skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Accuracy evaluation of the optical surface monitoring system on EDGE linear accelerator in a phantom study

Abstract

Frameless stereotactic radiosurgery (SRS) requires dedicated systems to monitor the patient position during the treatment to avoid target underdosage due to involuntary shift. The optical surface monitoring system (OSMS) is here evaluated in a phantom-based study. The new EDGE linear accelerator from Varian (Varian, Palo Alto, CA) integrates, for cranial lesions, the common cone beam computed tomography (CBCT) and kV-MV portal images to the optical surface monitoring system (OSMS), a device able to detect real-time patient's face movements in all 6 couch axes (vertical, longitudinal, lateral, rotation along the vertical axis, pitch, and roll). We have evaluated the OSMS imaging capability in checking the phantoms' position and monitoring its motion. With this aim, a home-made cranial phantom was developed to evaluate the OSMS accuracy in 4 different experiments: (1) comparison with CBCT in isocenter location, (2) capability to recognize predefined shifts up to 2° or 3 cm, (3) evaluation at different couch angles, (4) ability to properly reconstruct the surface when the linac gantry visually block one of the cameras. The OSMS system showed, with a phantom, to be accurate for positioning in respect to the CBCT imaging system with differences of 0.6 ± 0.3 mm for linear vector displacement,more » with a maximum rotational inaccuracy of 0.3°. OSMS presented an accuracy of 0.3 mm for displacement up to 1 cm and 1°, and 0.5 mm for larger displacements. Different couch angles (45° and 90°) induced a mean vector uncertainty < 0.4 mm. Coverage of 1 camera produced an uncertainty < 0.5 mm. Translations and rotations of a phantom can be accurately detect with the optical surface detector system.« less

Authors:
; ; ; ; ;
Publication Date:
OSTI Identifier:
22577880
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Dosimetry; Journal Volume: 41; Journal Issue: 2; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; 62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; BEAM MONITORS; BEAM POSITION; BIOMEDICAL RADIOGRAPHY; CAMERAS; COMPUTERIZED TOMOGRAPHY; LINEAR ACCELERATORS; PATIENTS; PHANTOMS; RADIOTHERAPY; SURGERY

Citation Formats

Mancosu, Pietro, Fogliata, Antonella, E-mail: Antonella.Fogliata@humanitas.it, Stravato, Antonella, Tomatis, Stefano, Cozzi, Luca, and Scorsetti, Marta. Accuracy evaluation of the optical surface monitoring system on EDGE linear accelerator in a phantom study. United States: N. p., 2016. Web. doi:10.1016/J.MEDDOS.2015.12.003.
Mancosu, Pietro, Fogliata, Antonella, E-mail: Antonella.Fogliata@humanitas.it, Stravato, Antonella, Tomatis, Stefano, Cozzi, Luca, & Scorsetti, Marta. Accuracy evaluation of the optical surface monitoring system on EDGE linear accelerator in a phantom study. United States. doi:10.1016/J.MEDDOS.2015.12.003.
Mancosu, Pietro, Fogliata, Antonella, E-mail: Antonella.Fogliata@humanitas.it, Stravato, Antonella, Tomatis, Stefano, Cozzi, Luca, and Scorsetti, Marta. 2016. "Accuracy evaluation of the optical surface monitoring system on EDGE linear accelerator in a phantom study". United States. doi:10.1016/J.MEDDOS.2015.12.003.
@article{osti_22577880,
title = {Accuracy evaluation of the optical surface monitoring system on EDGE linear accelerator in a phantom study},
author = {Mancosu, Pietro and Fogliata, Antonella, E-mail: Antonella.Fogliata@humanitas.it and Stravato, Antonella and Tomatis, Stefano and Cozzi, Luca and Scorsetti, Marta},
abstractNote = {Frameless stereotactic radiosurgery (SRS) requires dedicated systems to monitor the patient position during the treatment to avoid target underdosage due to involuntary shift. The optical surface monitoring system (OSMS) is here evaluated in a phantom-based study. The new EDGE linear accelerator from Varian (Varian, Palo Alto, CA) integrates, for cranial lesions, the common cone beam computed tomography (CBCT) and kV-MV portal images to the optical surface monitoring system (OSMS), a device able to detect real-time patient's face movements in all 6 couch axes (vertical, longitudinal, lateral, rotation along the vertical axis, pitch, and roll). We have evaluated the OSMS imaging capability in checking the phantoms' position and monitoring its motion. With this aim, a home-made cranial phantom was developed to evaluate the OSMS accuracy in 4 different experiments: (1) comparison with CBCT in isocenter location, (2) capability to recognize predefined shifts up to 2° or 3 cm, (3) evaluation at different couch angles, (4) ability to properly reconstruct the surface when the linac gantry visually block one of the cameras. The OSMS system showed, with a phantom, to be accurate for positioning in respect to the CBCT imaging system with differences of 0.6 ± 0.3 mm for linear vector displacement, with a maximum rotational inaccuracy of 0.3°. OSMS presented an accuracy of 0.3 mm for displacement up to 1 cm and 1°, and 0.5 mm for larger displacements. Different couch angles (45° and 90°) induced a mean vector uncertainty < 0.4 mm. Coverage of 1 camera produced an uncertainty < 0.5 mm. Translations and rotations of a phantom can be accurately detect with the optical surface detector system.},
doi = {10.1016/J.MEDDOS.2015.12.003},
journal = {Medical Dosimetry},
number = 2,
volume = 41,
place = {United States},
year = 2016,
month = 7
}
  • Purpose: To evaluate the total systematic accuracy of a frameless, image guided stereotactic radiosurgery system. Methods: The localization accuracy and intermodality difference was determined by delivering radiation to an end-to-end prototype phantom, in which the targets were localized using optical surface monitoring system (OSMS), electromagnetic beacon-based tracking (Calypso®), cone-beam CT, “snap-shot” planar x-ray imaging, and a robotic couch. Six IMRT plans with jaw tracking and a flattening filter free beam were used to study the dosimetric accuracy for intracranial and spinal stereotactic radiosurgery treatment. Results: End-to-end localization accuracy of the system evaluated with the end-to-end phantom was 0.5 ± 0.2more » mm with a maximum deviation of 0.9 mm over 90 measurements (including jaw, MLC, and cone measurements for both auto and manual fusion) for single isocenter, single target treatment, 0.6 ± 0.4 mm for multitarget treatment with shared isocenter. Residual setup errors were within 0.1 mm for OSMS, and 0.3 mm for Calypso. Dosimetric evaluation based on absolute film dosimetry showed greater than 90% pass rate for all cases using a gamma criteria of 3%/1 mm. Conclusions: The authors’ experience demonstrates that the localization accuracy of the frameless image-guided system is comparable to robotic or invasive frame based radiosurgery systems.« less
  • The Anisotropic Analytical Algorithm (AAA) is a new pencil beam convolution/superposition algorithm proposed by Varian for photon dose calculations. The configuration of AAA depends on linear accelerator design and specifications. The purpose of this study was to investigate the accuracy of AAA for an Elekta SL25 linear accelerator for small fields and intensity modulated radiation therapy (IMRT) treatments in inhomogeneous media. The accuracy of AAA was evaluated in two studies. First, AAA was compared both with Monte Carlo (MC) and the measurements in an inhomogeneous phantom simulating lung equivalent tissues and bone ribs. The algorithm was tested under lateral electronicmore » disequilibrium conditions, using small fields (2x2 cm{sup 2}). Good agreement was generally achieved for depth dose and profiles, with deviations generally below 3% in lung inhomogeneities and below 5% at interfaces. However, the effects of attenuation and scattering close to the bone ribs were not fully taken into account by AAA, and small inhomogeneities may lead to planning errors. Second, AAA and MC were compared for IMRT plans in clinical conditions, i.e., dose calculations in a computed tomography scan of a patient. One ethmoid tumor, one orophaxynx and two lung tumors are presented in this paper. Small differences were found between the dose volume histograms. For instance, a 1.7% difference for the mean planning target volume dose was obtained for the ethmoid case. Since better agreement was achieved for the same plans but in homogeneous conditions, these differences must be attributed to the handling of inhomogeneities by AAA. Therefore, inherent assumptions of the algorithm, principally the assumption of independent depth and lateral directions in the scaling of the kernels, were slightly influencing AAA's validity in inhomogeneities. However, AAA showed a good accuracy overall and a great ability to handle small fields in inhomogeneous media compared to other pencil beam convolution algorithms.« less
  • Purpose: Dynamic tumor tracking radiation therapy can potentially reduce internal margin without prolongation of irradiation time. However, dynamic tumor tracking technique requires an extra margin (tracking margin, TM) for the uncertainty of tumor localization, prediction, and beam repositioning. The purpose of this study was to evaluate a dosimetric impact caused by TM. Methods: We used 4D XCAT to create 9 digital phantom datasets of different tumor size and motion range: tumor diameter TD=(1, 3, 5) cm and motion range MR=(1, 2, 3) cm. For each dataset, respiratory gating (30%–70% phase) and tumor tracking treatment plans were created using 8-field 3D-CRTmore » by 4D dose calculation implemented in RayStation. The dose constraint was based on RTOG0618. For the tracking plan, TMs of (0, 2.5, 5) mm were considered by surrounding a normal setup margin: SM=5 mm. We calculated V20 of normal lung to evaluate the dosimetric impact for each case, and estimated an equivalent TM that affects the same impact on V20 obtained by the gated plan. Results: The equivalent TMs for (TD=1 cm, MR=2 cm), (TD=1 cm, MR=3 cm), (TD=5 cm, MR=2 cm), and (TD=5 cm, MR=3 cm) were estimated as 1.47 mm, 3.95 mm, 1.04 mm, and 2.13 mm, respectively. The larger the tumor size, the equivalent TM became smaller. On the other hand, the larger the motion range, the equivalent TM was found to be increased. Conclusion: Our results showed the equivalent TM changes depending on tumor size and motion range. The tracking plan with TM less than the equivalent TM achieves a dosimetric impact better than the gated plan in less treatment time. This study was partially supported by JSPS Kakenhi and Varian Medical Systems.« less
  • Purpose: Following the ‘end-to-end testing’ paradigm of Dynamic Target Tracking option in our Image-Guided dedicated SBRT VeroTM linac, we verify the capability of the system to deliver planned dose to moving targets in the heterogeneous thorax phantom (CIRSTM). The system includes gimbaled C-band linac head, robotic 6 degree of freedom couch and a tumor tracking method based on predictive modeling of target position using fluoroscopically tracked implanted markers and optically tracked infrared reflecting external markers. Methods: 4DCT scan of the motion phantom with the VisicoilTM implanted marker in the close vicinity of the target was acquired, the ‘exhale’=most prevalent phasemore » was used for planning (iPlan by BrainLabTM). Typical 3D conformal SBRT treatment plans aimed to deliver 6-8Gy/fx to two types of targets: a)solid water-equivalent target 3cm in diameter; b)single VisicoilTM marker inserted within lung equivalent material. The planning GTV/CTV-to-PTV margins were 2mm, the block margins were 3 mm. The dose calculated by MonteCarlo algorithm with 1% variance using option Dose-to-water was compared to the ion chamber (CC01 by IBA Dosimetry) measurements in case (a) and GafchromicTM EBT3 film measurements in case (b). During delivery, the target 6 motion patterns available as a standard on CIRSTM motion phantom were investigated: in case (a), the target was moving along the designated sine or cosine4 3D trajectory; in case (b), the inserted marker was moving sinusoidally in 1D. Results: The ion chamber measurements have shown the agreement with the planned dose within 1% under all the studied motion conditions. The film measurements show 98.1% agreement with the planar calculated dose (gamma criteria: 3%/3mm). Conclusion: We successfully verified the capability of the SBRT VeroTM linac to perform real-time tumor tracking and accurate dose delivery to the target, based on predictive modeling of the correlation between implanted marker motion and external surrogate of breathing motion.« less
  • Purpose: Dose accuracy has been shown to vary with dose per segment and dose rate when delivered with static multileaf collimator (SMLC) intensity modulated radiation therapy (IMRT) by Varian C-series MLC controllers. The authors investigated the impact of monitor units (MUs) per segment and dose rate on the dose delivery accuracy of SMLC-IMRT fields on a Varian TrueBeam linear accelerator (LINAC), which delivers dose and manages motion of all components using a single integrated controller. Methods: An SMLC sequence was created consisting of ten identical 10 x 10 cm{sup 2} segments with identical MUs. Beam holding between segments was achievedmore » by moving one out-of-field MLC leaf pair. Measurements were repeated for various combinations of MU/segment ranging from 1 to 40 and dose rates of 100-600 MU/min for a 6 MV photon beam (6X) and dose rates of 800-2400 MU/min for a 10 MV flattening-filter free photon (10XFFF) beam. All measurements were made with a Farmer (0.6 cm{sup 3}) ionization chamber placed at the isocenter in a solid-water phantom at 10 cm depth. The measurements were performed on two Varian LINACs: C-series Trilogy and TrueBeam. Each sequence was delivered three times and the dose readings for the corresponding segments were averaged. The effects of MU/segment, dose rate, and LINAC type on the relative dose variation ({Delta}{sub i}) were compared using F-tests ({alpha} = 0.05). Results: On the Trilogy, large {Delta}{sub i} was observed in small MU segments: at 1 MU/segment, the maximum {Delta}{sub i} was 10.1% and 57.9% at 100 MU/min and 600 MU/min, respectively. Also, the first segment of each sequence consistently overshot ({Delta}{sub i} > 0), while the last segment consistently undershot ({Delta}{sub i} < 0). On the TrueBeam, at 1 MU/segment, {Delta}{sub i} ranged from 3.0% to 4.5% at 100 and 600 MU/min; no obvious overshoot/undershoot trend was observed. F-tests showed statistically significant difference [(1 - {beta}) =1.0000] between the Trilogy and the TrueBeam up to 10 MU/segment, at all dose rates greater than 100 MU/min. The linear trend of decreasing dose accuracy as a function of increasing dose rate on the Trilogy is no longer apparent on TrueBeam, even for dose rates as high as 2400 MU/min. Dose inaccuracy averaged over all ten segments in each beam delivery sequence was larger for Trilogy than TrueBeam, with the largest discrepancy (0.2% vs 3%) occurring for 1 MU/segment beams at both 300 and 600 MU/min. Conclusions: Earlier generations of Varian LINACs exhibited large dose variations for small MU segments in SMLC-IMRT delivery. Our results confirmed these findings. The dose delivery accuracy for SMLC-IMRT is significantly improved on TrueBeam compared to Trilogy for every combination of low MU/segment (1-10) and high dose rate (200-600 MU/min), in part due to the faster sampling rate (100 vs 20 Hz) and enhanced electronic integration of the MLC controller with the LINAC. SMLC-IMRT can be implemented on TrueBeam with higher dose accuracy per beam ({+-}0.2% vs {+-}3%) than previous generations of Varian C-series LINACs for 1 MU/segment delivered at 600 MU/min).« less