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PortalSim

The System that converts your analog simulator to a digital
fluoroscopy and dynamic treatment simulator with DICOM connection (patented)

What is it?

PortalSim is an add-on computer system for the conventional simulator
in a radiation therapy clinic. It transforms the conventional simulator
into a digital dynamic treatment simulation system for External Beam
Radiation Therapy (EBRT), Intensity-Modulated Radiation Therapy (IMRT)
and Image-Guided Radiation Therapy (IGRT). The patient’s anatomical
contours, the geometrical information of the Beam Limiting Device (BLD)
such as block and MLC, and the reference images such as Digitally
Reconstructed Radiograph (DRR) can be overlaid on the distortion-free
real-time fluoroscopy so as to help medical staff verify the treatment
plan more accurately and more efficiently. The simulation result can be
captured, encoded in DICOM format and sent to Record & Record (R&V)
system, such as MOSAIQ (IMPAC) and ARIA (VARIS), for attending radiation
oncologist to review and approve.

Figure 1 shows the typical look of its graphical user interface in dynamic treatment simulation mode. For those who like traditional simulator monitor, it can be switched to full-screen mode (Figure 2) with quite a few digital nuances and superior image quality on a big high-resolution flat panel image monitor.

Figure 1 The typical look of
PortalSim in dynamic treatment simulation mode.

Who needs it?

It is developed for a radiation therapy facility that is looking for more efficient and more accurate
filmless treatment simulation system for IMRT or IGRT without replacing the conventional analog simulator
in high capital investment. It is also a valuable auxiliary tool for researchers who are interested in projects
pertaining to deformable image registration, intra-fraction organ motion and tumor tracking and, adaptive
radiation therapy.

In many radiation therapy facilities, the conventional simulator still plays an important role in the
process of patient positioning and beam port verification. When IMRT and IGRT are pursued, higher patient
repositioning accuracy would be desirable to deliver highly 3D conformal high dose region to target volume,
and so be the simulation system. With this system in place, the treatment simulation procedure can be
conducted comprehensively down to segmental level. If needed the delivery of IMRT or IGRT treatment can
be rehearsed and recorded prior to real treatment. On the other hand, it also keeps the conventional way
of use but with better image quality by means of digital image enhancement. For example, the digitized
orthogonal setup images can be exported via DICOM / DICOM RT connection to RTP systems for HDR/LDR treatment
planning, or for quantitative placement verification of brachytherapy applicators such as MammoSite
balloon catheter.

How it works?

An image frame grabber of high performance is installed in a personal computer to digitize fluoroscopic
video from the image intensifier at a rate of 1024×1024 pixels per frame and 30 frames per second. Prior to
simulation, the patient’s treatment plan, DRRs, contours, MLC segments and beam block geometry are exported
from radiotherapy treatment planning systems to a DICOM / DICOM RT server. This server is coupled with a
customized database that is also accessible to and under management of PortalSim. It is also accessible to
PortView, a sister client application for remote review of portal images. The intrinsic image distortion of
the image intensifier is corrected in real-time manner so that geometrical and anatomical information of the
plan can be projected on fluoroscopic image to help set up patient and verify dynamic treatment process. In
the case of moving tumor due to respiration, breathing phase can be retrieved from the moving BB imprinted
onto fluoroscopic image sequence with the help of a breathing cycle indicator, and thereby PortalSim is endowed with the capability of simulating respiration gated IMRT treatment and four-dimensional image guided radiation therapy. The simulation process can be recorded in AVI format for later review to provide valuable information for improving field design and patient immobilization techniques. The What-You-See-Is-What-You-Get report printing features together with DICOM compatibility eliminates the need of radiographic film.

Download the latest upgrade

PortalSim is constantly evolving. The users are advised to check our website
periodically and have your systems upgraded if there is a newer version. The
latest version is 2.5 build 580 (February 04, 2008). To download the whole package, please
click here.

Highlights of PortalSim

Reference DRR and live distortion-free fluoroscopic image are displayed side-by-side on the same screen
with matching crosshairs (Figure 2). Click here to download a demo simulation report.

  • Reference DRR and live distortion-free fluoroscopic image are displayed side-by-side on the same
    screen (Figure 2).

Figure 2 Check image registration in full-screen mode.

 

  • Reference DRR is overlaid on live distortion-free fluoroscopic image in different patterns to
    facilitate the image comparison.

 

Figure 3 Another method to check image registration. There are 8
rendering methods for checking image registration.

 

  • Individual MLC segments or the intensity beam aperture and GTV contours are projected
    onto fluoroscopic image to verify the delivery.

 

Figure 4 Anatomical contours are projected on real-time fluoro.

 

  • IMRT or IGRT treatment rehearsal (the dynamic treatment simulation is recorded
    and exported in AVI format).

 

Figure 5 In the case of IMRT and IGRT, treatment process can be
rehearsed and recorded in AVI movie.

 

  • How to Contact Us

    For the license and technical support, please contact

    Yulong Yan PhD
    Tel: (214) 645 7636
    Fax: (214) 645 2885
    Email: Yulong.Yan@utsouthwestern.edu

    For sales information, please contact

    Dawn Bolt, MHSA
    Tel: (501) 526 6157
    Fax: (501) 686 7285
    Email: BoltDawnM@uams.edu