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      A novel method for monitoring the constancy of beam path accuracy in CyberKnife†

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          Abstract

          The aim of current work was to present a novel evaluation procedure implemented for checking the constancy of beam path accuracy of a CyberKnife system based on ArcCHECK. A tailor‐made Styrofoam with four implanted fiducial markers was adopted to enable the fiducial tracking during beam deliveries. A simple two‐field plan and an isocentric plan were created for determining the density override of Arc CHECK in MultiPlan and the constancy of beam path accuracy respectively. Correlation curves for all diodes involved in the study were obtained by analyzing the dose distributions calculated by MultiPlan after introducing position shifts in anteroposterior, superoinferior, and left–right directions. The ability of detecting systematic position error was also evaluated by changing the position of alignment center intentionally. The one standard deviation ( SD) result for reproducibility test showed the RMS of 0.054 mm and the maximum of 0.263 mm, which was comparable to the machine self‐test result. The mean of absolute value of position errors in the constancy test was measured to 0.091 mm with a SD of 0.035 mm, while the root‐mean‐square was 0.127 mm with a SD of 0.034 mm. All introduced systematic position errors range from 0.3 to 2 mm were detected successfully. Efficient method for evaluating the constancy of beam path accuracy of CyberKnife has been developed and proven to be sensitive enough for detecting a systematic drift of robotic manipulator. Once the workflow is streamlined, our proposed method will be an effective and easy quality assurance procedure for medical physicists.

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          Most cited references19

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          The CyberKnife Robotic Radiosurgery System in 2010.

          This review provides a complete technical description of the CyberKnife VSI System, the latest addition to the CyberKnife product family, which was released in September 2009. This review updates the previous technical reviews of the original system version published in the late 1990s. Technical developments over the last decade have impacted virtually every aspect of the CyberKnife System. These developments have increased the geometric accuracy of the system and have enhanced the dosimetric accuracy and quality of treatment, with advanced inverse treatment planning algorithms, rapid Monte Carlo dose calculation, and post-processing tools that allow trade-offs between treatment efficiency and dosimetric quality to be explored. This review provides a system overview with detailed descriptions of key subsystems. A detailed review of studies of geometric accuracy is also included, reporting a wide range of experiments involving phantom tests and patient data. Finally, the relationship between technical developments and the greatly increased range of clinical applications they have allowed is reviewed briefly.
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            Report of AAPM TG 135: quality assurance for robotic radiosurgery.

            The task group (TG) for quality assurance for robotic radiosurgery was formed by the American Association of Physicists in Medicine's Science Council under the direction of the Radiation Therapy Committee and the Quality Assurance (QA) Subcommittee. The task group (TG-135) had three main charges: (1) To make recommendations on a code of practice for Robotic Radiosurgery QA; (2) To make recommendations on quality assurance and dosimetric verification techniques, especially in regard to real-time respiratory motion tracking software; (3) To make recommendations on issues which require further research and development. This report provides a general functional overview of the only clinically implemented robotic radiosurgery device, the CyberKnife. This report includes sections on device components and their individual component QA recommendations, followed by a section on the QA requirements for integrated systems. Examples of checklists for daily, monthly, annual, and upgrade QA are given as guidance for medical physicists. Areas in which QA procedures are still under development are discussed.
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              Evaluation of the ArcCHECK QA system for IMRT and VMAT verification.

              The purposes of this study were to perform tests for the ArcCHECK QA system, and to evaluate the suitability of this system for IMRT and VMAT verification. The device was tested for short term reproducibility, dose linearity, dose rate dependence, dose per pulse dependence, field size dependence, out of field dependence and directional dependence. Eight simple plans that each used four beams of different field sizes as well as IMRT and VMAT plans for various organs of 10 patients were measured by ArcCHECK. The phantom data was then compared with ion chamber measurements and planned results. The ArcCHECK diodes performed well for all tests except directional dependence, which varies from a minimum of -4.9% (seen only when the beam is incident on the diode at 180°) to a maximum of 9.1% (approximately at 105°). For simple plan verification, the absolute dose pass rates of γ index (3%/3 mm) were almost identical. They had an average pass rate of 94.6% ± 1.3% when the field size was ≤20 cm in the X direction (right to left direction), but the pass rate fell rapidly when the field size was >20 cm in the X direction. For all patient-specific IMRT and VMAT QA, the pass rates exceeded 95% and 93%, respectively, and high reproducibility of these results has been observed from week to week. The comparative measurements show that the ArcCHECK QA system is completely suitable for clinical IMRT and VMAT verification. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                kimi.b.yang@hksh.com
                Journal
                J Appl Clin Med Phys
                J Appl Clin Med Phys
                10.1002/(ISSN)1526-9914
                ACM2
                Journal of Applied Clinical Medical Physics
                John Wiley and Sons Inc. (Hoboken )
                1526-9914
                19 April 2019
                May 2019
                : 20
                : 5 ( doiID: 10.1002/acm2.2019.20.issue-5 )
                : 109-119
                Affiliations
                [ 1 ] Medical Physics and Research Department Hong Kong Sanatorium & Hospital Hong Kong Hong Kong
                Author notes
                [*] [* ] Author to whom correspondence should be addressed. Bin Yang

                E‐mail: kimi.b.yang@ 123456hksh.com

                Article
                ACM212585
                10.1002/acm2.12585
                6523015
                31004395
                0cc024a9-5a19-4850-b74b-20f7e2f90c19
                © 2019 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 October 2018
                : 18 March 2019
                : 23 March 2019
                Page count
                Figures: 9, Tables: 2, Pages: 11, Words: 5200
                Categories
                87.55.Qr
                87.55.n-
                87.56.Fc
                Radiation Oncology Physics
                Radiation Oncology Physics
                Custom metadata
                2.0
                acm212585
                May 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.3 mode:remove_FC converted:16.05.2019

                arccheck,beam path accuracy,cyberknife,quality assurance

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