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Title: SU-G-TeP2-04: Comprehensive Machine Isocenter Evaluation with Separation of Gantry, Collimator, and Table Variables

Abstract

Purpose: To develop and demonstrate application of a method that characterizes deviation of linac x-ray beams from the centroid of the volumetric radiation isocenter as a function of gantry, collimator, and table variables. Methods: A set of Winston-Lutz ball-bearing images was used to determine the gantry radiation isocenter as the midrange of deviation values resulting from gantry and collimator rotation. Also determined were displacement of table axis from gantry isocenter and recommended table axis adjustment. The method, previously reported, has been extended to include the effect of collimator walkout by obtaining measurements with 0 and 180 degree collimator rotation for each gantry angle. Twelve images were used to characterize the volumetric isocenter for the full range of available gantry, collimator, and table rotations. Results: Three Varian True Beam, two Elekta Infinity and four Versa HD linacs at five institutions were tested using identical methodology. Varian linacs exhibited substantially less deviation due to head sag than Elekta linacs (0.4 mm vs. 1.2 mm on average). One linac from each manufacturer had additional isocenter deviation of 0.3 to 0.4 mm due to jaw instability with gantry and collimator rotation. For all linacs, the achievable isocenter tolerance was dependent on adjustment of collimatormore » position offset, transverse position steering, and alignment of the table axis with gantry isocenter, facilitated by these test results. The pattern and magnitude of table axis wobble vs. table angle was reproducible and unique to each machine. Conclusion: This new method provides a comprehensive set of isocenter deviation values including all variables. It effectively facilitates minimization of deviation between beam center and target (ball-bearing) position. This method was used to quantify the effect of jaw instability on isocenter deviation and to identify the offending jaw. The test is suitable for incorporation into a routine machine QA program. Software development was performed by Radiological Imaging Technology, Inc.« less

Authors:
 [1];  [2]; ;  [3]; ;  [4];  [5];  [6]
  1. Southeast Missouri Hospital, Cape Girardeau, MO (United States)
  2. Radiological Imaging Technology, Colorado Springs, CO (United States)
  3. University Of Iowa, Iowa City, IA (United States)
  4. University of Louisville, Louisville, KY (United States)
  5. Sharp Memorial Hospital, San Diego, CA (United States)
  6. Tri-State Regional Cancer Center, Ashland, KY (United States)
Publication Date:
OSTI Identifier:
22649384
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; BEAMS; BIOMEDICAL RADIOGRAPHY; COLLIMATORS; COMPUTER CODES; IMAGES; LINEAR ACCELERATORS; ROTATION; X RADIATION

Citation Formats

Hancock, S, Clements, C, Hyer, D, Nixon, E, Martin, E, Wang, B, Jani, S, and Gossman, M. SU-G-TeP2-04: Comprehensive Machine Isocenter Evaluation with Separation of Gantry, Collimator, and Table Variables. United States: N. p., 2016. Web. doi:10.1118/1.4957039.
Hancock, S, Clements, C, Hyer, D, Nixon, E, Martin, E, Wang, B, Jani, S, & Gossman, M. SU-G-TeP2-04: Comprehensive Machine Isocenter Evaluation with Separation of Gantry, Collimator, and Table Variables. United States. doi:10.1118/1.4957039.
Hancock, S, Clements, C, Hyer, D, Nixon, E, Martin, E, Wang, B, Jani, S, and Gossman, M. 2016. "SU-G-TeP2-04: Comprehensive Machine Isocenter Evaluation with Separation of Gantry, Collimator, and Table Variables". United States. doi:10.1118/1.4957039.
@article{osti_22649384,
title = {SU-G-TeP2-04: Comprehensive Machine Isocenter Evaluation with Separation of Gantry, Collimator, and Table Variables},
author = {Hancock, S and Clements, C and Hyer, D and Nixon, E and Martin, E and Wang, B and Jani, S and Gossman, M},
abstractNote = {Purpose: To develop and demonstrate application of a method that characterizes deviation of linac x-ray beams from the centroid of the volumetric radiation isocenter as a function of gantry, collimator, and table variables. Methods: A set of Winston-Lutz ball-bearing images was used to determine the gantry radiation isocenter as the midrange of deviation values resulting from gantry and collimator rotation. Also determined were displacement of table axis from gantry isocenter and recommended table axis adjustment. The method, previously reported, has been extended to include the effect of collimator walkout by obtaining measurements with 0 and 180 degree collimator rotation for each gantry angle. Twelve images were used to characterize the volumetric isocenter for the full range of available gantry, collimator, and table rotations. Results: Three Varian True Beam, two Elekta Infinity and four Versa HD linacs at five institutions were tested using identical methodology. Varian linacs exhibited substantially less deviation due to head sag than Elekta linacs (0.4 mm vs. 1.2 mm on average). One linac from each manufacturer had additional isocenter deviation of 0.3 to 0.4 mm due to jaw instability with gantry and collimator rotation. For all linacs, the achievable isocenter tolerance was dependent on adjustment of collimator position offset, transverse position steering, and alignment of the table axis with gantry isocenter, facilitated by these test results. The pattern and magnitude of table axis wobble vs. table angle was reproducible and unique to each machine. Conclusion: This new method provides a comprehensive set of isocenter deviation values including all variables. It effectively facilitates minimization of deviation between beam center and target (ball-bearing) position. This method was used to quantify the effect of jaw instability on isocenter deviation and to identify the offending jaw. The test is suitable for incorporation into a routine machine QA program. Software development was performed by Radiological Imaging Technology, Inc.},
doi = {10.1118/1.4957039},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: The delivery of high quality stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) treatments to the patient requires knowledge of the position of the isocenter to submillimeter accuracy. To meet the requirements the deviation between the radiation and mechanical isocenters must be less than 1 mm. The use of add-on micromultileaf collimators ({mu}MLCs) in SRS and SRT is an additional challenge to the anticipated high-level geometric and dosimetric accuracy of the treatment. The aim of this work was to quantify the gantry excursions during rotation with and without an add-on {mu}MLC attached to the gantry head. In addition, the shiftmore » in the position of the isocenter and its correlation to the kV beam center of the cone-beam CT system was included in the study. Methods: The quantification of the gantry rotational performance was done using a pointer supported by an in-house made rigid holder attached to the gantry head of the accelerator. The pointer positions were measured using a digital theodolite. To quantify the effect of an {mu}MLC of 50 kg, the measurements were repeated with the {mu}MLC attached to the gantry head. The displacement of the isocenter due to an add-on {mu}MLC of 50 kg was also investigated. In case of the pointer measurement the {mu}MLC was simulated by weights attached to the gantry head. A method of least squares was applied to determine the position and displacement of the mechanical isocenter. Additionally, the displacement of the radiation isocenter was measured using a ball-bearing phantom and the electronic portal image device system. These measurements were based on 8 MV photon beams irradiated onto the ball from the four cardinal angles and two opposed collimator angles. The measurements and analysis of the data were carried out automatically using software delivered by the manufacturer. Results: The displacement of the mechanical isocenter caused by a 50 kg heavy {mu}MLC was found to be (-0.01 {+-} 0.05, -0.10 {+-} 0.03, -0.26 {+-} 0.05) mm in lateral, longitudinal, and vertical direction, respectively. Similarly, the displacement of the radiation isocenter was found to be (0.00 {+-} 0.03, -0.08 {+-} 0.06, -0.32 {+-} 0.02) mm. Good agreement was found between the displacement of the two isocenters. A displacement of the kV cone-beam CT beam center due to the attached weight of 50 kg could not be detected. Conclusions: General characteristics of the gantry arm excursions and displacements caused by an add-on {mu}MLC have been reported. A 50 kg heavy add-on {mu}MLC results in a isocenter displacement downward of 0.26-0.32 mm. The authors recommend that the beam center of the kV cone-beam CT image system should be matched to the isocenter related to the weight of the {mu}MLC. Consequently, the imperfections in isocenter localizations are transferred to the conventional radiotherapy where the clinical consequences of uncertainties in the submillimeter regime are negligible.« less
  • Purpose: This study utilizes the Taguchi Method to evaluate the VMAT planning parameters of single isocenter treatment plans for multiple brain metastases. An optimization model based on Taguchi and utility concept is employed to optimize the planning parameters including: arc arrangement, calculation grid size, calculation model, and beam energy on multiple performance characteristics namely conformity index and dose to normal brain. Methods: Treatment plans, each with 4 metastatic brain lesions were planned using single isocenter technique. The collimator angles were optimized to avoid open areas. In this analysis four planning parameters (a–d) were considered: (a)-Arc arrangements: set1: Gantry 181cw179 couch0;more » gantry179ccw0, couch315; and gantry0ccw181, couch45. set2: set1 plus additional arc: Gantry 0cw179, couch270. (b)-Energy: 6-MV; 6MV-FFF (c)-Calculation grid size: 1mm; 1.5mm (d)-Calculation models: AAA; Acuros Treatment planning was performed in Varian Eclipse (ver.11.0.30). A suitable orthogonal array was selected (L8) to perform the experiments. After conducting the experiments with the combinations of planning parameters the conformity index (CI) and the normal brain dose S/N ratio for each parameter was calculated. Optimum levels for the multiple response optimizations were determined. Results: We determined that the factors most affecting the conformity index are arc arrangement and beam energy. These tests were also used to evaluate dose to normal brain. In these evaluations, the significant parameters were grid size and calculation model. Using the utility concept we determined the combination of each of the four factors tested in this study that most significantly influence quality of the resulting treatment plans: (a)-arc arrangement-set2, (b)-6MV, (c)-calc.grid 1mm, (d)-Acuros algorithm. Overall, the dominant significant influences on plan quality are (a)-arcarrangement, and (b)-beamenergy. Conclusion: Results were analyzed using ANOVA and were found to be within the confidence interval. Further investigation using this methodology. Such parameters might include: virtual OAR and optimization criterion such as normal tissue objective.« less
  • Purpose: Determine the shape, size, geometric center, and virtual center of the isocenter for a proton gantry and compare to electron/X-ray accelerator gantries. Methods and materials: The majority of commercial electron/X-ray accelerator gantries consist of a rotating treatment head mounted to a stationary stand through a slewing ring bearing. The world's first proton gantry uses two rotating external rings, to which is mounted a fixed treatment nozzle with a movable snout that extends close to the center of rotation. The radial aspect of the isocenter for two similar proton gantries and two different electron/X-ray gantries were measured in the gantrymore » frame of reference with a front pointer and a theodolite. These results were then transformed into room coordinates. The axial aspect of the isocenter was measured with a dial indicator. Results: The radial aspect of the isocenter for slewing ring gantries has the shape of two concentric circles. The radial aspect of the isocenter for external ring gantries is shaped like a butterfly. The size of the mechanical isocenter is independent of the gantry style. Conclusions: The locations of the geometric and virtual centers can be determined to within 0.2 mm. Multiple gantry angle treatments can be delivered with a single setup allowing 2 mm for gantry and nozzle deflections. Precision treatments can be delivered allowing only 0.5 mm if the measured isocenter path is applied.« less
  • Purpose: The Mevion proton therapy machine is the first to feature a gantry mounted sychro-cyclotron. In addition, the system utilizes a 6D motion couch and kV imaging for precise proton therapy. To quantify coincidence between these systems, isocentricity tests were performed based on kV imaging alignment using radiochromic film. Methods: The 100 ton gantry and 6D robotic couch can rotate 190° around isocenter to provide necessary beam angles for treatment. The kV sources and detector panels are deployed as needed to acquire orthogonal portals. Gantry and couch mechanical isocenter were tested using star-shots and radiochromic-film (RCF). Using kV imaging, themore » star-shot phantom was aligned to an embedded fiducial and the isocenter was marked on RCF with a pinprick. The couch and gantry stars were performed by irradiating films at every 45° and 30°, respectively. A proton beam with a range and modulation-width of 18 cm was used. A Winston-Lutz test was also performed at the same gantry and couch rotations using a custom jig holding RCF and a tungsten ball placed at isocenter. A 2 cm diameter circular aperture was used for the irradiation. Results: The couch star-shot indicated a minimum tangent circle of 0.6 mm, with a 0.9 mm offset from the manually marked isocenter. The gantry star-shot showed a 0.6 mm minimum tangent circle with a 0.5 mm offset from the pinprick. The Winston Lutz test performed for gantry rotation showed a maximum deviation from center of 0.5 mm. Conclusion: Based on star-shots and Winston-Lutz tests, the proton gantry and 6D couch isocentricity are within 1 mm. In this study, we have shown that the methods commonly utilized for Linac characterization can be applied to proton therapy. This revolutionary proton therapy system possesses excellent agreement between the mechanical and radiation isocenter, providing highly precise treatment.« less
  • Purpose: For stereotactic radiosurgery, the AAPM Report No. 54 [AAPM Task Group 42 (AAPM, 1995)] requires the overall stability of the isocenter (couch, gantry, and collimator) to be within a 1 mm radius. In reality, a rotating system has no rigid axis and thus no isocenter point which is fixed in space. As a consequence, the isocenter concept is reviewed here. It is the aim to develop a measurement method following the revised definitions. Methods: The mechanical isocenter is defined here by the point which rotates on the shortest path in the room coordinate system. The path is labeled asmore » “isocenter path.” Its center of gravity is assumed to be the mechanical isocenter. Following this definition, an image-based and radiation-free measurement method was developed. Multiple marker pairs in a plane perpendicular to the assumed gantry rotation axis of a linear accelerator are imaged with a smartphone application from several rotation angles. Each marker pair represents an independent measuring system. The room coordinates of the isocenter path and the mechanical isocenter are calculated based on the marker coordinates. The presented measurement method is by this means strictly focused on the mechanical isocenter. Results: The measurement result is available virtually immediately following completion of measurement. When 12 independent measurement systems are evaluated, the standard deviations of the isocenter path points and mechanical isocenter coordinates are 0.02 and 0.002 mm, respectively. Conclusions: The measurement is highly accurate, time efficient, and simple to adapt. It is therefore suitable for regular checks of the mechanical isocenter characteristics of the gantry and collimator rotation axis. When the isocenter path is reproducible and its extent is in the range of the needed geometrical accuracy, it should be taken into account in the planning process. This is especially true for stereotactic treatments and radiosurgery.« less