Computer-aided construction and quantitative evaluation of missing-tissue compensators.

We have implemented a system for the design and construction of missing-tissue compensators for Radiation Therapy. The patient topography is obtained by Moire' photography. The thickness of lead required to compensate for a given amount of missing tissue was determined experimentally for three photo-beam energies and a combination of field sizes and geometries. With the aid of a computer, tissue deficit information is converted to isolead-thickness lines. These are used as input to a computer-controlled milling machine to fabricate the compensator. The effectiveness of compensation was evaluated in phantom and in vivo. This work describes the initial effort required to implement a program for compensation of tissue deficit at the patient's surface. It also introduces tools for assessing quantitatively the degree of dose uniformity which can be achieved using compensators in clinical applications.