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Multiple initial imaging and CBCT
Outline VesicaART study
•
Planning CT on void bladder and back up plan with robust margins
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Contour bladder on CBCT at the first 5 fractions and generate
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PSV
Small
, encompassing the two smallest bladder volumes, PSV
Medium
, the
union of all five volumes, PSV
Large
, standard PTV margins
•
CBCT fraction 6-30, bony anatomy match
•
Clinical selection of the library plan with the smallest possible PSV
•
Using this technique PTV volumes were reduced by 30% on average
Vestergaard, Acta 2014