A large screen digitizer system for radiation therapy treatment planning

PURPOSE: This paper describes a new technique for manually drawing contours of anatomy over image data for the purposes of radiation therapy treatment planning. METHODS AND MATERIALS: A large area rear-projectible digitizer tablet is used together with a projection TV system to display computer graphics and image data. Large images of computed tomography or magnetic resonance cross-sections are displayed and the digitizer is used to directly trace outlines of important organs. Digitizer menus allow multiple functions for selecting images and structures, for changing the grayscale level and window, and for zooming and roaming the image. RESULTS: This device has been in clinical operation for many years and has proven to greatly increase the speed of entering cross-sectional outlines defined for serial computed tomography images sets. A small timing study of clinical usage demonstrates up to a factor of ten improvement in the speed of contour entry. CONCLUSION: For 3-dimensional radiation therapy, tumor, and target volumes, as well as important critical organs, must be delineated from serial sets of computed tomography or magnetic resonance images. Often 30 or more slices must be considered and the process of outlining structures on this number of slices can represent a significant fraction of the total treatment planning time. The device described in this paper greatly improve the ease and speed of manual contour entry for 3-dimensional radiation therapy planning.