First Demonstration of Combined kV/MV Image-Guided Real-Time Dynamic Multileaf-Collimator Target Tracking

Journal Article · Wed Jul 01 04:00:00 EDT 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.02.012· OSTI ID:21276875

Cho, Byungchul ^[1]; Poulsen, Per R ^[1]; Sloutsky, Alex ^[2]; Sawant, Amit; Keall, Paul J ^[1]

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1. Department of Radiation Oncology, Stanford University, Stanford, CA (United States)
2. Varian Medical Systems, Palo Alto, CA (United States)

Purpose: For intrafraction motion management, a real-time tracking system was developed by combining fiducial marker-based tracking via simultaneous kilovoltage (kV) and megavoltage (MV) imaging and a dynamic multileaf collimator (DMLC) beam-tracking system. Methods and Materials: The integrated tracking system employed a Varian Trilogy system equipped with kV/MV imaging systems and a Millennium 120-leaf MLC. A gold marker in elliptical motion (2-cm superior-inferior, 1-cm left-right, 10 cycles/min) was simultaneously imaged by the kV and MV imagers at 6.7 Hz and segmented in real time. With these two-dimensional projections, the tracking software triangulated the three-dimensional marker position and repositioned the MLC leaves to follow the motion. Phantom studies were performed to evaluate time delay from image acquisition to MLC adjustment, tracking error, and dosimetric impact of target motion with and without tracking. Results: The time delay of the integrated tracking system was {approx}450 ms. The tracking error using a prediction algorithm was 0.9 {+-} 0.5 mm for the elliptical motion. The dose distribution with tracking showed better target coverage and less dose to surrounding region over no tracking. The failure rate of the gamma test (3%/3-mm criteria) was 22.5% without tracking but was reduced to 0.2% with tracking. Conclusion: For the first time, a complete tracking system combining kV/MV image-guided target tracking and DMLC beam tracking was demonstrated. The average geometric error was less than 1 mm, and the dosimetric error was negligible. This system is a promising method for intrafraction motion management.

• OSTI ID: 21276875
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 74; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
COLLIMATORS
COMPUTER CODES
ERRORS
FAILURES
GOLD
IMAGES
NEOPLASMS
PHANTOMS
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
X RADIATION