6 Modern Imaging in Brachytherapy

Modern Imaging 129

There are different ways of handling the image information for treatment planning (level 1-3, part 7 of this chapter). The most accurate and reliable method is to enter the image information directly into the treatment planning system . Film radiographs are still widely used and usually have to be digitised first. These projection images may then be linked to the sectional images taken. There are different methods available to do this matching procedure, which is at present usually based on applicator landmarks (fixed, non fixed) and/or on anatomical landmarks. The digital sectional images can usually be entered directly into the treatment planning computer (via network). Treatment planning can also be directly based on sectional images (Fig 5.3).

Fig 5.3: Infrastructure for modern imaging based brachytherapy integrating all information from the different forms of imaging into provisional treatment planning, into image guided procedures and into definitive treatment planning for brachytherapy. Networking between the different imaging devices and the brachytherapy treatment planning system is a precondition for practical use.