTV1 to create the planning target volume (PTV1), and an SM of 5–7 mm was added to the CTV2 to create the PTV2.
IMRT plans were performed using TomoTherapy planning stations (Hi-Art ver. 4.2.3 or TomoHD ver. 1.2.3; Accuray Inc., Sunnyvale, CA, USA). The prescribed doses to the PTV1 (1ºDpre) and PTV2 (2ºDpre) were 70.0 Gy and 50.4 Gy, respectively, at 28 fractions. The dose constraints in the treatment plans were: (1) the 1ºDpre had to cover at least 98% of the PTV, and (2) the maximum dose (Dmax) of the PTV had to be less than 107% of the 1ºDpre. Doses to organs-at-risk (OARs), such as the rectum wall, bladder, penile bulb, femoral heads, and bowel, were also considered.
IMRT plans were performed using TomoTherapy planning stations (Hi-Art ver. 4.2.3 or TomoHD ver. 1.2.3; Accuray Inc., Sunnyvale, CA, USA). The prescribed doses to the PTV1 (1ºDpre) and PTV2 (2ºDpre) were 70.0 Gy and 50.4 Gy, respectively, at 28 fractions. The dose constraints in the treatment plans were: (1) the 1ºDpre had to cover at least 98% of the PTV, and (2) the maximum dose (Dmax) of the PTV had to be less than 107% of the 1ºDpre. Doses to organs-at-risk (OARs), such as the rectum wall, bladder, penile bulb, femoral heads, and bowel, were also considered.
5
IMRT for Liver Tumor Volumetric Planning
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All patients underwent enhanced computerized tomography (CT) scan at 2.5–5 mm slice thickness for the IMRT plan. Gross tumor volume (GTV) was defined as tumor focus. CT-positron emission tomography fusion and magnetic resonance imaging fusion for extrahepatic metastasis and intrahepatic lesions were performed, respectively. The GTV and organs at risk were contoured on the Pinnacle 3 system (Philips, Netherlands) or MIM software (version 6.8; MIM, USA). The planned target volume (PTV) was defined as GTV plus asymmetrical dilation of 1 cm in the craniocaudal direction and 5 mm in the axial direction to set uncertainty and respiratory movement. The IMRT plans were designed using the Pinnacle 3 system or Monaco treatment planning system version 5.1. The final median biologically effective dose, which used α/β ratio = 10 according to the linear-quadratic model, was 67.2 Gy (interquartile range, 60–78 Gy). IMRT was delivered via a 6 MV X-ray linear accelerator (ELEKTA Synergy or ELEKTA Versa-HD, Sweden) using cone-beam CT to correct the positions.
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