Figure 3: Enhancing plan
evaluation in VERT
Students are gaining familiarity with the equipment on which they will be for enhancing students’ skills in the evaluation of plans produced and the planning
gaining real life experience so that when they commence their placements they process itself. For example, 3D visualisation of the contoured structure sets can show
are, in theory, more confident and better placed to focus their learning on the clearly inadequacies in contouring technique that may not be immediately obvious in
development of clinical and patient oriented skills rather than basic psychomotor the treatment planning system. This can provide the stimulus for a discussion of the
skills. These practical skills are being developed in structured, interactive sessions reasons behind inadequacies such as partial voluming effects. Surface colourwash
that also promote the development of other knowledge and skills that underpin and dose surface displays in VERT can add new insights for students that they cannot
clinical practice. These include the basic principles of radiation treatments, the gain easily from interpretation of a dose volume histogram alone. Early feedback
concept of the isocentre, the concept of ‘reference movements from tattoos’, and from students indicates that this is a feature of VERT that is of particular value and
relating treatment set-ups to anatomy. The extent to which VERT enhances skills should be further exploited. Figure 3 illustrates dose colourwashes for two different
and confidence prior to first placements is being evaluated currently and early plans and clearly indicates the advantages of one over the other.
feedback appears to show some success in this respect.
Allowing students to practice set-ups
Demonstrating and exploring radiotherapy techniques Beavis, Phillips and Ward
3
recognised that limited opportunities for practice in
The ability to import plans and associated DICOM data into VERT is presenting useful high pressure radiotherapy departments were a key driver for the development
opportunities to demonstrate and explain radiotherapeutic approaches in lecture and implementation of a hybrid virtual environment. Some techniques are either
and seminar settings (universities), and in planned or ad-hoc tutorial settings relatively uncommon or inherently more demanding. For example, skin apposition
(departments). Users in some universities with their own treatment planning systems techniques (electron set-ups) demand good spatial awareness, psychomotor
are generating a range of typical plans around a particular site and importing them skills and, ultimately, a large amount of experience. The opportunity to be able
into VERT. Using the prostate as an example, three plans may be generated – a simple to practise these in a safe environment is intuitively valuable and the VERT
isocentric technique, a 3D conformal technique and an inverse planned intensity technology facilitates this via the provision of a range of skin apposition technique
modulated radiotherapy (IMRT) technique. Where time allows, students are generating scenarios along with a feature allowing objective assessment of performance.
these plans themselves. Visualisation of these forms the basis for a seminar session Figure 4 illustrates an electron set-up in VERT.
focusing on a discussion of the merits and limitations of the various approaches. The
rationale for using VERT for this purpose lies mainly in the value of 3D visualisation User tracking (Immersive VERT) can further enhance the degree of realism
enhancing students’ understanding of complex 3D phenomena, although the experienced during practicing treatment set-ups. It also minimises the requirement
advantages of the format in terms of its engaging and interactive nature should not be for an independent person to manipulate the view for the user, something which can
underestimated. The ability to manipulate the graphics, introduce set-up errors, overlay increase the incidence of reported ‘simulator sickness’
15
. However, the significance
computed tomography (CT) data, dose colourwashes and dose surface displays, can of user tracking in terms of performance/outcome has yet to be assessed and it
promote a problem based learning approach. must be remembered that its use dictates that sessions are individual; this may be
problematic if student numbers are anything more than minimal.
Integration with in house treatment planning systems for
enhancing plan evaluation
Enhancing learning and teaching of anatomy
A subsidiary use of VERT in relation to that highlighted above lies in its potential The ability to visualise imported CT data; for example, the visible human female
20
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IMAGING & ONCOLOGY
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2009
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