As treatment plans have become more sophisticated, the ability of all radiation oncology facilities to cure tumors without harming patients has improved. Much of this success is directly attributable to the use of sophisticated computer systems operated by highly trained, full-time dedicated medical physicists. Typical planning systems depict for every patient both tumors and sensitive normal tissues in 3-dimensional space. The radiation oncologist and the medical physicist seek to include all of the tumor and as little normal tissue as possible within the "envelope of irradiation." Such plans are said to conform to the tumor and are often referred to as "conformal irradiation."

This ability to localize structures in 3-dimensional space and plan the treatment portals in a virtual environment requires the use of imaging information that can be referenced to the treatment machine for precise alignment of the beams relative to the target. The Department of Radiation Oncology has a dedicated CT-simulator with patient setup indicators that relate the patient's position on the CT to the therapy unit. Our unit, a General Electric Lightspeed Plus, is an advanced multi-slice helical scanner. This allows us to acquire a full set of finely detailed images in a very short period of time and proceed to planning the patient's treatment in the absence of the patient. A computer-generated reconstruction of the patient with full anatomic information is used for the planning of optimal beam orientations.

At NYU we have chosen to use only commercially designed and supplied treatment planning hardware and software, rather than home-built units. All such units must be approved by the FDA prior to sale and are then further tested by our physics staff.

At NYU all plans must be reviewed and approved by the attending physician, in writing, before they can be used in a patient's care.

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