CT simulation
CT simulation Section
Radiation oncology patients undergo at least one simulation procedure before starting their course of radiotherapy. CT simulation is a process conducted prior to radiotherapy to determine the size, shape, and location of the tumor. During the radiotherapy simulation phase, CT imaging is performed alongside the use of auxiliary tools such as skin tattoos, photographs, and immobilization devices. The approximate time required for the initial simulation process may take up to an hour and a half. At this stage, you will meet with radiation therapy specialists who work closely with radiation oncologists and physicists.
During the preparation phase, our professional team gathers all the necessary information to ensure that your positioning for daily treatments is accurate and reproducible. Following the initial explanations, a CT scan is performed on the patient to create 3D images for treatment planning. These images are utilized by the oncologist to identify the tumor and surrounding areas. The Siemens CT simulator at Pardis Center features the largest bore of its kind, specifically designed for treatment planning. At this stage of the patient’s treatment, based on the markers placed on the skin, images with precise coordinates are prepared to guide the treatment process accurately.
Upon arriving at the center to begin treatment, an electronic medical record will be created for you, and our team will explain the treatment process in detail before initiating your care. In the treatment room, you will be positioned for therapy, lying on the treatment table according to the pre-determined setup established during the simulation day, based on the marked guidelines from the simulation session.
Our team carefully evaluates your condition and performs initial markings on your body. After imaging in the treatment room, final markings are made, and adhesive markers are applied to your body. These markers will be used in subsequent treatment sessions.
Do not attempt to remove these signs during the treatment process under any circumstances, and report any changes to our team. Periodic imaging will be conducted during the course of treatment.
CT Simulation Stages
Permanent skin marking or scarring
After imaging is performed, reference points are tattooed on the patient’s skin to be used during treatment. In some cases, photographs of the treatment area and the patient’s position on the table may be taken to better document the setup for the treatment day. This ensures that the radiation therapist can accurately replicate the position throughout the course of treatment.
Immobilization device
During the simulation process, tools may be utilized to stabilize specific anatomical parts of the body and minimize patient movement during treatment. This helps reduce the volume of healthy tissue exposed to the radiation beam and ensures the target tissue is precisely positioned for therapy. It is important to note that these tools will be used throughout the entire course of treatment. Examples of such tools include chest incline boards or foam wedges, head frames, thermoplastic masks for immobilizing the head, neck, or limbs, and vacuum bags for molding the patient’s body.
Thermoplastic masks are softened using a tank of warm water and then molded over the patient’s face. As they cool, they gradually conform to the shape of the patient’s head, helping to keep the patient stable during treatment. Vacuum bags are also placed under the patient’s body on the day of imaging. Using specialized pumps, the air inside the bag is evacuated, causing the bag to harden and take the shape of the patient’s body.
Departments of Pardisnoor
A wide array of advanced imaging and therapeutic services is offered, including CT scans, MRI, digital radiology, mammography, ultrasound, bone density assessments, and digital dental care.
Interventional clinics, fully equipped to perform minimally invasive procedures under ultrasound and fluoroscopy guidance, are prepared to deliver comprehensive services.
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Frequently Asked Questions
How long does the CT simulation process take, and what is its purpose?
This process, conducted prior to the start of radiotherapy, is designed to precisely determine the size, shape, and location of the tumor. The approximate duration for this step, including the waiting time, is about an hour and a half. During this phase, three-dimensional images are prepared by the medical team (oncologist and physicist) to plan the treatment, ensuring that the radiation is accurately targeted to the intended area.
What are the uses of immobilization tools such as thermoplastic masks and vacuum bags?
These tools are used to stabilize the patient’s body and minimize movement during treatment. The use of thermoplastic masks (which mold to the shape of the face with warm water) or vacuum bags (which conform to the patient’s body) ensures that healthy tissues are not exposed to radiation and that the target tissue remains in the exact, reproducible position during each treatment session.
Why should the markings and lines on the skin not be removed during the course of treatment?
On the simulation day, addressing points are either tattooed or marked on the skin to determine the precise treatment coordinates. These markings and specialized adhesives serve as the primary guide for the radiation therapist to align the equipment during subsequent sessions. Removing or altering these markings can compromise the accuracy of the device’s targeting; therefore, the patient must take care to preserve them and promptly report any changes to the treatment team.