Geometric Verification of Dynamic Wave Arc Delivery With the Vero System Using Orthogonal X-ray Fluoroscopic Imaging

Burghelea, M.; Verellen, Dirk; Gevaert, Thierry; Depuydt, Tom; Tournel, Koen; Hung, Cecilia; Simon, V.; Hiraoka, Masahiro; Ridder, Mark De

doi:10.1016/j.ijrobp.2015.02.053

Cited by 13 publications

(11 citation statements)

References 25 publications

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“…Although additional immobilization is unlikely to be necessary for intracranial treatments, this may be a significant issue for other body sites and requires investigation. An alternative linac configuration capable of rotation around the vertical axis allows non-coplanar treatment without patient movement and would address some of these problems [32,33]. However, the reduced range of rotation achievable [32] may limit the utility of this approach for intracranial sites.…”

Section: Region Of Interest/metricmentioning

confidence: 99%

Non-coplanar trajectories to improve organ at risk sparing in volumetric modulated arc therapy for primary brain tumors

Smyth

Evans

Bamber

et al. 2016

Radiotherapy and Oncology

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Section: Region Of Interest/metricmentioning

confidence: 99%

Non-coplanar trajectories to improve organ at risk sparing in volumetric modulated arc therapy for primary brain tumors

Smyth

Evans

Bamber

et al. 2016

Radiotherapy and Oncology

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“…The concept of DWA was developed as "unicursal irradiation" 3 and the geometric verification and quality assurances were subsequently confirmed. 4,5 DWA allows sequential noncoplanar beams to be safely and quickly used without rotating the couch. DWA can be realized with intensity modulated beams, and a new radiation technique that combines DWA with intensity modulation has been developed: volumetric-modulated Dynamic WaveArc therapy (VMDWAT).…”

Section: Introductionmentioning

confidence: 99%

Volumetric modulated Dynamic WaveArc therapy reduces the dose to the hippocampus in patients with pituitary adenomas and craniopharyngiomas

Uto

Mizowaki

Ogura

et al. 2017

Practical Radiation Oncology

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“…Re-verification of the patient setup after or during rotation of the couch is therefore currently required in clinical routine [ 22 , 23 ]. The Wave Arc planning module allows one to design individualized patient treatments, while the Vero’s hardware controller ensures a continuous reliable delivery [ 8 , 9 ]. No additional patient immobilization is required other than that already employed in clinical routine, since the O-ring design allows two-dimensional movements without any couch maneuvering.…”

Section: Discussionmentioning

confidence: 99%

“…The speed of the gantry and ring can be accurately modulated due to the rigid gear transmission design, which allows the system to preserve its rigidity even during complex gantry-ring movements. The theoretical concept of DWA was presented by Mizowaki et al [ 7 ] under the term “3D unicursal irradiation” and the technique was subject to other more technically orientated reports regarding geometrical and dosimetric accuracy [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Initial characterization, dosimetric benchmark and performance validation of Dynamic Wave Arc

et al. 2016

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BackgroundDynamic Wave Arc (DWA) is a clinical approach designed to maximize the versatility of Vero SBRT system by synchronizing the gantry-ring noncoplanar movement with D-MLC optimization. The purpose of this study was to verify the delivery accuracy of DWA approach and to evaluate the potential dosimetric benefits.MethodsDWA is an extended form of VMAT with a continuous varying ring position. The main difference in the optimization modules of VMAT and DWA is during the angular spacing, where the DWA algorithm does not consider the gantry spacing, but only the Euclidian norm of the ring and gantry angle. A preclinical version of RayStation v4.6 (RaySearch Laboratories, Sweden) was used to create patient specific wave arc trajectories for 31 patients with various anatomical tumor regions (prostate, oligometatstatic cases, centrally-located non-small cell lung cancer (NSCLC) and locally advanced pancreatic cancer-LAPC). DWA was benchmarked against the current clinical approaches and coplanar VMAT. Each plan was evaluated with regards to dose distribution, modulation complexity (MCS), monitor units and treatment time efficiency. The delivery accuracy was evaluated using a 2D diode array that takes in consideration the multi-dimensionality of DWA during dose reconstruction.ResultsIn centrally-located NSCLC cases, DWA improved the low dose spillage with 20 %, while the target coverage was increased with 17 % compared to 3D CRT. The structures that significantly benefited from using DWA were proximal bronchus and esophagus, with the maximal dose being reduced by 17 % and 24 %, respectively. For prostate and LAPC, neither technique seemed clearly superior to the other; however, DWA reduced with more than 65 % of the delivery time over IMRT. A steeper dose gradient outside the target was observed for all treatment sites (p < 0.01) with DWA. Except the oligometastatic cases, where the DWA-MCSs indicate a higher modulation, both DWA and VMAT modalities provide plans of similar complexity. The average ɣ (3 % /3 mm) passing rate for DWA plans was 99.2 ± 1 % (range from 96.8 to 100 %).ConclusionsDWA proven to be a fully functional treatment technique, allowing additional flexibility in dose shaping, while preserving dosimetrically robust delivery and treatment times comparable with coplanar VMAT.Electronic supplementary materialThe online version of this article (doi:10.1186/s13014-016-0633-7) contains supplementary material, which is available to authorized users.

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Geometric Verification of Dynamic Wave Arc Delivery With the Vero System Using Orthogonal X-ray Fluoroscopic Imaging

Cited by 13 publications

References 25 publications

Non-coplanar trajectories to improve organ at risk sparing in volumetric modulated arc therapy for primary brain tumors

Non-coplanar trajectories to improve organ at risk sparing in volumetric modulated arc therapy for primary brain tumors

Volumetric modulated Dynamic WaveArc therapy reduces the dose to the hippocampus in patients with pituitary adenomas and craniopharyngiomas

Initial characterization, dosimetric benchmark and performance validation of Dynamic Wave Arc

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