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planning:userguide:walkthroughs:prostate_plan [2018/08/16 17:16] – [Plan Creation] mhendersonplanning:userguide:walkthroughs:prostate_plan [2021/07/29 18:28] (current) – external edit 127.0.0.1
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-====== Prostate Plan Walkthrough ======+===== Prostate Plan Walkthrough =====
  
-===== Launching Planning =====+==== Launching Planning ====
   - Open the Astroid Launcher and login{{ :- planning:userguide:walkthroughs:launcher_1.jpg?nolink&400 |}}   - Open the Astroid Launcher and login{{ :- planning:userguide:walkthroughs:launcher_1.jpg?nolink&400 |}}
   - Select your realm   - Select your realm
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   - Click the LAUNCH button. The version of planning that is installed in your realm will now open   - Click the LAUNCH button. The version of planning that is installed in your realm will now open
  
-===== Creating a Patient =====+==== Creating a Patient ====
  
   - From within the Planning App click on the Imports block   - From within the Planning App click on the Imports block
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   - Click on the //Open Patient// button{{ :planning:userguide:walkthroughs:pro_open_patient_3.png?400 |}}   - Click on the //Open Patient// button{{ :planning:userguide:walkthroughs:pro_open_patient_3.png?400 |}}
  
-===== Course Prescription =====+==== Course Prescription ====
 Prescription information is stored in the //Course// and must be added prior to making a treatment plan for a new patient. Prescription information is stored in the //Course// and must be added prior to making a treatment plan for a new patient.
  
-  - The patient opens directly after importing +  - Open the patient after importing the CT and Structure Set 
 +  - Open the Patient Course (note: it will automatically open if the patient is freshly created)
   - Next proceed to //Prescriptions//   - Next proceed to //Prescriptions//
     - Select //Create New Prescription//{{ :planning:userguide:walkthroughs:pro_create_new_rx.png?400 |}}     - Select //Create New Prescription//{{ :planning:userguide:walkthroughs:pro_create_new_rx.png?400 |}}
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   - Click //Done// to complete the //Course// editing     - Click //Done// to complete the //Course// editing  
  
-===== Plan Creation =====+==== Plan Creation ====
 The required //Course// and //Patient Model// information was selected during import, so now we can move to creation of a treatment //Plan// The required //Course// and //Patient Model// information was selected during import, so now we can move to creation of a treatment //Plan//
  
   - From the Patient Overview tree, click //Add Plan// under the Patient Model entry{{ :planning:userguide:walkthroughs:plan_4.jpg?nolink&400 |}}    - From the Patient Overview tree, click //Add Plan// under the Patient Model entry{{ :planning:userguide:walkthroughs:plan_4.jpg?nolink&400 |}} 
-    - Name the plan and click //OK//{{ :planning:userguide:walkthroughs:plan_3.jpg?nolink&400 |}}+    - Name the plan and click //OK// (the description is optional) {{ :planning:userguide:walkthroughs:plan_5.jpg?nolink&400 |}}
     - This creates an empty plan with its prescription set to fulfill all portions of the Course Prescription     - This creates an empty plan with its prescription set to fulfill all portions of the Course Prescription
   - Now open the new plan by clicking the //Open// button under the new plan entry in the Patient Overview tree   - Now open the new plan by clicking the //Open// button under the new plan entry in the Patient Overview tree
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     - Click the //OK// button     - Click the //OK// button
    - Now we are ready to make our beams    - Now we are ready to make our beams
-    - Start by clicking //Create New Beam//{{ :planning:userguide:walkthroughs:pro_new_create_new_beam.png?400 |}}+    - Start by clicking //Create New PBS Beam//{{ :planning:userguide:walkthroughs:pro_new_create_new_beam.png?400 |}}
       - Enter the following for each beam        - Enter the following for each beam 
         - General         - General
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             - You may use the sliders, the +/- buttons, or simply type in the values to adjust these angles {{ :planning:userguide:walkthroughs:pro_new_approach.png?400 |}}             - You may use the sliders, the +/- buttons, or simply type in the values to adjust these angles {{ :planning:userguide:walkthroughs:pro_new_approach.png?400 |}}
         - Snout         - Snout
-          - In this example select the 20x20 snout {{ :planning:userguide:walkthroughs:pro_new_snout.png?400 |}} +          - For this example any snout can be selected {{ :planning:userguide:walkthroughs:pro_new_snout.png?400 |}} 
         - Aperture (if desired)         - Aperture (if desired)
           - If there is the need to use an Aperture for sharper penumbra the user can do so at this time (see [[planning:userguide:tutorials:all_tutorials#creating_an_aperture|Creating an Aperture]])           - If there is the need to use an Aperture for sharper penumbra the user can do so at this time (see [[planning:userguide:tutorials:all_tutorials#creating_an_aperture|Creating an Aperture]])
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           - The air gap is specified as the distance from the final beamline device (aperture or shifter) or the snout end if no devices are present           - The air gap is specified as the distance from the final beamline device (aperture or shifter) or the snout end if no devices are present
           - The view automatically shifts to the 3D view when entering this sub-block and you can adjust the air gap to ensure patient collisions are avoided           - The view automatically shifts to the 3D view when entering this sub-block and you can adjust the air gap to ensure patient collisions are avoided
-          - The default air gap of 30 mm is sufficient for both beams in this example +          - The default air gap is sufficient for both beams in this example 
         - Spot placement          - Spot placement 
           - Since we want both beams to use the same spot settings, we have those at the plan level and there is no need to edit the spot placements here for the beams           - Since we want both beams to use the same spot settings, we have those at the plan level and there is no need to edit the spot placements here for the beams
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             - These proton DRRs are used only for visualization purposes and will have no effect on the plan construction process {{ :planning:userguide:walkthroughs:pro_new_drr.png?400 |}}             - These proton DRRs are used only for visualization purposes and will have no effect on the plan construction process {{ :planning:userguide:walkthroughs:pro_new_drr.png?400 |}}
       - Click //Done// to complete the first beam       - Click //Done// to complete the first beam
-      - After creating the first beam (at gantry angle 90) it is recommended that you //Clone// it and simply change new beam's ganry angle to save time in creating the second beam (the //Clone// button is available under a beam when it is selected for viewing from the list of beams){{ :planning:userguide:walkthroughs:pro_new_clone.png?400 |}} +   - After creating the first beam, at gantry angle 90, it is recommended that you //Clone// it and simply change new beam's ganry angle to save time in creating the second beam at gantry angle 270 (the //Clone// button is available under a beam when it is selected for viewing from the list of beams){{ :planning:userguide:walkthroughs:pro_new_clone.png?400 |}} 
       - Once you have //Cloned// the beam choose the //Edit// button to make changes to the gantry angle {{ :planning:userguide:walkthroughs:pro_new_edit_beam.png?400 |}}       - Once you have //Cloned// the beam choose the //Edit// button to make changes to the gantry angle {{ :planning:userguide:walkthroughs:pro_new_edit_beam.png?400 |}}
         - Note for more complex plans, there are often additional parameters to change (such as the aperture and the air gap) when creating additional beams via the //Clone// option          - Note for more complex plans, there are often additional parameters to change (such as the aperture and the air gap) when creating additional beams via the //Clone// option 
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 ==== Optimization ==== ==== Optimization ====
-With the two beams completely defined, we can now move on organizing our treatment fraction groups and specifying the constraints and objectives for the treatment+With the two beams completely defined, we can now move on to organizing our treatment fraction groups and specifying the constraints and objectives for the treatment
   - Open the //Optimization// block (see [[planning:userguide:tutorials:all_tutorials#astroid_optimization|Astroid Optimization]] for a detailed explanation of //Optimization//, //Feasibility// and //Constraints//, as well as //Running the Optimizer//)   - Open the //Optimization// block (see [[planning:userguide:tutorials:all_tutorials#astroid_optimization|Astroid Optimization]] for a detailed explanation of //Optimization//, //Feasibility// and //Constraints//, as well as //Running the Optimizer//)
  
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         - Add a min dose constraint of 79.2 Gy (1.8 Gy per fx)         - Add a min dose constraint of 79.2 Gy (1.8 Gy per fx)
         - Add a max dose constraint of 85.5 Gy          - Add a max dose constraint of 85.5 Gy 
-      - At this point your //Fraction Group// should appear as shown below {{ :planning:userguide:walkthroughs:walkthrough_prostate_fg_complete.png?300 |}}+      - At this point your //Fraction Group// should appear as shown below {{ :planning:userguide:walkthroughs:walkthrough_prostate_fg_complete.png?400 |}}
       - Click //Done// to complete the //Fraction Group//       - Click //Done// to complete the //Fraction Group//
  
  
 === Constraints and Feasibility === === Constraints and Feasibility ===
-    - This is our only Fraction Group for this plan, so we'll move on to the plan level constraints and feasibility 
     - Open the //Constraints / Feasibility// sub-block      - Open the //Constraints / Feasibility// sub-block 
-      - First we'll enter the //Constraints// for the planning (target) volumes and a global maximum constraint +      - First we will enter the //Constraints// for the planning (target) volumes and a global maximum constraint 
-        - Remember these are the "hard stops/non negotiables" for the plan +        - For this example do the following: 
-        - These doses will be decided per the users' department protocols +          - Click the //Edit// button 
-        - For this case do the following: +          - Click //Add Structure// and select (Skin)
-          - Click //Add Structure// and select External_body (Skin)+
             - Add a max set to 85.5             - Add a max set to 85.5
-          - Click //OK//  +          - Click the //OK// button
-          - Note that we already have PTV dose constraints at the Fraction Group Target level, so no additional ones are needed here+
 <WRAP center round info 85%> <WRAP center round info 85%>
 After the target constraints have been entered, it's generally good practice to test the plan feasibility. The Feasibility calculation is run by clicking //calculate// at the bottom of this block. The Feasibility calculation is based solely on the constraints and it should be used to ensure there is a possible solution (plan) that can meet the specified constraints. Establishing Feasibility is often an iterative process in order to get appropriate constraints established for a particular plan. In other words, the user may need to enter a constraint, check the feasibility, then progressively tighten the constraint and check the feasibility until the plan is no longer feasible. It is recommended practice to start by obtaining a feasible plan utilizing only target constraints (and a global max constraint) then add OAR constraints as desired. Remember, using a narrow range of constraints can improve the optimizer performance and improve the resolution of the Pareto surface navigation. After the target constraints have been entered, it's generally good practice to test the plan feasibility. The Feasibility calculation is run by clicking //calculate// at the bottom of this block. The Feasibility calculation is based solely on the constraints and it should be used to ensure there is a possible solution (plan) that can meet the specified constraints. Establishing Feasibility is often an iterative process in order to get appropriate constraints established for a particular plan. In other words, the user may need to enter a constraint, check the feasibility, then progressively tighten the constraint and check the feasibility until the plan is no longer feasible. It is recommended practice to start by obtaining a feasible plan utilizing only target constraints (and a global max constraint) then add OAR constraints as desired. Remember, using a narrow range of constraints can improve the optimizer performance and improve the resolution of the Pareto surface navigation.
 </WRAP> </WRAP>
  
-      - Run the //Feasibility// by clicking the //calculate// link <WRAP center>{{ :planning:userguide:walkthroughs:pro23.png?300 |}}</WRAP>+      - Run the //Feasibility// by clicking the //calculate// link <WRAP center>{{ :planning:userguide:walkthroughs:pro23.png?400 |}}</WRAP>
         - The feasibility should return as passing, if not, please confirm your plan parameters match those shown throughout this walkthrough and try again         - The feasibility should return as passing, if not, please confirm your plan parameters match those shown throughout this walkthrough and try again
-      - Now with the target constraints set, we'll move on to our OAR's+      - Now with the target constraints set, we'll continue to add our OAR's
         - Again these will be set per department protocol         - Again these will be set per department protocol
         - For this example create the following OAR constraints:         - For this example create the following OAR constraints:
           - Rectum max mean 50 Gy           - Rectum max mean 50 Gy
-          - Bladder max mean 60 Gy {{ :planning:userguide:walkthroughs:pro_new_con_feas.png?400 |}}+          - Bladder max mean 60 Gy {{ :planning:userguide:walkthroughs:fesability_1.jpg?nolink&400 |}}
       - Run //Feasibility// as before       - Run //Feasibility// as before
         - The feasibility should return as passing again, if not, please confirm your plan parameters match those shown throughout this walkthrough and try again         - The feasibility should return as passing again, if not, please confirm your plan parameters match those shown throughout this walkthrough and try again
 +      - If the feasibility has passed click the //OK// button
  
 === Objectives and Optimizer === === Objectives and Optimizer ===
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         - //Objectives// are the goals that you would like to achieve and these will be the driving forces for the //Optimizer//         - //Objectives// are the goals that you would like to achieve and these will be the driving forces for the //Optimizer//
         - Expand the //Objectives / Optimizer// sub-block and then click //Edit// under the //Objectives// section         - Expand the //Objectives / Optimizer// sub-block and then click //Edit// under the //Objectives// section
-        - For this example we will use the following objectives:+        - For this example we will use the following objectives (Click the //Add structure// drop down menu to add the following)
           - The External_Body (Skin) will automatically populate           - The External_Body (Skin) will automatically populate
           - Rectum min_mean (Minimize the mean dose to the Rectum)           - Rectum min_mean (Minimize the mean dose to the Rectum)
           - Testes min_max (Minimize the maximum dose to the Testes)           - Testes min_max (Minimize the maximum dose to the Testes)
           - Left & Right Femur min_overdose 45 Gy (Minimize the amount of the structure the receives dose above 45 Gy)           - Left & Right Femur min_overdose 45 Gy (Minimize the amount of the structure the receives dose above 45 Gy)
-          - PTV min_max (Minimize the maximum dose within the PTV) {{ :planning:userguide:walkthroughs:pro_new_obj.png?400 |}}+          - PTV min_max (Minimize the maximum dose within the PTV) {{ :planning:userguide:walkthroughs:optimizer_1.jpg?nolink&400 |}}
       - Click //OK// to complete the //Objectives//       - Click //OK// to complete the //Objectives//
-      - We are now ready to run the MCO, by opening the //Navigation// sub-block and clicking the //calculate// link+      - We are now ready to run the MCO, by clicking the //calculate// link
         - This may take up to 10 minutes for this plan depending upon your available cloud services resources         - This may take up to 10 minutes for this plan depending upon your available cloud services resources
         - Keep in mind that even though this process may take some time, the planner will be able to make adjustments easily in the Navigation without running a new plan         - Keep in mind that even though this process may take some time, the planner will be able to make adjustments easily in the Navigation without running a new plan
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     - If you find a plan that you like, but wish to continue exploring further, you can click the //Save// button to save the current slider state and then continue exploring     - If you find a plan that you like, but wish to continue exploring further, you can click the //Save// button to save the current slider state and then continue exploring
     - You may return to the last saved state at any time by clicking the //Reset// button     - You may return to the last saved state at any time by clicking the //Reset// button
-    - The //Cancel// button will close the navigation block, reverting back to the last //Saved// state{{ :planning:userguide:walkthroughs:pro_new_navigation_sliders.png?400 |}}+    - The //Cancel// button will close the navigation block, reverting back to the last //Saved// state{{ :planning:userguide:walkthroughs:navigation_1.jpg?nolink&400 |}}
   - The plan is ready for physician review at this point   - The plan is ready for physician review at this point
     - Physicians often find it useful to Navigate the solution and explore trade-offs in real time, which can often alter the traditional physician approval process into an interactive, real-time trade-off analysis and on the spot plan approval     - Physicians often find it useful to Navigate the solution and explore trade-offs in real time, which can often alter the traditional physician approval process into an interactive, real-time trade-off analysis and on the spot plan approval
planning/userguide/walkthroughs/prostate_plan.1534439817.txt.gz · Last modified: 2021/07/29 18:25 (external edit)