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What Is a Radiation Therapy Simulator?

A radiation therapy simulator is a device or imaging setup used to plan and rehearse radiation treatment before therapy begins. Modern simulation often uses a CT simulator that captures images in the same position used for treatment. The simulator helps the radiation team map the treatment area and nearby organs. It does not usually deliver the full treatment dose.

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What Is a Radiation Therapy Simulator?

A radiation therapy simulator is a device or imaging setup used to plan and rehearse radiation treatment before therapy begins. Modern simulation often uses a CT simulator that captures images in the same position used for treatment. The simulator helps the radiation team map the treatment area and nearby organs. It does not usually deliver the full treatment dose.

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What Is a Radiation Therapy Simulator Used For?

A radiation therapy simulator is used to plan how radiation beams will be directed safely and accurately. It helps the team define the treatment position, treatment fields, target area, and organs that need protection. Simulation also helps create reference marks, immobilization devices, and image data for treatment planning software. The goal is to make daily radiation treatments more consistent.

How a Radiation Therapy Simulator Works

A CT simulator takes cross-sectional images of the patient in the planned treatment position. The images are transferred to treatment planning software, where the radiation oncologist and planning team outline the tumor or target area and nearby normal tissues. The system helps plan beam angles, shapes, and dose distribution. Room lasers, table positions, and reference marks help reproduce the setup during treatment.

How Is Radiation Simulation Done?

The patient lies on a treatment-style table while the team positions the body carefully. Cushions, molds, masks, or other immobilization devices may be used to help the patient stay still. A CT scan or other imaging is performed, and small skin marks or tattoos may be placed for alignment. After simulation, the planning team creates and checks the treatment plan before the first radiation session.

Safety and Limitations

Radiation simulation involves imaging exposure, but it is used to support accurate treatment planning. The scan does not treat the cancer by itself. Some patients may need contrast material, special breathing instructions, bladder or bowel preparation, or repeated simulation if anatomy changes. Patients should tell the care team about pregnancy, allergies, implanted devices, pain with positioning, or trouble lying still.

FAQs About Radiation Therapy Simulators

Is a radiation therapy simulator the same as a treatment machine?

No. A simulator is used for planning and setup. The treatment machine delivers the prescribed radiation therapy.

Does radiation simulation hurt?

No. The scan itself is not painful, but holding the treatment position can be uncomfortable for some patients.

Why are marks or tattoos used during simulation?

They help the radiation team align the patient in the same position for each treatment session.

Will I get radiation treatment during simulation?

Usually no. Simulation is a planning appointment, not the main treatment session.

References

Radiation Therapy. RadiologyInfo.org. https://www.radiologyinfo.org/en/info/intro_onco. Date Accessed June 16, 2026.

What Goes into Planning Your Radiation Therapy. American Cancer Society. https://www.cancer.org/cancer/managing-cancer/treatment-types/radiation/basics.html. Date Accessed June 16, 2026.

Radiation Therapy Treatment Process. OncoLink. https://www.oncolink.org/cancer-treatment/radiation/introduction-to-radiation-therapy/radiation-therapy-treatment-process. Date Accessed June 16, 2026.

External radiation therapy. Canadian Cancer Society. https://cancer.ca/en/treatments/treatment-types/radiation-therapy/external-radiation-therapy. Date Accessed June 16, 2026.

Radiation Therapy Simulation & Planning. Beth Israel Deaconess Medical Center. https://bidmc.org/services/cancer/treatments/radiation-therapy/simulation-planning. Date Accessed June 16, 2026.