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Radiotherapy simulation mrp006

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Information about Radiotherapy simulation mrp006
Education

Published on March 9, 2014

Author: mtv243

Source: slideshare.net

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Radiotherapy Physics
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28/02/2014 OSSAMA ANJAK 1 ‫א‬ ‫א‬ RADIOTHERAPY SIMULATION ‫هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ oanjak@yahoo.com 28/02/2014 OSSAMA ANJAK 2 1

‫اﻟﻬﺪف‬ ‫اﻟﺘﻌﺮف ﻋﻠﻰ:‬ ‫اﻟﺘﻌﺮف ﻋﻠﻰ اﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻲ ﻣﺤﺎآﺎة اﻟﻤﻌﺎﻟﺠﺔ اﻹﺷﻌﺎﻋﻴﺔ.‬ ‫اﻟﺘﻌﺮف ﻋﻠﻰ اﻟﺘﻘﻨﻴﺎت واﻟﺘﺠﻬﻴﺰات اﻟﻤﺘﻤﻤﺔ اﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ اﻹﺷﻌﺎﻋﻴﺔ‬ ‫4‬ ‫2‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫اﻟﻐﺎﻳﺔ ﻣﻦ اﻟﻤﻌﺎﻟﺠﺔ اﻹﺷﻌﺎﻋﻴﺔ‬ ‫ﻗﺘﻞ آﺎﻓﺔ اﻟﺨﻼﻳﺎ اﻟﺴﺮﻃﺎﻧﻴﺔ.‬ ‫ﺗﻌﺮﻳﺾ اﻟﻬﺪف )اﻟﻮرم( إﻟﻰ أﻋﻠﻰ ﺟﺮﻋﺔ‬ ‫إﺷﻌﺎﻋﻴﺔ ﻳﻤﻜﻦ اﻟﻮﺻﻮل إﻟﻴﻬﺎ.‬ ‫ﺗﺨﻔﻴﺾ اﻟﺠﺮﻋﺔ إﻟﻰ اﻟﻨﺴﺞ اﻟﻤﺤﻴﻄﺔ إﻟﻰ‬ ‫أدﻧﻰ ﺣﺪ ﻣﻤﻜﻦ.‬ ‫‪OSSAMA ANJAK‬‬ ‫5‬ ‫4102/20/82‬ ‫ﺘﺨﻁﻴﻁ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﺍﻟﺘﺸﺨﻴﺹ‬ ‫ﻗﺭﺍﺭ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﺍﻟﺤﺴﺎﺏ ﺍﻟﻴﺩﻭﻱ‬ ‫ﻟﺯﻤﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﺘﻬﻴﺌﺔ ﺍﻟﻤﺭﻴﺽ‬ ‫ﻟﻠﻤﻌﺎﻟﺠﺔ‬ ‫ﺘﺤﺩﻴﺩ ﻤﻨﻁﻁﻘﺔ‬ ‫ﺍﻟﻬﺩﻑ ‪GTV‬‬ ‫ﺘﺨﻁﻴﻁ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﺍﻟﺘﺴﺠﻴل ﻭﺍﻟﺘﺤﻘﻕ‬ ‫ﻤﺘﺎﺒﻌﺔ ﺍﻟﻤﺭﻴﺽ‬ ‫א‬ ‫6‬ ‫3‬ ‫ﺍﻟﻤﺤﺎﻜﺎﺓ‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫ﺟﻬﺎز اﻟﻤﺤﺎآﻲ‬ ‫‪Radiotherapy Simulator‬‬ ‫ﺟﻬﺎز اﻟﻤﺤﺎآﻲ‬ ‫ﺟﻬﺎز ﺗﺼﻮﻳﺮ وﺗﻨﻈﻴﺮ ﺑﺎﺳﺘﺨﺪام‬ ‫أﺷﻌﺔ-‪ X‬ذو ﻣﻴﺰات ﺧﺎﺻﺔ:‬ ‫ﻣﺤﺎآﺎة أﺟﻬﺰة اﻟﻤﻌﺎﻟﺠﺔ اﻹﺷﻌﺎﻋﻴﺔ.‬ ‫ﺗﺄﻣﻴﻦ آﺎﻓﺔ اﻟﺤﺮآﺎت اﻟﻤﻴﻜﺎﻧﻴﻜﻴﺔ‬ ‫اﻟﻤﺘﻮﻓﺮة ﻓﻲ ﺟﻬﺎز اﻟﻤﻌﺎﻟﺠﺔ.‬ ‫ﻣﺰود ﺑﻄﺎوﻟﺔ ﻣﻄﺎﺑﻘﺔ ﻟﻄﺎوﻟﺔ‬ ‫اﻟﻤﻌﺎﻟﺠﺔ اﻹﺷﻌﺎﻋﻴﺔ.‬ ‫8‬ ‫4‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫ﻣﺤﺎآﻲ اﻟﻤﻌﺎﻟﺠﺔ اﻹﺷﻌﺎﻋﻴﺔ‬ ‫1. اﻟﺮأس:‬ ‫أﻧﺒﻮب أﺷﻌﺔ-‪.X‬‬ ‫ﻣﺤﺪدات اﻟﺤﺰﻣﺔ‬ ‫اﻹﺷﻌﺎﻋﻴﺔ‬ ‫ﺧﻄﻮط ﺗﺤﺪﻳﺪ ﺳﺎﺣﺔ‬ ‫اﻟﻤﻌﺎﻟﺠﺔ‬ ‫2. اﻟﺬراع‬ ‫4. اﻟﻄﺎوﻟﺔ‬ ‫3. ﻣﺴﺘﻘﺒﻞ اﻷﺷﻌﺔ:‬ ‫ﻧﻈﺎم اﻟﺘﻨﻈﻴﺮ‬ ‫اﻟﻔﻠﻢ‬ ‫‪OSSAMA ANJAK‬‬ ‫9‬ ‫اﻟﻤﺤﺎآـﻲ‬ ‫4102/20/82‬ ‫‪Simulator‬‬ ‫א‬ ‫א‬ ‫01‬ ‫5‬ ‫‪OSSAMA ANJAK‬‬ ‫‪Simulator‬‬ ‫4102/20/82‬

‫اﻟﻤﺤﺎآﻲ‬ ‫א‬ ‫‪Simulator‬‬ ‫א‬ ‫:‬ ‫ﺣﺮآﺔ اﻟﺬراع‬ ‫ﺣﺮآﺎت اﻟﻤﺤﺪدات‬ ‫ﺣﺮآﺎت اﻟﻄﺎوﻟﺔ.‬ ‫ﺣﺮآﺎت ﺣﺎﻣﻞ ﻣﺴﺘﻘﺒﻞ اﻟﺼﻮرة‬ ‫11‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫وﺿﻌﻴﺔ اﻟﻤﺮﻳﺾ ﻋﻠﻰ ﺟﻬﺎز اﻟﻤﺤﺎآﻲ‬ ‫ﻓﻲ ﻣﻌﻈﻢ اﻟﺤﺎﻻت ﺗﻜﻮن وﺿﻌﻴﺔ اﻟﻤﺮﻳﺾ اﺳﺘﻠﻘﺎء ﻇﻬﺮي‬ ‫ﻓﻲ ﺑﻌﺾ اﻟﺤﺎﻻت ﻳﻮﺿﻊ اﻟﻤﺮﻳﺾ ﻣﺴﺘﻠﻘﻴﺎ ﻋﻠﻰ اﻟﺒﻄﻦ أو ﻋﻠﻰ‬ ‫ً‬ ‫ﺟﺎﻧﺒﻪ.‬ ‫21‬ ‫6‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫وﺿﻌﻴﺔ اﻟﻤﺮﻳﺾ أﺛﻨﺎء اﻟﻤﺤﺎآﺎة‬ ‫ﻳﺠﺐ أن ﺗﻜﻮن وﺿﻌﻴﺔ اﻟﻤﺮﻳﺾ ﻋﻠﻰ ﺟﻬﺎز اﻟﻤﺤﺎآﻲ:‬ ‫ﻣﺮﻳﺤﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﺮﻳﺾ.‬ ‫ﻳﻤﻜﻦ ﺗﻨﻔﻴﺬهﺎ ﻋﻠﻰ ﺟﻬﺎز اﻟﻤﻌﺎﻟﺠﺔ.‬ ‫ﻗﺎﺑﻠﺔ ﻟﻠﺘﻜﺮار.‬ ‫‪OSSAMA ANJAK‬‬ ‫31‬ ‫4102/20/82‬ ‫اﻟﻤﺤﺎآﺎة‬ ‫ﻳﺠﺐ ﺗﺴﺠﻴﻞ آﺎﻓﺔ اﻟﻤﻌﻠﻮﻣﺎت ﻋﻦ وﺿﻌﻴﺔ ﺟﻬﺎز اﻟﻤﺤﺎآﻲ:‬ ‫أﺑﻌﺎد اﻟﺴﺎﺣﺔ‬ ‫اﻟﻤﺴﺎﻓﺔ ‪.SSD‬‬ ‫ﻋﻤﻖ اﻟﻮرم.‬ ‫زواﻳﺎ اﻟﺪوران )اﻟﻤﺤﺪدات، اﻟﺬراع، اﻟﻄﺎوﻟﺔ، ......(.‬ ‫ارﺗﻔﺎع اﻟﻤﺮآﺰ ﻋﻦ ﺳﻄﺢ اﻟﻄﺎوﻟﺔ.‬ ‫اﻟﻤﺮآﺰ.‬ ‫.........‬ ‫41‬ ‫7‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫ﻧﻘﺎط ﻣﺮﺟﻌﻴﺔ‬ ‫ﻳﺠﺐ ﺗﺴﺠﻴﻞ آﺎﻓﺔ اﻟﻤﻌﻠﻮﻣﺎت ﻋﻦ وﺿﻌﻴﺔ اﻟﻤﺮﻳﺾ‬ ‫ﻋﻠﻰ ﺟﻬﺎز اﻟﻤﺤﺎآﻲ‬ ‫اﻷدوات اﻟﻤﺴﺎﻋﺪة اﻟﻤﺴﺘﺨﺪﻣﺔ.‬ ‫اﻟﻨﻘﺎط اﻟﻤﺮﺟﻌﻴﺔ.‬ ‫........‬ ‫51‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫ﺘﻬﻴﺌﺔ ﺍﻟﻤﺭﻴﺽ ﻤﻥ‬ ‫ﺃﺠل ﺍﻟﻤﺤﺎﻜﺎﺓ‬ ‫61‬ ‫8‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫ﻣﺤﺎآﺎة اﻟﻤﻌﺎﻟﺠﺔ )اﻟﺘﺨﻄﻴﻂ(.‬ ‫اﻟﺘﻮﺛﻴﻖ‬ ‫71‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫اﻟﻤﺤﺎآﺎة ﺑﺎﺳﺘﺨﺪام اﻟﺘﺼﻮﻳﺮ‬ ‫اﻟﻄﺒﻘﻲ‬ ‫‪CT Simulator‬‬ ‫81‬ ‫9‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫اﻟﻤﺤﺎآﺎة ﺑﺎﺳﺘﺨﺪام اﻟﺘﺼﻮﻳﺮ اﻟﻄﺒﻘﻲ‬ ‫ﺗﺨﻄﻴﻂ اﻟﻤﻌﺎﻟﺠﺔ ﺛﻼﺛﻲ اﻷﺑﻌﺎد ‪: 3D treatment planning‬‬ ‫ﺗﺠﺮي ﻣﻌﺎﻟﺠﺔ ﻗﺎﻋﺪة ﺑﻴﺎﻧﺎت ﺻﻮر اﻟـ ‪ CT dataset‬ﻟﻠﻤﻨﻄﻘﺔ ﺑﺎﺳﺘﺨﺪام‬ ‫ﻓﺎﺻﻞ ﻣﻨﺎﺳﺐ ﺑﻴﻦ اﻟﻤﻘﺎﻃﻊ ) ‪0.5 cm - 1 cm‬ﻣﻦ أﺟﻞ اﻟﺼﺪر و 5.0‬ ‫‪cm‬ﻣﻦ أﺟﻞ اﻟﺤﻮض و ‪ 0.3 cm‬ﻣﻦ أﺟﻞ اﻟﺮأس واﻟﻌﻨﻖ(.‬ ‫ﻳﺠﺐ رﺳﻢ اﻟﻤﺤﻴﻂ اﻟﺨﺎرﺟﻲ )ﻳﻈﻬﺮ اﻟﺠﻠﺪ أو ﻗﻨﺎع اﻟﺘﺜﺒﻴﺖ‬ ‫‪ (immobilization mask‬ﻋﻠﻰ آﻞ ﻣﻘﻄﻊ ﻣﻦ ﻣﻘﺎﻃﻊ اﻟـ ‪ CT‬اﻟﻤﺴﺘﺨﺪﻣﺔ‬ ‫ﻓﻲ ﺗﺨﻄﻴﻂ اﻟﻤﻌﺎﻟﺠﺔ.‬ ‫أﻳﻀﺎ ﻳﺘﻢ رﺳﻢ اﻟﻮرم وﺣﺠﻢ اﻟﻬﺪف ﻋﻠﻰ ﻣﻘﺎﻃﻊ اﻟـ ‪.CT‬‬ ‫ً‬ ‫أﻳﻀﺎ ﻳﺠﺐ رﺳﻢ اﻷﻋﻀﺎء اﻟﺘﻲ ﺗﻀﺮر ﺑﺎﻹﺷﻌﺎع وآﺬﻟﻚ ﺗﺮﺳﻢ اﻷﻋﻀﺎء‬ ‫اﻟﻬﺎﻣﺔ اﻷﺧﺮى إذا آﺎن اﻟﻤﻄﻠﻮب رﺳﻢ اﻟﻤﺨﻄﻂ اﻹﺣﺼﺎﺋﻲ ﻟﺘﻮزع اﻟﺠﺮﻋﺔ‬ ‫اﻹﺷﻌﺎﻋﻴﺔ ‪dose-volume histograms‬‬ ‫‪OSSAMA ANJAK‬‬ ‫91‬ ‫اﻟﻤﺤﺎآﺎة ﺑﺠﻬﺎز اﻟـ ‪CT‬‬ ‫4102/20/82‬ ‫)‪(CT Simulation‬‬ ‫א‬ ‫ﻟﻴﺰرات ﻣﺘﺤﺮآﺔ‬ ‫ﻣﺴﻘﻂ اﻟﻤﺮآﺰ‬ ‫02‬ ‫01‬ ‫ﺻﻮر ‪CT‬‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

28/02/2014 OSSAMA ANJAK ‫א‬ 21 ‫מ‬ (Treatment planning System, TPS) 28/02/2014 OSSAMA ANJAK 22 11

‫ﻤﻨﻅﻭﻤﺔ ﺍﻟﺘﺨﻁﻴﻁ ﺍﻟﺤﺎﺴﻭﺒﻲ )ﻨﻅﺎﻡ ﺘﺨﻁﻴﻁ ﺍﻟﻤﻌﺎﻟﺠﺔ(‬ ‫ﺒﺎﺭﺍﻤﺘﺭﺍﺕ ﺍﻟﺤﺯﻤﺔ‬ ‫ﺍﻷﻓﻼﻡ‬ ‫ﻟﻭﺤﺔ ﺍﻟﻤﻔﺎﺘﻴﺢ‬ ‫ﺍﻟﻭﺴﺎﺌل ﺍﻟﺘﺸﺨﻴﺼﻴﺔ: ,‪CT‬‬ ‫‪MRI, PET, SPECT‬‬ ‫ﺍﻟﺸﺎﺸﺔ‬ ‫ﻤﻨﻅﻭﻤﺔ ﺒﻴﺎﻨﺎﺕ ﺍﻟﻤﺭﻴﺽ‬ ‫ﺤﺎﺴﻭﺏ‬ ‫ﺤﺎﺴﻭﺏ‬ ‫ﺍﻟﺘﺨﻁﻴﻁ‬ ‫ﺍﻟﺘﺨﻁﻴﻁ‬ ‫ﺍﻟﺘﺴﺠﻴل‬ ‫ﻭﺍﻟﺘﺤﻘﻕ‬ ‫ﺃﺩﻭﺍﺕ ﺍﻟﻤﻌﺎﻟﺠﺔ: ,‪MLC‬‬ ‫ﺍﻟﻤﺭﺸﺤﺎﺕ ﺍﻹﺴﻔﻴﻨﻴﺔ ﺍﻟﺩﻴﻨﺎﻤﻴﻜﻴﺔ،‬ ‫‪IMRT‬‬ ‫32‬ ‫ﺍﻟﻤﻨﻅﻭﻤﺔ ﺍﻟﻤﺤﻭﺴﺒﺔ ﻟﺘﺤﺼﻴل‬ ‫ﺒﻴﺎﻨﺎﺕ ﺍﻟﺤﺯﻤﺔ‬ ‫ﺘﺼﻨﻴﻊ ﺍﻟﺤﻤﺎﻴﺎﺕ‬ ‫ﺍﻟﻁﺎﺒﻌﺔ‬ ‫ﻭﺍﻟﺭﺍﺴﻤﺔ‬ ‫‪OSSAMA ANJAK‬‬ ‫ﺃﺩﻭﺍﺕ ﺍﻟﺘﺨﺯﻴﻥ‬ ‫ﺸﺭﻴﻁ ﻤﻤﻐﻨﻁ، ﻗﺭﺹ‬ ‫4102/20/82‬ ‫وﺿﻌﻴﺔ اﻟﺘﺼﻮﻳﺮ‬ ‫‪R‬‬ ‫42‬ ‫21‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫وﺿﻌﻴﺔ اﻟﺘﺼﻮﻳﺮ‬ ‫52‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫وﺿﻌﻴﺔ اﻟﺘﺼﻮﻳﺮ‬ ‫62‬ ‫31‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫وﺿﻌﻴﺔ اﻟﺘﺼﻮﻳﺮ اﻟﻄﺒﻘﻲ ‪CT‬‬ ‫‪Sagital Plan‬‬ ‫‪Horizantal Plan‬‬ ‫‪Veirtcal Plan‬‬ ‫72‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫اﻟﻤﺤﺎآﺎة ﺑﺎﺳﺘﺨﺪام اﻟﺘﺼﻮﻳﺮ اﻟﻄﺒﻘﻲ‬ ‫اﺧﺘﻼف وﺿﻌﻴﺔ اﻟﺘﺼﻮﻳﺮ‬ ‫82‬ ‫41‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫اﻟﻤﺤﺎآﺎة ﺑﺎﺳﺘﺨﺪام اﻟﺘﺼﻮﻳﺮ اﻟﻄﺒﻘﻲ‬ ‫ﺗﻌﺪﻳﻞ ﺳﻄﺢ اﻟﻄﺎوﻟﺔ ﻟﺠﻬﺎز اﻟﺘﺼﻮﻳﺮ اﻟﻄﺒﻘﻲ‬ ‫92‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫اﻟﻤﺤﺎآﺎة ﺑﺎﺳﺘﺨﺪام اﻟﺘﺼﻮﻳﺮ اﻟﻄﺒﻘﻲ‬ ‫اﺳﺘﺨﺪام ﺗﻘﻨﻴﺔ اﻟﺘﺼﻮﻳﺮ اﻟﺤﻠﺰوﻧﻲ ‪Spiral CT Scan‬‬ ‫ٍ‬ ‫03‬ ‫51‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫اﻟﺘﻮاﻓﻖ ﻓﻲ اﻟﻤﺤﺎور‬ ‫13‬ ‫اﻟﺘﻮاﻓﻖ ﻓﻲ اﻟﻤﺤﺎور‬ ‫23‬ ‫61‬ ‫‪OXYZ‬‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫‪OXYZ‬‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

28/02/2014 OSSAMA ANJAK 33 3D Simulation & Planning CT Slice with Target Volume 28/02/2014 OSSAMA ANJAK 34 17

‫ﺗﻌﺎرﻳﻒ‬ ICRU Report 50 Tumor GTV Gross Tumor Volume CTV Clinical Target Volume PTV Planning Target Volume TV Treated Volume IV Irradiated Volume 28/02/2014 OSSAMA ANJAK 35 3D Simulation & Planning ‫ﺗﻌﻴﻴﻦ ﻣﺨﻄﻂ ﻟﻌﺪد ﻣﻦ اﻟﺤﺠﻮم‬ ‫ ﻣﻦ أﺟﻞ ﺣﺎﻟﺔ‬CT ‫ﻋﻠﻰ ﻣﻘﻄﻊ‬ :‫اﻟﻤﻌﺎﻟﺠﺔ‬ GTV CTV PTV organs at risk (bladder and rectum). 28/02/2014 OSSAMA ANJAK 36 18

3D Simulation & Planning ‫ﺗﺤﺪﻳﺪ اﻟﻬﺪف‬ (‫)ﻣﻮﺿﻊ اﻟﻤﻌﺎﻟﺠﺔ‬ GTV, PTV 28/02/2014 OSSAMA ANJAK 37 3D Simulation & Planning ‫מ‬ 28/02/2014 OSSAMA ANJAK ‫א‬ ‫א‬ 38 19

3D Simulation & Planning ‫ﺗﻮزع اﻟﺠﺮﻋﺔ اﻹﺷﻌﺎﻋﻴﺔ‬ 28/02/2014 OSSAMA ANJAK 39 ‫دراﺳﺔ ﺗﻮزع اﻟﺠﺮﻋﺔ اﻹﺷﻌﺎﻋﻴﺔ‬ 28/02/2014 OSSAMA ANJAK 40 20

‫ﺗﻘﻴﻴﻢ ﻣﺨﻄﻂ اﻟﻤﻌﺎﻟﺠﺔ‬ 28/02/2014 OSSAMA ANJAK 41 3D Simulation & Planning 2D 28/02/2014 OSSAMA ANJAK 42 21

3D Simulation & Planning 2D 2D OSSAMA ANJAK 28/02/2014 43 3D Simulation & Planning 3D 2D CT-Simulation + MLC 28/02/2014 OSSAMA ANJAK 44 22

3D Simulation & Planning 3D IMRT 3D OSSAMA ANJAK 28/02/2014 45 3D Simulation & Planning 1999 … 1950 … Megavoltage Isocentric Setup 28/02/2014 OSSAMA ANJAK Dynamic Collimation 46 23

ICRU Reference Point – some examples Single field 28/02/2014 OSSAMA ANJAK 47 ICRU Reference Point – some examples Parallel Opposed Pair 28/02/2014 OSSAMA ANJAK 48 24

ICRU Reference Point – some examples Wedge Pair Reference Point 28/02/2014 OSSAMA ANJAK 49 ICRU Reference Point – some examples Fixed SSD isodose distribution Wedge Pair (3 Field) Isocentric isodose distribution Reference Point 28/02/2014 OSSAMA ANJAK 50 25

ICRU Reference Point – some more examples Reference Point 4 Field OSSAMA ANJAK 28/02/2014 51 MLC ‫اﻟﻤﺤﺪد اﻟﻤﺘﻌﺪد اﻟﻮرﻳﻘﺎت‬ ‫ﻤﺘﺤﺭﻜﺔ ﺨﻼل ﺠﻠﺴﺔ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﺜﺎﺒﺘﺔ ﺨﻼل ﺠﻠﺴﺔ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ 28/02/2014 Dynamic Treatment OSSAMA ANJAK 52 26

Wedge Filter ‫اﻟﻤﺮﺷﺢ اﻹﺳﻔﻴﻨﻲ‬ Physical Wedge Dynamic Wedge 28/02/2014 OSSAMA ANJAK 53 Wedge Filter ‫اﻟﻤﺮﺷﺢ اﻹﺳﻔﻴﻨﻲ‬ 28/02/2014 OSSAMA ANJAK 54 27

IAEA: Lessons Learned from Accidental... Describes 92 accidental exposures 26 relate to radiation treatment planning 16 external beam therapy 10 brachytherapy 28/02/2014 OSSAMA ANJAK 55 28

Where to find more information? The Physics of Radiology H.E Johns & J R Cunningham The Physics of Radio Therapy Faiz M Khan The Modern Technology of Radiation Oncology, edited by J. Van Dyk International Commission on Radiation Units and Measurements Report No. 50 and 62 OSSAMA ANJAK 28/02/2014 ‫א‬ ‫א א‬ 57 ‫א‬ ‫א‬ ‫ﻏﺮﻓﺔ ﺻﺐ اﻟﺤﻤﺎﻳﺎت‬ Molding Room 28/02/2014 OSSAMA ANJAK 58 29

‫اﻟﺤﻤﺎﻳﺎت‬ ‫وﻗﺎﻳﺔ اﻟﻤﻨﺎﻃﻖ اﻟﺘﻲ ﻳﺠﺐ ﻋﺪم‬ ‫ﺗﻌﺮﻳﻀﻬﺎ ﻟﻺﺷﻌﺎع.‬ ‫ﻳﺴﺘﻌﻤﻞ إﻣﺎ ﻗﻮاﻟﺐ أو ﺣﻤﺎﻳﺎت‬ ‫ﻣﺼﻨﻌﺔ ﻣﺤﻠﻴﺎ ﻟﻜﻞ ﻣﺮﻳﺾ ﻋﻠﻰ ﺣ ّة‬ ‫ﺪ‬ ‫ً‬ ‫‪OSSAMA ANJAK‬‬ ‫95‬ ‫4102/20/82‬ ‫ﺗﺼﻨﻴﻊ اﻟﺤﻤﺎﻳﺎت‬ ‫ﺗﺴﺘﻌﻤﻞ ﺻﻮرة اﻟﻤﺮﻳﺾ اﻟﻤﻠﺘﻘﻄﺔ ﺑﺠﻬﺎز اﻟﻤﺤﺎآﻲ‬ ‫ﻟﺘﺤﺪﻳﺪ ﺣﻮاف اﻟﺤﻤﺎﻳﺔ وﻗﺺ اﻟﻘﺎﻟﺐ ﻟﻠﻮﺻﻮل إﻟﻰ‬ ‫اﻟﺸﻜﻞ اﻟﻤﻄﻠﻮب.‬ ‫06‬ ‫03‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫أﺟﻬﺰة ﻗﺺ اﻟﻘﻮاﻟﺐ‬ ‫16‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫ﺗﺼﻨﻴﻊ اﻟﺤﻤﺎﻳﺎت‬ ‫ﺳﻜﺐ اﻟﺨﻠﻴﻄﺔ ﻓﻲ اﻟﻘﺎﻟﺐ.‬ ‫ﺗﺼﻨﻴﻊ اﻟﺤﻤﺎﻳﺔ‬ ‫ﺗﺜﺒﻴﺖ اﻟﺤﻤﺎﻳﺔ ﻋﻠﻰ اﻟﻠﻮﺣﺔ‬ ‫اﻟﺨﺎﺻﺔ.‬ ‫26‬ ‫13‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫ﺗﺼﻨﻴﻊ اﻟﺤﻤﺎﻳﺎت‬ ‫36‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫اﻟﺤﻤﺎﻳﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻹﻟﻜﺘﺮوﻧﺎت‬ ‫46‬ ‫23‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫א‬ ‫א א‬ ‫א א‬ ‫أدوات ﺗﺜﺒﻴﺖ اﻟﻤﺮﻳﺾ‬ ‫‪OSSAMA ANJAK‬‬ ‫56‬ ‫4102/20/82‬ ‫ﻣﺜﺒﺘﺎت اﻟﺮأس واﻟﻌﻨﻖ‬ ‫ﺗﺴﺘﻌﻤﻞ ﻣﺜﺒﺘﺎت اﻟﻤﺮﻳﺾ:‬ ‫ﻟﺰﻳﺎدة اﻟﺪﻗﺔ ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ.‬ ‫ﺗﺜﺒﻴﺖ اﻟﻤﺮﺿﻰ ﻓﻲ ﺑﻌﺾ اﻟﺤﺎﻻت )أﻃﻔﺎل، أورام دﻣﺎﻏﻴﺔ ...(‬ ‫66‬ ‫33‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫اﻷدوات اﻟﻤﺴﺎﻋﺪة‬ ‫76‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫اﻷدوات اﻟﻤﺴﺎﻋﺪة‬ ‫86‬ ‫43‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫ﻣﺜﺒﺘﺎت اﻟﺠﺴﻢ‬ ‫96‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫ﺘﺼﻨﻴﻊ ﻤﺜﺒﺘﺎﺕ ﺍﻟﺭﺃﺱ ﻭﺍﻟﻌﻨﻕ‬ ‫ﺣﻮض ﻣﺎء ﺳﺎﺧﻦ‬ ‫07‬ ‫53‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫ﻣﺮاﺣﻞ ﺗﺼﻨﻴﻊ ﻣﺜﺒﺖ اﻟﺮأس واﻟﻌﻨﻖ‬ ‫17‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫ﻣﺮاﺣﻞ ﺗﺼﻨﻴﻊ ﻣﺜﺒﺖ اﻟﺮأس واﻟﻌﻨﻖ‬ ‫27‬ ‫63‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫ﺗﻬﻴﺌﺔ اﻟﻤﺮﻳﺾ‬ 28/02/2014 OSSAMA ANJAK 73 ‫ﺗﻬﻴﺌﺔ اﻟﻤﺮﻳﺾ‬ 28/02/2014 OSSAMA ANJAK 74 37

‫ﺗﺜﺒﻴﺖ اﻟﻘﻨﺎع ﻋﻠﻰ اﻟﺮأس واﻟﻜﺘﻔﻴﻦ‬ ‫57‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫ﺗﺜﺒﻴﺖ اﻟﻘﻨﺎع ﻋﻠﻰ اﻟﺮأس واﻟﻜﺘﻔﻴﻦ‬ ‫67‬ ‫83‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫ﺗﺜﺒﻴﺖ اﻟﻘﻨﺎع ﻋﻠﻰ اﻟﺮأس واﻟﻜﺘﻔﻴﻦ‬ ‫77‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬ ‫رﺳﻢ اﻟﻨﻘﺎط اﻟﻤﺮﺟﻌﻴﺔ‬ ‫87‬ ‫93‬ ‫‪OSSAMA ANJAK‬‬ ‫4102/20/82‬

‫اﻟﺸﻜﻞ اﻟﻨﻬﺎﺋﻲ‬ ‫97‬ ‫‪OSSAMA ANJAK‬‬ ‫أﺳـــــﺌﻠﺔ وﻣﻨﺎﻗﺸـــــﺔ‬ ‫04‬ ‫4102/20/82‬

28/02/2014 OSSAMA ANJAK 81 41

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