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Title: SU-F-P-31: Dosimetric Effects of Roll and Pitch Corrections Using Robotic Table

Abstract

Purpose: To quantify the dosimetric effect of roll and pitch corrections being performed by two types of robotic tables available at our institution: BrainLabTM 5DOF robotic table installed at VERO (BrainLab&MHI) dedicated SBRT linear accelerator and 6DOF robotic couch by IBA Proton Therapy with QFixTM couch top. Methods: Planning study used a thorax phantom (CIRSTM), scanned at 4DCT protocol; targets (IGTV, PTV) were determined according to the institutional lung site-specific standards. 12 CT sets were generated with Pitch and Roll angles ranging from −4 to +4 degrees each. 2 table tops were placed onto the scans according to the modality-specific patient treatment workflows. The pitched/rolled CT sets were fused to the original CT scan and the verification treatment plans were generated (12 photon SBRT plans and 12 proton conventional fractionation lung plans). Then the CT sets were fused again to simulate the effect of patient roll/pitch corrections by the robotic table. DVH sets were evaluated for all cases. Results: The effect of not correcting the phantom position for roll/pitch in photon SBRT cases was reducing the target coverage by 2% as maximum; correcting the positional errors by robotic table varied the target coverage within 0.7%. in case of proton treatment,more » not correcting the phantom position led to the coverage loss up to 4%, applying the corrections using robotic table reduced the coverage variation to less than 2% for PTV and within 1% for IGTV. Conclusion: correcting the patient position by using robotic tables is highly preferable, despite the small dosimetric changes introduced by the devices.« less

Authors:
; ; ;  [1]
  1. University of Florida Proton Therapy Institute, Jacksonville, FL (United States)
Publication Date:
OSTI Identifier:
22624470
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; CHEST; COMPUTERIZED TOMOGRAPHY; CORRECTIONS; FRACTIONATION; IMAGE PROCESSING; LINEAR ACCELERATORS; LUNGS; PATIENTS; PHANTOMS; PROTON BEAMS; RADIOTHERAPY; VERIFICATION

Citation Formats

Mamalui, M, Su, Z, Flampouri, S, and Li, Z. SU-F-P-31: Dosimetric Effects of Roll and Pitch Corrections Using Robotic Table. United States: N. p., 2016. Web. doi:10.1118/1.4955738.
Mamalui, M, Su, Z, Flampouri, S, & Li, Z. SU-F-P-31: Dosimetric Effects of Roll and Pitch Corrections Using Robotic Table. United States. doi:10.1118/1.4955738.
Mamalui, M, Su, Z, Flampouri, S, and Li, Z. 2016. "SU-F-P-31: Dosimetric Effects of Roll and Pitch Corrections Using Robotic Table". United States. doi:10.1118/1.4955738.
@article{osti_22624470,
title = {SU-F-P-31: Dosimetric Effects of Roll and Pitch Corrections Using Robotic Table},
author = {Mamalui, M and Su, Z and Flampouri, S and Li, Z},
abstractNote = {Purpose: To quantify the dosimetric effect of roll and pitch corrections being performed by two types of robotic tables available at our institution: BrainLabTM 5DOF robotic table installed at VERO (BrainLab&MHI) dedicated SBRT linear accelerator and 6DOF robotic couch by IBA Proton Therapy with QFixTM couch top. Methods: Planning study used a thorax phantom (CIRSTM), scanned at 4DCT protocol; targets (IGTV, PTV) were determined according to the institutional lung site-specific standards. 12 CT sets were generated with Pitch and Roll angles ranging from −4 to +4 degrees each. 2 table tops were placed onto the scans according to the modality-specific patient treatment workflows. The pitched/rolled CT sets were fused to the original CT scan and the verification treatment plans were generated (12 photon SBRT plans and 12 proton conventional fractionation lung plans). Then the CT sets were fused again to simulate the effect of patient roll/pitch corrections by the robotic table. DVH sets were evaluated for all cases. Results: The effect of not correcting the phantom position for roll/pitch in photon SBRT cases was reducing the target coverage by 2% as maximum; correcting the positional errors by robotic table varied the target coverage within 0.7%. in case of proton treatment, not correcting the phantom position led to the coverage loss up to 4%, applying the corrections using robotic table reduced the coverage variation to less than 2% for PTV and within 1% for IGTV. Conclusion: correcting the patient position by using robotic tables is highly preferable, despite the small dosimetric changes introduced by the devices.},
doi = {10.1118/1.4955738},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: The study compared the dosimetry plans of Stereotatic Body Radiotherapy (SBRT) prostate cancer patients using the M6 Cyberknife with Multi-leaf Collimation (MLC) compared with the plans using G4 Cyberknife with circular collimators. Methods: Eight previously treated prostate cancer patients' SBRT plans using circular collimators, designed with Multiplan v3.5.3, were used as a benchmark. The CT, contours and the optimization scripts were imported into Multiplan v5.0 system and replanned with MLC. The same planning objectives were used: more than 95% of PTV received 36.25Gy, 90% of prostate received 40Gy and maximum dose <45Gy, in five fractions. For organs at risk,more » less than 1cc of rectum received 36Gy and less than 10cc of bladder received 37Gy. Plans were evaluated on parameters derived from dose volume. The beam number, MU and delivery time were recorded to compare the treatment efficiency. Results: The mean CTV volume was 41.3cc (27.5∼57.6cc) and mean PTV volume was 76.77cc (59.1∼99.7cc). The mean PTV coverage was comparable between MLC (98.87%) and cone (98.74%). MLC plans had a slightly more favorable homogeneity index (1.22) and conformity index (1.17), than the cone (1.24 and 1.15). The mean rectum volume of 36 Gy (0.52cc) of MLC plans was slightly larger than cone (0.38cc) and the mean bladder volume of 37 Gy was smaller in MLC (1.82cc) than in cone plans (3.09cc). The mean number of nodes and beams were 65.9 and 80.5 in MLC vs 65.9 and 203.6 in cone. The mean MUs were significantly less for MLC plans (24,228MUs) than cone (32,347MUs). The total delivery time (which included 5 minutes for setup) was less, 29.6min (26∼32min) for MLC vs 45min (35∼55min) for cone. Conclusion: While the differences in the dosimetry between the MLC and circular collimator plans were rather minor, the MLC plans were much more efficient and required significantly less treatment time.« less
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  • Purpose: Image guided radiotherapy (IGRT) using cone beam computed tomography (CBCT) images greatly reduces interfractional patient positional uncertainties. An understanding of uncertainties in the IGRT process itself is essential to ensure appropriate use of this technology. The purpose of this study was to develop a phantom capable of assessing the accuracy of IGRT hardware and software including a 6 degrees of freedom patient positioning system and to investigate the accuracy of the Elekta XVI system in combination with the HexaPOD robotic treatment couch top. Methods: The constructed phantom enabled verification of the three automatic rigid body registrations (gray value, bone,more » seed) available in the Elekta XVI software and includes an adjustable mount that introduces known rotational offsets to the phantom from its reference position. Repeated positioning of the phantom was undertaken to assess phantom rotational accuracy. Using this phantom the accuracy of the XVI registration algorithms was assessed considering CBCT hardware factors and image resolution together with the residual error in the overall image guidance process when positional corrections were performed through the HexaPOD couch system. Results: The phantom positioning was found to be within 0.04 ({sigma}= 0.12) Degree-Sign , 0.02 ({sigma}= 0.13) Degree-Sign , and -0.03 ({sigma}= 0.06) Degree-Sign in X, Y, and Z directions, respectively, enabling assessment of IGRT with a 6 degrees of freedom patient positioning system. The gray value registration algorithm showed the least error in calculated offsets with maximum mean difference of -0.2({sigma}= 0.4) mm in translational and -0.1({sigma}= 0.1) Degree-Sign in rotational directions for all image resolutions. Bone and seed registration were found to be sensitive to CBCT image resolution. Seed registration was found to be most sensitive demonstrating a maximum mean error of -0.3({sigma}= 0.9) mm and -1.4({sigma}= 1.7) Degree-Sign in translational and rotational directions over low resolution images, and this is reduced to -0.1({sigma}= 0.2) mm and -0.1({sigma}= 0.79) Degree-Sign using high resolution images. Conclusions: The phantom, capable of rotating independently about three orthogonal axes was successfully used to assess the accuracy of an IGRT system considering 6 degrees of freedom. The overall residual error in the image guidance process of XVI in combination with the HexaPOD couch was demonstrated to be less than 0.3 mm and 0.3 Degree-Sign in translational and rotational directions when using the gray value registration with high resolution CBCT images. However, the residual error, especially in rotational directions, may increase when the seed registration is used with low resolution images.« less
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