Quality assurance of Cyberknife robotic stereotactic radiosurgery using an angularly independent silicon detector

Alhujaili, S.; Biasi, Giordano; Alzorkany, F.; Grogan, Garry; Kafi, Abdullah Al; Lane, Jonathan A.; Hug, B.; Aldosari, A. H.; Alshaikh, Sami; Farzad, Pejman Rowshan; Ebert, Martin A.; Moftah, Belal; Rosenfeld, Anatoly B.; Petasecca, Marco

doi:10.1002/acm2.12496

Cited by 11 publications

(9 citation statements)

References 33 publications

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“…This confirms the capability of the sensor to replicate the reference data for the TPS commissioning. The calibration factor is within 5% with data obtained in previous experiments with different generation machines and different diodes [23] confirming the reproducibility and reliability of the diode's response and stability of the fabrication process.…”

Section: Tissue-phantom Ratio (Tpr)supporting

confidence: 81%

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On the evaluation of edgeless diode detectors for patient-specific QA in high-dose stereotactic radiosurgery

et al. 2021

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In this work, the potential of an innovative "edgeless" silicon diode was evaluated as a response to the still unmet need of a reliable tool for plan dosimetry verification of very high dose, non-coplanar, patient-specific radiosurgery treatments. In order to prove the effectiveness of the proposed technology, we focused on radiosurgical treatments for functional disease like tremor or pain. Methods: The edgeless diodes response has been validated with respect to clinical practice standard detectors by reproducing the reference dosimetry data adopted for the Treatment Planning System. In order to evaluate the potential for radiosurgery patient-specific treatment plan verification, the anthropomorphic phantom Alderson RANDO has been adopted along with three edgeless sensors, one placed in the centre of the Planning Target Volume, one superiorly and one inferiorly. Results: The reference dosimetry data obtained from the edgeless detectors are within 2.6% for output factor, offaxis ratio and well within 2% for tissue phantom ratio when compared to PTW 60,018 diode. The edgeless detectors measure a dose discrepancy of approximately 3.6% from the mean value calculated by the TPS. Larger discrepancies are obtained in very steep gradient dose regions when the sensors are placed outside the PTV. Conclusions: The angular independent edgeless diode is proposed as an innovative dosimeter for patient quality assurance of brain functional disorders and other radiosurgery treatments. The comparison of the diode measurements with TPS calculations confirms that edgeless diodes are suitable candidates for patient-specific dosimetric verification in very high dose ranges delivered by non-isocentric stereotactic radiosurgery modalities.

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Section: Tissue-phantom Ratio (Tpr)supporting

confidence: 81%

“…Being non-tissue-equivalent, their response is depth and field-size dependent owing to perturbations to electron and photon fluence spectra introduced by their sensitive volumes and the extra-cameral packaging materials [21,22]. An extensive literature review of the angular dependence of commercial solid-state devices is reported in [23].…”

Section: Introductionmentioning

confidence: 99%

On the evaluation of edgeless diode detectors for patient-specific QA in high-dose stereotactic radiosurgery

et al. 2021

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“…Using such small field sizes, accurate and reliable dose measurements methods are required. 7 , 8 , 9 , 10 , 11 , 12 , 13 …”

Section: Introductionmentioning

confidence: 99%

“…Using such small field sizes, accurate and reliable dose measurements methods are required. [7][8][9][10][11][12][13] Radiochromic films are the gold standard for 2D verification of dose distributions during radiation therapy and for many geometric quality assurance (QA) tests.…”

Section: Introductionmentioning

confidence: 99%

Radioluminescence imaging feasibility for robotic radiosurgery field size quality assurance

et al. 2022

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To investigate the feasibility of radioluminescence imaging (RLI) as a novel 2D quality assurance (QA) dosimetry system for CyberKnife®. Methods: We developed a field size measurement system based on a commercial complementary metal oxide semiconductor (CMOS) camera facing a radioluminescence screen located at the isocenter normal to the beam axis. The radioluminescence light collected by a lens was used to measure 2D dose distributions. An image transformation procedure, based on two reference phantoms, was developed to correct for projective distortion due to the angle (15 • ) between the optical and beam axis. Dose profiles were measured for field sizes ranging from 5 mm to 60 mm using fixed circular and iris collimators and compared against gafchromic (GC) film. The corresponding full width at half maximum (FWHM) was measured using RLI and benchmarked against GC film. A small shift in the source-to-surface distance (SSD) of the measurement plane was intentionally introduced to test the sensitivity of the RLI system to field size variations. To assess reproducibility, the entire RLI procedure was tested by acquiring the 60 mm circle field three times on two consecutive days. Results:The implemented procedure for perspective image distortion correction showed improvements of up to 1 mm using the star phantom against the square phantom. The FWHM measurements using the RLI system indicated a strong agreement with GC film with maximum absolute difference equal to 0.131 mm for fixed collimators and 0.056 mm for the iris. A 2D analysis of RLI with respect to GC film showed that the differences in the central region are negligible, while small discrepancies are in the penumbra region. Changes in field sizes of 0.2 mm were detectable by RLI. Repeatability measurements of the beam FWHM have shown a standard deviation equal to 0.11 mm. Conclusions:The first application of a RLI approach for CyberKnife® field size measurement was presented and tested. Results are in agreement with GC film measurements.Spatial resolution and immediate availability of the data indicate that RLI is a feasible technique for robotic radiosurgery QA.

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“…The small and non-isocentric non-coplanar beams of Cyberknife are characterized by high-dose gradient and a lack of lateral charged particle equilibrium. Therefore, a dosimetric tool with high spatial resolution, tissue equivalence, and directional independence is required ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Assessment of Delivery Quality Assurance for Stereotactic Radiosurgery With Cyberknife

Zhang

Pan

et al. 2021

Front. Oncol.

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PurposeThe purpose of this study is to establish and assess a practical delivery quality assurance method for stereotactic radiosurgery with Cyberknife by analyzing the geometric and dosimetric accuracies obtained using a PTW31016 PinPoint ionization chamber and EBT3 films. Moreover, this study also explores the relationship between the parameters of plan complexity, target volume, and deliverability parameters and provides a valuable reference for improving plan optimization and validation.MethodsOne hundred fifty cases of delivery quality assurance plans were performed on Cyberknife to assess point dose and planar dose distribution, respectively, using a PTW31016 PinPoint ionization chamber and Gafchromic EBT3 films. The measured chamber doses were compared with the planned mean doses in the sensitive volume of the chamber, and the measured planar doses were compared with the calculated dose distribution using gamma index analysis. The gamma passing rates were evaluated using the criteria of 3%/1 mm and 2%/2 mm. The statistical significance of the correlations between the complexity metrics, target volume, and the gamma passing rate were analyzed using Spearman’s rank correlation coefficient.ResultsFor point dose comparison, the averaged dose differences (± standard deviations) were 1.6 ± 0.73% for all the cases. For planar dose distribution, the mean gamma passing rate for 3%/1 mm, and 2%/2 mm evaluation criteria were 94.26% ± 1.89%, and 93.86% ± 2.16%, respectively. The gamma passing rates were higher than 90% for all the delivery quality assurance plans with the criteria of 3%/1 mm and 2%/2 mm. The difference in point dose was lowly correlated with volume of PTV, number of beams, and treatment time for 150 DQA plans, and highly correlated with volume of PTV for 18 DQA plans of small target. DQA gamma passing rate (2%/2 mm) was a moderate significant correlation for the number of nodes, number of beams and treatment time, and a low correlation with MU.ConclusionPTW31016 PinPoint ionization chamber and EBT3 film can be used for routine Cyberknife delivery quality assurance. The point dose difference should be within 3%. The gamma passing rate should be higher than 90% for the criteria of 3%/1 mm and 2%/2 mm. In addition, the plan complexity and PTV volume were found to have some influence on the plan deliverability.

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Quality assurance of Cyberknife robotic stereotactic radiosurgery using an angularly independent silicon detector

Cited by 11 publications

References 33 publications

On the evaluation of edgeless diode detectors for patient-specific QA in high-dose stereotactic radiosurgery

On the evaluation of edgeless diode detectors for patient-specific QA in high-dose stereotactic radiosurgery

Radioluminescence imaging feasibility for robotic radiosurgery field size quality assurance

Assessment of Delivery Quality Assurance for Stereotactic Radiosurgery With Cyberknife

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