Electromagnetic Detection and Real-Time DMLC Adaptation to Target Rotation During Radiotherapy
- Department of Radiation Oncology, Stanford University, Stanford, CA (United States)
- Calypso Medical Technologies, Seattle, WA (United States)
- Varian Medical Systems, Palo Alto, CA (United States)
Purpose: Intrafraction rotation of more than 45 Degree-Sign and 25 Degree-Sign has been observed for lung and prostate tumors, respectively. Such rotation is not routinely adapted to during current radiotherapy, which may compromise tumor dose coverage. The aim of the study was to investigate the geometric and dosimetric performance of an electromagnetically guided real-time dynamic multileaf collimator (DMLC) tracking system to adapt to intrafractional tumor rotation. Materials/Methods: Target rotation was provided by changing the treatment couch angle. The target rotation was measured by a research Calypso system integrated with a real-time DMLC tracking system employed on a Varian linac. The geometric beam-target rotational alignment difference was measured using electronic portal images. The dosimetric accuracy was quantified using a two-dimensional ion chamber array. For each beam, the following five delivery modes were tested: 1) nonrotated target (reference); 2) fixed rotated target with tracking; 3) fixed rotated target without tracking; 4) actively rotating target with tracking; and 5) actively rotating target without tracking. Dosimetric performance of the latter four modes was measured and compared to the reference dose distribution using a 3 mm/3% {gamma}-test. Results: Geometrically, the beam-target rotational alignment difference was 0.3 Degree-Sign {+-} 0.6 Degree-Sign for fixed rotation and 0.3 Degree-Sign {+-} 1.3 Degree-Sign for active rotation. Dosimetrically, the average failure rate for the {gamma}-test for a fixed rotated target was 11% with tracking and 36% without tracking. The average failure rate for an actively rotating target was 9% with tracking and 35% without tracking. Conclusions: For the first time, real-time target rotation has been accurately detected and adapted to during radiation delivery via DMLC tracking. The beam-target rotational alignment difference was mostly within 1 Degree-Sign . Dose distributions to fixed and actively rotating targets with DMLC tracking were significantly superior to those without tracking.
- OSTI ID:
- 22056146
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 82, Issue 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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