To be most effective, radiation therapy must be aimed precisely (within millimeters, despite breathing and movement) at the same target(s) every time treatment is given. The process of measuring your anatomy and marking your skin in ways that help us guide the beams of radiation safely and exactly to their intended locations is commonly called "simulation." Simulators are very precise machines that can duplicate the geometry of different types of treatment machines and via fluoroscopy and x-ray pictures allow us to visualize important structures inside patients. This information is translated into aiming points, distances and angles. With the use of light and laser projection systems, we will place marks on your skin or on individually constructed immobilization devices that will help level and position you in 3-dimensional space. Marking can be done either with a bright, temporary carfuscin "paint" or a set of small permanent tattoos. You will choose which system we use for you. Immobilization devices will be constructed from one or more materials (chosen specifically for individual situations), including thermally shaped plastics, vacuum forming "bean bags," expanding foams and plaster casts.

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