Prism User’s Reference Manual Version 1.5 Ira J. Kalet, Mark H. Phillips, Jonathan P. Jacky and Robert S. Giansiracusaa Technical Report 2004-08-01 Radiation Oncology Department University of Washington Box 356043 Seattle, WA 98195-6043 September 14, 2005 aIt is a pleasure to acknowledge many helpful discussions with and other contributions from members of the faculty and staff of the Radiation Oncology Department of the University of Washington, Seattle, Washington, USA and the Oncology Institute of Soroka Medical Center, Ben Gurion University of the Negev, Beersheva, Israel. 2 c 2004 by Ira J. Kalet, Mark H. Phillips, Jonathan P. Jacky, and Robert S. Giansiracusa. This work may not be copied or reproduced in whole or part for any commercial purpose. Permission to photocopy in whole or part without payment of fee is granted for nonprofit educational and research purposes provided that all such copies include the following notice: a notice that such copying is by permission of the author(s); an acknowledgement of the author(s) of the work; and all applicable portions of this copyright notice. All rights reserved. Contents 1 About this manual 11 1.1 Whatyouneedtoknow............................... 11 1.2 What this manual includes . 11 2 Capabilities, inputs and outputs 13 2.1 Functional capabilities . ...... 13 2.2 Components and products of the planning task . .......... 14 2.3 The shared treatment planning database . ......... 16 2.4 Dosecomputation................................. 16 2.4.1 Types of radiation sources . 16 2.4.2 What the system produces . 18 2.5 Graphicdisplays ................................. 18 2.5.1 Transverse, coronal and sagittal views . ........ 19 2.5.2 Beam’seyeviews............................... 22 2.5.3 Presentation.................................. 23 2.6 Contents of chart printout . ...... 23 2.6.1 Title page and combined doses section . ...... 23 2.6.2 External beam setup and dosimetry . 24 2.6.3 Dose per treatment by field and total dose by field . ........ 26 2.6.4 Linesources ................................. 27 2.6.5 Seeds ..................................... 27 2.6.6 Miscellaneous ................................ 27 2.7 Otherchartprintouts .... ...... ..... ...... ...... .. 27 2.7.1 Leaf collimator settings . 27 2.7.2 Neutroncharts ................................ 27 3 Coordinate conventions in Prism 29 3.1 Patientspace .................................... 29 3.2 Couchspace...................................... 31 3.3 Treatmentroomspace.... ...... ..... ...... ...... ... 31 3.4 Gantryspace ..................................... 31 3.5 Collimatorspace ................................. 32 3.6 Viewspace ...................................... 32 3 4 CONTENTS 3.7 Screenspace..................................... 32 3.8 Plotspace ....................................... 33 4 User environment and customization 35 4.1 Equipment requirements and setup . ....... 35 4.2 User and site customization . ...... 38 4.2.1 The .prismrc user customization file . 38 4.2.2 The prism.config system configuration file . 40 4.3 Userlevelfunctions..... ...... ..... ...... ...... .. 41 4.4 The Prism graphical user interface . ........ 42 4.4.1 Controlpanels ................................ 43 4.4.2 User interface guidelines . 44 4.4.3 Selector panels - lists of objects . ...... 48 4.4.4 Images, window and level . 50 4.4.5 Objects and declutter . 50 5 Beam panel 51 5.1 The Copy operations ................................. 51 5.1.1 The Copy here operation ......................... 51 5.1.2 The Copy 90 and Copy 270 operations . 52 5.1.3 The Copy 180 operation .......................... 52 5.2 Beam control buttons and textlines . ........ 54 5.2.1 Beamname.................................. 54 5.2.2 Machine.................................... 55 5.2.3 MonitorUnits................................. 55 5.2.4 NumberofFractions ...... ..... ...... ...... ..... 55 5.2.5 Color ..................................... 55 5.2.6 AttenuationFactor . ...... ..... ...... ...... ..... 55 5.2.7 ArcSize.................................... 56 5.2.8 AxisOn.................................... 56 5.3 Wedges ........................................ 56 5.3.1 Wedgeselection ............................... 56 5.3.2 WedgeRotation................................ 56 5.4 Blocks......................................... 56 5.5 Machinerotations................................ 56 5.6 Couchlinearmotions .............................. 57 5.7 Collimatorsubpanels . 57 5.7.1 Changingmachinetype. 58 5.7.2 The electron cutout editing panel . ...... 58 6 Block editing panel 61 6.1 Blockoutlinedrawing. 61 6.2 Film orientation on the digitizer . ........ 61 6.3 Othercontrols................................... 63 CONTENTS 5 6.3.1 SourcetoFilmDistance . 63 6.3.2 Rotationofblocks .............................. 63 6.3.3 Imagebutton ................................. 63 6.3.4 Objectsbutton ................................ 64 6.3.5 Window and level sliders . 64 6.3.6 Blockselectorpanel ...... ..... ...... ...... ..... 64 6.3.7 Name..................................... 64 6.3.8 Color ..................................... 64 6.3.9 BlockTransmission. 64 7 Brachytherapy sources panel 65 7.1 Source data entry controls . ..... 65 7.1.1 Addingsources................................ 67 7.1.2 Deletingsources ............................... 67 7.1.3 Modifyingsources .............................. 67 7.2 Source coordinate entry . ..... 67 7.2.1 Keyboard entry and XYZ method . 68 7.2.2 Orthogonalfilms ............................... 68 7.3 Source attribute editing . ...... 69 7.3.1 Arrowbuttons ................................ 69 7.3.2 Source color (the number button) . 69 7.3.3 Source type for each source . 69 7.3.4 Activity and units for each source . ..... 70 7.3.5 Application time for each source . ..... 70 7.3.6 Display of geometric information for each source . .......... 70 7.4 Thepointdosesubpanel .. ...... ..... ...... ...... ... 70 8 Dose-volume histogram (DVH) panel 73 8.1 DVHpanelbuttons ................................. 73 8.1.1 BinSize.................................... 73 8.1.2 MaxDose................................... 73 8.1.3 Prescription/Tolerance dose . ..... 73 8.1.4 Statistics ................................... 73 8.1.5 Cumulative/Differential DVH . 75 8.1.6 Biological Models for the Tumor Complication Probability (TCP) and the Normal Tissue Complication Probability (NTCP) . 75 8.1.7 Print...................................... 78 8.1.8 WriteHist................................... 78 9 MLC panel 79 9.1 MLCcontourdrawing ............................... 79 9.1.1 Accept .................................... 80 9.1.2 Clear ..................................... 80 9.1.3 Editmode................................... 81 6 CONTENTS 9.1.4 Ruler ..................................... 81 9.1.5 Scaleslider .................................. 81 9.2 Leafsettings.................................... 81 9.2.1 Setcontour .................................. 82 9.2.2 Setleaves................................... 82 9.2.3 Autoleaf ................................... 82 9.3 LeafeditingwiththeUWCNTS . 82 9.4 Imagedisplay .................................... 83 9.5 Objects – the declutter function . ........ 83 10 Neutron panel 85 11 Patient panel 89 11.1 Ending the Prism session: the Exit button . .......... 90 11.2 Patient and case identification . ........ 90 11.2.1 Casetimestamp................................ 90 11.2.2 CaseComments ............................... 91 11.3 The patient database and checkpoint facility . ............. 92 11.3.1 Select..................................... 92 11.3.2 Archive.................................... 93 11.3.3 Checkpoint and Retrieve . 93 11.4 Patient data entry facilities . ......... 94 11.4.1 Imagestudy.................................. 94 11.4.2 Anatomy ................................... 94 11.4.3 Immobilization device . 94 11.5 Additional functions on the patient panel . ............ 95 11.5.1 Other software tools . 95 11.5.2 Brachytherapy source catalog manager . ....... 95 11.6Plans.......................................... 95 12 Patient database manager panel 97 12.1 Patient list management . ...... 97 12.1.1 NextPrismID ................................ 98 12.1.2 PID(PrismID) ................................ 98 12.1.3 Patientname ................................. 98 12.1.4 Patient hospital ID . 98 12.1.5 Selectpatient ................................ 98 12.1.6 Updatepatient ................................ 98 12.2 Databasemanagement . 98 12.2.1 DB: Database selection . 98 12.2.2 Deletecase .................................. 99 12.2.3 Deleteplan .................................. 99 12.2.4 Deletepatient................................ 99 12.2.5 Deleteimages................................. 99 CONTENTS 7 13 Plan panel 101 13.1 Textinformation ................................ 102 13.2 Plantimestamp .................................. 102 13.3 Plan panel function buttons . ....... 104 13.3.1 CopyPlan................................... 104 13.3.2 Archive.................................... 104 13.3.3 Checkpt.................................... 104 13.3.4 BrachySources................................ 104 13.3.5 PointDoses.................................. 104 13.3.6 SortBeams .................................. 104 13.3.7 PrintChart .................................. 105 13.3.8 Computedose ................................ 105 13.4 Dosespecification. ..... ...... ..... ...... ...... .. 106 13.4.1 Dose grid resolution . 106 13.4.2 Dosegridcolor ...............................