Localizing the spinal cord in oblique off-cord lung boosts

Area of Science:

• Medical Imaging
• Radiation Oncology
• Radiography

Background:

• Accurate spinal cord localization is crucial for radiation therapy planning.
• Oblique projections in radiography can pose challenges for precise spinal cord delineation.
• Existing methods may lead to unnecessary spinal cord shielding, compromising tumor dose.

Purpose of the Study:

• To present a novel method for accurate spinal cord localization in oblique radiographic projections.
• To improve the precision of defining radiation therapy fields, particularly the medial border.
• To reduce the need for superfluous spinal cord blocks.

Main Methods:

• Generating a patient-specific template from axial CT slices acquired in the treatment position.
• Analyzing CT slices to determine spinal cord position relative to the beam central axis.
• Applying the template to the simulator fiducial plate for verification simulation and documenting cord position in the beam's eye view.

Main Results:

• The developed technique allows for accurate localization of the spinal cord in oblique projections.
• Radiation oncologists reported increased confidence in defining medial field borders for oblique setups.
• The method demonstrated a potential to minimize the use of unnecessary spinal cord blocks.

Conclusions:

• This CT-derived template method offers a reliable approach for spinal cord localization in oblique radiography.
• It enhances treatment planning accuracy and potentially improves tumor dose delivery by reducing superfluous shielding.
• The technique supports safer and more effective radiation therapy for spinal indications.