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Investigating end-to-end accuracy of image guided radiation treatment delivery using a micro-irradiator.

Publication ,  Journal Article
Rankine, LJ; Newton, J; Bache, ST; Das, SK; Adamovics, J; Kirsch, DG; Oldham, M
Published in: Phys Med Biol
November 7, 2013

There is significant interest in delivering precisely targeted small-volume radiation treatments, in the pre-clinical setting, to study dose-volume relationships with tumour control and normal tissue damage. For these studies it is vital that image guidance systems and target positioning are accurately aligned (IGRT), in order to deliver dose precisely and accurately according to the treatment plan. In this work we investigate the IGRT targeting accuracy of the X-RAD 225 Cx system from Precision X-Ray using high-resolution 3D dosimetry techniques. Small cylindrical PRESAGE® dosimeters were used with optical-CT readout (DMOS) to verify the accuracy of 2.5, 1.0, and 5.0 mm X-RAD cone attachments. The dosimeters were equipped with four target points, visible on both CBCT and optical-CT, at which a 7-field coplanar treatment plan was delivered with the respective cone. Targeting accuracy (distance to agreement between the target point and delivery isocenter) and cone alignment (isocenter precision under gantry rotation) were measured using the optical-CT images. Optical-CT readout of the first 2.5 mm cone dosimeter revealed a significant targeting error of 2.1 ± 0.6 mm and a cone misalignment of 1.3 ± 0.1 mm. After the IGRT hardware and software had been recalibrated, these errors were reduced to 0.5 ± 0.1 and 0.18 ± 0.04 mm respectively, within the manufacturer specified 0.5 mm. Results from the 1.0 mm cone were 0.5 ± 0.3 mm targeting accuracy and 0.4 ± 0.1 mm cone misalignment, within the 0.5 mm specification. The results from the 5.0 mm cone were 1.0 ± 0.2 mm targeting accuracy and 0.18 ± 0.06 mm cone misalignment, outside of accuracy specifications. Quality assurance of small field IGRT targeting and delivery accuracy is a challenging task. The use of a 3D dosimetry technique, where targets are visible on both CBCT and optical-CT, enabled identification and quantification of a targeting error in 3D. After correction, the targeting accuracy of the irradiator was verified to be within 0.5 mm (or 1.0 mm for the 5.0 mm cone) and the cone alignment was verified to be within 0.2 mm (or 0.4 mm for the 1.0 mm cone). The PRESAGE®/DMOS system proved valuable for end-to-end verification of small field IGRT capabilities.

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Published In

Phys Med Biol

DOI

EISSN

1361-6560

Publication Date

November 7, 2013

Volume

58

Issue

21

Start / End Page

7791 / 7801

Location

England

Related Subject Headings

  • Radiotherapy, Image-Guided
  • Radiometry
  • Nuclear Medicine & Medical Imaging
  • Feasibility Studies
  • Cone-Beam Computed Tomography
  • 5105 Medical and biological physics
  • 1103 Clinical Sciences
  • 0903 Biomedical Engineering
  • 0299 Other Physical Sciences
 

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Rankine, L. J., Newton, J., Bache, S. T., Das, S. K., Adamovics, J., Kirsch, D. G., & Oldham, M. (2013). Investigating end-to-end accuracy of image guided radiation treatment delivery using a micro-irradiator. Phys Med Biol, 58(21), 7791–7801. https://doi.org/10.1088/0031-9155/58/21/7791
Rankine, L. J., J. Newton, S. T. Bache, S. K. Das, J. Adamovics, D. G. Kirsch, and M. Oldham. “Investigating end-to-end accuracy of image guided radiation treatment delivery using a micro-irradiator.Phys Med Biol 58, no. 21 (November 7, 2013): 7791–7801. https://doi.org/10.1088/0031-9155/58/21/7791.
Rankine LJ, Newton J, Bache ST, Das SK, Adamovics J, Kirsch DG, et al. Investigating end-to-end accuracy of image guided radiation treatment delivery using a micro-irradiator. Phys Med Biol. 2013 Nov 7;58(21):7791–801.
Rankine, L. J., et al. “Investigating end-to-end accuracy of image guided radiation treatment delivery using a micro-irradiator.Phys Med Biol, vol. 58, no. 21, Nov. 2013, pp. 7791–801. Pubmed, doi:10.1088/0031-9155/58/21/7791.
Rankine LJ, Newton J, Bache ST, Das SK, Adamovics J, Kirsch DG, Oldham M. Investigating end-to-end accuracy of image guided radiation treatment delivery using a micro-irradiator. Phys Med Biol. 2013 Nov 7;58(21):7791–7801.
Journal cover image

Published In

Phys Med Biol

DOI

EISSN

1361-6560

Publication Date

November 7, 2013

Volume

58

Issue

21

Start / End Page

7791 / 7801

Location

England

Related Subject Headings

  • Radiotherapy, Image-Guided
  • Radiometry
  • Nuclear Medicine & Medical Imaging
  • Feasibility Studies
  • Cone-Beam Computed Tomography
  • 5105 Medical and biological physics
  • 1103 Clinical Sciences
  • 0903 Biomedical Engineering
  • 0299 Other Physical Sciences