Do you do a CT simulation for post op heterotopic ossification prophylaxis?

Yes, we treat a fair amount of HO cases at our institution in NJ, and in most cases, at least that I know of, we have always obtained CTs for planning. Honestly, because the anatomy is so straightforward in the hip area to be treated, just plain 2D imaging will suffice. In the old school way, we used calipers to determine midplane, and go from there. It seems with the newer planning systems CTs or similar imaging are a must. Plus, with the young Med Phys folks, the 2D method might throw them off :)

Who still keeps a conventional sim in their dept these days? Ct sim would be the quickest and easiest thing to do, creating a volume to match the traditional angled two field arrangement that's been used in the past.

We usually consult several days before, perform the ct sim and have the plan ready to go before vsim and tx the evening before surgery is scheduled.