ROI Flipbook (Revised)pdf

REFERENCE GUIDE:
DRAWING AN

ISOCENTER REGION OF INTEREST

© 2015 Vision RT Ltd . All rights reserved 0 0004-0002 v 2.3 16 Sep 15

DISCLAIMER

• This reference guide is intended to assist the user in the
creation of a proper region of interest
• The examples included in this guide, depict a generalized
region of interest for each treatment site
• The region of interest should be modified to meet the
individual needs of each patient, ensuring adequate
AlignRT coverage and topography

© 2015 Vision RT Ltd . All rights reserved 1 0004-0002 v 2.3 16 Sep 15

CREATING AN ROI

HOW TO DRAW A PROPER REGION OF INTEREST (ROI):

1. Draw the ROI to include the isocenter (if possible) and surrounding
area

2. Ensure the ROI extends laterally to the patient’s midline to ensure
delta readout if a camera is occluded

3. Include patient topography such as ribs
4. Ensure to ONLY include the patient’s skin surface in the ROI excluding

anything not part of the patient. (Ex. Immobilization device, gown,
patient clothing, table etc.)
5. Ensure the ROI is not too large or too small (may affect the frame rate)

© 2015 Vision RT Ltd . All rights reserved 2 0004-0002 v 2.3 16 Sep 15

TANGENTIAL BREAST Include:
• Breast tissue and chest wall
© 2015 Vision RT Ltd . All rights reserved • As much stable surface as possible
• Lateral aspect of the breast tissue
to midline of patient

Do not include
• Axilla / Arm, or the abdomen
• Anything not part of the patient
(ex. immobilization device, gown)
• Contralateral breast

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TANGENTIAL BREAST – EXAMPLE ONLY

Include:
• Breast tissue and surrounding rigid
chest wall
• As much stable surface as possible

• Lateral aspect of the breast tissue
to the AP/PA midline of patient

© 2015 Vision RT Ltd . All rights reserved 4 0004-0002 v 2.3 16 Sep 15

TANGENTIAL BREAST Do not include
• Axilla, Arm, or abdomen
IMAGES WITH THE • Anything not part of the patient
DONT’S HERE (ex. immobilization device, gown)
• Contralateral breast

© 2015 Vision RT Ltd . All rights reserved 5 0004-0002 v 2.3 16 Sep 15

TANGENTIAL BREAST CHEST WALL AND SURROUNDING
BREAST TISSUE
© 2015 Vision RT Ltd . All rights reserved Include:
• Chest wall surrounding the breast

tissue
• Lateral aspect of the chest wall
tissue

Do not include
• Breast tissue
• Arm/axilla, below rib cage
• Contralateral breast

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MULTIFIELD BREAST / CHESTWALL

Do include:
• Breast or chest wall
• Small portion of sclv area AP
• Lateral aspect of breast chest
wall tissue to the patient’s
AP/PA midline

• Don’t include:
• Axilla / Arm
• Neck / Chin
• Contralateral breast chest wall

© 2015 Vision RT Ltd . All rights reserved 7 0004-0002 v 2.3 16 Sep 15

CHESTWALL Do include:
• Breast or chest wall
© 2015 Vision RT Ltd . All rights reserved • Lateral aspect of breast
chest wall tissue to the
patients midline

• Don’t include:
• Axilla / Arm
• Neck / Chin
• Contralateral breast chest
wall

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MULTIFIELD BREAST / CHESTWALL

Do include:
• Breast or chest wall
• More superior ROI to include
portion of AP sclv

• Lateral aspect to the patient’s
AP/PA midline

© 2015 Vision RT Ltd . All rights reserved 9 0004-0002 v 2.3 16 Sep 15

BREATHOLD BREAST NOTE: THE FREE BREATHING AND BREATH HOLD

© 2015 Vision RT Ltd . All rights reserved SURFACES SHOULD HAVE SIMILAR ROIs

Include:
• Breast Tissue
• As much stable surface as possible

(ribs)
• Lateral aspect posterior of the

breast tissue to the patient’s midline

Don’t Include: 0004-0002 v 2.3 16 Sep 15
• Axilla
• Anything not part of patient
• Contralateral breast

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IMRT BREAST Do Include:

© 2015 Vision RT Ltd . All rights reserved • Breast tissue

• As much stable surface as
possible (ribs)

• Lateral Aspect of left and right
breast to the patient’s AP/PA
midline – this is to ensure the
cameras can see regardless of
gantry position

Don’t include:

• Axilla

• Anything not part of the patient
(immobilization device)

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PRONE BREAST- MONITORING FIELD

Do Include:
• Breast tissue
• Ipsilateral shoulder
including scapula

Don’t Include:
• Arms
• Upper shoulders

© 2015 Vision RT Ltd . All rights reserved 12 0004-0002 v 2.3 16 Sep 15

PRONE BREAST – SETUP FIELD

Do Include:
• Breast tissue
• Ipsilateral and
Contralateral shoulder
including scapula

Don’t Include:
• Arms
• Upper shoulders

© 2015 Vision RT Ltd . All rights reserved 13 0004-0002 v 2.3 16 Sep 15

SBRT - LUNG/LIVER Do Include:
• Sternum
© 2015 Vision RT Ltd . All rights reserved • Anterior Ribs
• Lateral Ribs to the
patient’s AP/PA midline

Don’t Include:
• Diaphragm/abdomen
area
• Non reproducible area
• Anything not part of the
patient

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MONO ISO HEAD & NECK Do Include:
• Mandible (if viewable)
© 2015 Vision RT Ltd . All rights reserved • Anterior portion of neck
• Lateral side of neck to
the patient’s midline

Don’t Include:
• Mouth
• Shoulders
• Anything not part of the
patient (ex. mask)

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SRS BRAIN Do Include:
• Eye brows, nose,
© 2015 Vision RT Ltd . All rights reserved forehead, cheeks
• Laterally: Outer Canthus
to the anterior of the
tragus

Don’t Include:
• Mouth
• Mask
• Hair (side burns, bangs,
etc...)

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EXTREMITY Do Include:
• Surrounding tissue of
© 2015 Vision RT Ltd . All rights reserved isocenter
• Patient topography so
ROI doesn’t look
cylindrical (ex. Joint)

Don’t Include:
• Clothing or
immobilization
• Cylinder shape

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CRANIOSPINAL - BRAIN Do Include:

© 2015 Vision RT Ltd . All rights reserved • Eye brows, eyes, nose,
cheeks

• Laterally: Outer canthus
to the anterior portion
of the tragus

Don’t Include: 0004-0002 v 2.3 16 Sep 15
• Mouth
• Neck
• Mask
• Shoulders

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CRANIOSPINAL – UPPER SPINE

Do Include:
• Sternum
• Lateral sides of the chest

Don’t Include:
• Diaphragm
• Abdomen area
• Non- reproducible area
• Anything not part of
patient

© 2015 Vision RT Ltd . All rights reserved 19 0004-0002 v 2.3 16 Sep 15

CRANIOSPINAL- LOWER SPINE

Do Include:

• Stable portion of the skin
surface

• Lateral hips and thighs

Don’t Include:
• Abdomen, excessive

adipose tissue
• Anything not part of the
patient
• Non-reproducible area

© 2015 Vision RT Ltd . All rights reserved 20 0004-0002 v 2.3 16 Sep 15

ABDOMEN NOTE: THE ROI SELECTION FOR ABDOMEN CAN BE
DRAWN IN EITHER THORAX OR PELVIS AREA DEPENDING
© 2015 Vision RT Ltd . All rights reserved ON THE ISOCENTER LOCATION

Do Include:
• Stable portion of the skin
surface

Don’t Include:
• Large unstable areas
• Anything not part of the patient
• Non-reproducible area due to
breathing motion

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ABDOMEN - THORAX NOTE: THE ROI SELECTION FOR ABDOMEN CAN
BE DRAWN IN EITHER THORAX OR PELVIS AREA
© 2015 Vision RT Ltd . All rights reserved DEPENDING ON THE ISOCENTER LOCATION

Do Include:
• Stable portion of the skin
surface

• Don’t Include:
• Large unstable areas
• Anything not part of the
patient
• Non-reproducible area due
to breathing motion

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PELVIS Do Include:
• Anterior portion of hips
© 2015 Vision RT Ltd . All rights reserved • Lateral portion of hips to the
patient’s midline

Don’t Include:
• Excessive adipose tissue
• Non-reproducible areas
• Anything not part of the
patient

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PELVIS Do Include:
•Anterior portion of hips
© 2015 Vision RT Ltd . All rights reserved •Lateral portion of hips to
the patient’s midline

Don’t Include:
•Excessive adipose tissue
•Non-reproducible areas
•Anything not part of the
patient

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