Development and Longitudinal Analysis of Plan-Based Streamlined Quality Assurance on Multiple Positioning Guidance Systems With Single Phantom Setup
This study was to propose and validate an efficient and streamlined quality assurance (QA) method with a single phantom setup to check performances of patient positioning guidance systems including six-degree-of-freedom (6DoF) couch, X-ray modalities (kV-kV, MV-MV and CBCT), optical surface imaging...
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| Vydáno v: | Frontiers in oncology Ročník 11; s. 683733 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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Switzerland
Frontiers Media S.A
16.06.2021
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| ISSN: | 2234-943X, 2234-943X |
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| Abstract | This study was to propose and validate an efficient and streamlined quality assurance (QA) method with a single phantom setup to check performances of patient positioning guidance systems including six-degree-of-freedom (6DoF) couch, X-ray modalities (kV-kV, MV-MV and CBCT), optical surface imaging system (AlignRT), lasers and optical distance indicator (ODI).
The QA method was based on a pseudo-patient treatment plan using the AlignRT cube phantom. The cube was first randomly set up on the couch, and the initial position offsets were acquired by AlignRT and CBCT. The cube was restored to its reference position by 6DoF couch shift, during which the couch motion accuracy and tracking performances of AlignRT and CBCT were derived. After that, the residual offsets were acquired by kV-kV, MV-MV and AlignRT to derive the isocenter discrepancies. Finally, the laser alignment and ODI values were visually inspected. The QA procedure had been internally approved as a standard weekly QA test, and the results over 50 weeks were longitudinally analyzed for clinical validation.
The 6DoF couch motion errors as well as the tracking errors of AlignRT were sub-millimeter and sub-degree, and no deviation over 1 mm or 1 deg was identified. The ROI mode of isocenter (ISO) in AlignRT exhibited more consistent results than the centroid (CEN). While the isocenter discrepancy between CBCT and kV-kV was negligible, the maximal discrepancies between CBCT and MV-MV were 0.4 mm in LNG and 0.3 deg in PITCH. The isocenter discrepancies between CBCT and AlignRT were <0.5 mm in translation and <0.3 deg in rotation. For AlignRT, the isocenter discrepancies between the DICOM and SGRT references were about 0.6 mm in VRT, 0.5 mm in LNG and 0.2 deg in PITCH. As the therapists became familiar with the workflow, the average time to complete the whole procedure was around 23 min.
The streamlined QA exhibits desirable practicality as an efficient multipurpose performance check on positioning guidance systems. The stability, tracking performance and isocenter congruence of the positioning guidance systems have been fully validated for all clinical image guidance RT application, even SRS/SBRT, which requires the strictest tolerance. |
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| AbstractList | This study was to propose and validate an efficient and streamlined quality assurance (QA) method with a single phantom setup to check performances of patient positioning guidance systems including six-degree-of-freedom (6DoF) couch, X-ray modalities (kV-kV, MV-MV and CBCT), optical surface imaging system (AlignRT), lasers and optical distance indicator (ODI).
The QA method was based on a pseudo-patient treatment plan using the AlignRT cube phantom. The cube was first randomly set up on the couch, and the initial position offsets were acquired by AlignRT and CBCT. The cube was restored to its reference position by 6DoF couch shift, during which the couch motion accuracy and tracking performances of AlignRT and CBCT were derived. After that, the residual offsets were acquired by kV-kV, MV-MV and AlignRT to derive the isocenter discrepancies. Finally, the laser alignment and ODI values were visually inspected. The QA procedure had been internally approved as a standard weekly QA test, and the results over 50 weeks were longitudinally analyzed for clinical validation.
The 6DoF couch motion errors as well as the tracking errors of AlignRT were sub-millimeter and sub-degree, and no deviation over 1 mm or 1 deg was identified. The ROI mode of isocenter (ISO) in AlignRT exhibited more consistent results than the centroid (CEN). While the isocenter discrepancy between CBCT and kV-kV was negligible, the maximal discrepancies between CBCT and MV-MV were 0.4 mm in LNG and 0.3 deg in PITCH. The isocenter discrepancies between CBCT and AlignRT were <0.5 mm in translation and <0.3 deg in rotation. For AlignRT, the isocenter discrepancies between the DICOM and SGRT references were about 0.6 mm in VRT, 0.5 mm in LNG and 0.2 deg in PITCH. As the therapists became familiar with the workflow, the average time to complete the whole procedure was around 23 min.
The streamlined QA exhibits desirable practicality as an efficient multipurpose performance check on positioning guidance systems. The stability, tracking performance and isocenter congruence of the positioning guidance systems have been fully validated for all clinical image guidance RT application, even SRS/SBRT, which requires the strictest tolerance. PurposeThis study was to propose and validate an efficient and streamlined quality assurance (QA) method with a single phantom setup to check performances of patient positioning guidance systems including six-degree-of-freedom (6DoF) couch, X-ray modalities (kV–kV, MV–MV and CBCT), optical surface imaging system (AlignRT), lasers and optical distance indicator (ODI).Methods and MaterialsThe QA method was based on a pseudo-patient treatment plan using the AlignRT cube phantom. The cube was first randomly set up on the couch, and the initial position offsets were acquired by AlignRT and CBCT. The cube was restored to its reference position by 6DoF couch shift, during which the couch motion accuracy and tracking performances of AlignRT and CBCT were derived. After that, the residual offsets were acquired by kV–kV, MV–MV and AlignRT to derive the isocenter discrepancies. Finally, the laser alignment and ODI values were visually inspected. The QA procedure had been internally approved as a standard weekly QA test, and the results over 50 weeks were longitudinally analyzed for clinical validation.ResultsThe 6DoF couch motion errors as well as the tracking errors of AlignRT were sub-millimeter and sub-degree, and no deviation over 1 mm or 1 deg was identified. The ROI mode of isocenter (ISO) in AlignRT exhibited more consistent results than the centroid (CEN). While the isocenter discrepancy between CBCT and kV–kV was negligible, the maximal discrepancies between CBCT and MV–MV were 0.4 mm in LNG and 0.3 deg in PITCH. The isocenter discrepancies between CBCT and AlignRT were <0.5 mm in translation and <0.3 deg in rotation. For AlignRT, the isocenter discrepancies between the DICOM and SGRT references were about 0.6 mm in VRT, 0.5 mm in LNG and 0.2 deg in PITCH. As the therapists became familiar with the workflow, the average time to complete the whole procedure was around 23 min.ConclusionsThe streamlined QA exhibits desirable practicality as an efficient multipurpose performance check on positioning guidance systems. The stability, tracking performance and isocenter congruence of the positioning guidance systems have been fully validated for all clinical image guidance RT application, even SRS/SBRT, which requires the strictest tolerance. This study was to propose and validate an efficient and streamlined quality assurance (QA) method with a single phantom setup to check performances of patient positioning guidance systems including six-degree-of-freedom (6DoF) couch, X-ray modalities (kV-kV, MV-MV and CBCT), optical surface imaging system (AlignRT), lasers and optical distance indicator (ODI).PURPOSEThis study was to propose and validate an efficient and streamlined quality assurance (QA) method with a single phantom setup to check performances of patient positioning guidance systems including six-degree-of-freedom (6DoF) couch, X-ray modalities (kV-kV, MV-MV and CBCT), optical surface imaging system (AlignRT), lasers and optical distance indicator (ODI).The QA method was based on a pseudo-patient treatment plan using the AlignRT cube phantom. The cube was first randomly set up on the couch, and the initial position offsets were acquired by AlignRT and CBCT. The cube was restored to its reference position by 6DoF couch shift, during which the couch motion accuracy and tracking performances of AlignRT and CBCT were derived. After that, the residual offsets were acquired by kV-kV, MV-MV and AlignRT to derive the isocenter discrepancies. Finally, the laser alignment and ODI values were visually inspected. The QA procedure had been internally approved as a standard weekly QA test, and the results over 50 weeks were longitudinally analyzed for clinical validation.METHODS AND MATERIALSThe QA method was based on a pseudo-patient treatment plan using the AlignRT cube phantom. The cube was first randomly set up on the couch, and the initial position offsets were acquired by AlignRT and CBCT. The cube was restored to its reference position by 6DoF couch shift, during which the couch motion accuracy and tracking performances of AlignRT and CBCT were derived. After that, the residual offsets were acquired by kV-kV, MV-MV and AlignRT to derive the isocenter discrepancies. Finally, the laser alignment and ODI values were visually inspected. The QA procedure had been internally approved as a standard weekly QA test, and the results over 50 weeks were longitudinally analyzed for clinical validation.The 6DoF couch motion errors as well as the tracking errors of AlignRT were sub-millimeter and sub-degree, and no deviation over 1 mm or 1 deg was identified. The ROI mode of isocenter (ISO) in AlignRT exhibited more consistent results than the centroid (CEN). While the isocenter discrepancy between CBCT and kV-kV was negligible, the maximal discrepancies between CBCT and MV-MV were 0.4 mm in LNG and 0.3 deg in PITCH. The isocenter discrepancies between CBCT and AlignRT were <0.5 mm in translation and <0.3 deg in rotation. For AlignRT, the isocenter discrepancies between the DICOM and SGRT references were about 0.6 mm in VRT, 0.5 mm in LNG and 0.2 deg in PITCH. As the therapists became familiar with the workflow, the average time to complete the whole procedure was around 23 min.RESULTSThe 6DoF couch motion errors as well as the tracking errors of AlignRT were sub-millimeter and sub-degree, and no deviation over 1 mm or 1 deg was identified. The ROI mode of isocenter (ISO) in AlignRT exhibited more consistent results than the centroid (CEN). While the isocenter discrepancy between CBCT and kV-kV was negligible, the maximal discrepancies between CBCT and MV-MV were 0.4 mm in LNG and 0.3 deg in PITCH. The isocenter discrepancies between CBCT and AlignRT were <0.5 mm in translation and <0.3 deg in rotation. For AlignRT, the isocenter discrepancies between the DICOM and SGRT references were about 0.6 mm in VRT, 0.5 mm in LNG and 0.2 deg in PITCH. As the therapists became familiar with the workflow, the average time to complete the whole procedure was around 23 min.The streamlined QA exhibits desirable practicality as an efficient multipurpose performance check on positioning guidance systems. The stability, tracking performance and isocenter congruence of the positioning guidance systems have been fully validated for all clinical image guidance RT application, even SRS/SBRT, which requires the strictest tolerance.CONCLUSIONSThe streamlined QA exhibits desirable practicality as an efficient multipurpose performance check on positioning guidance systems. The stability, tracking performance and isocenter congruence of the positioning guidance systems have been fully validated for all clinical image guidance RT application, even SRS/SBRT, which requires the strictest tolerance. |
| Author | Wang, Meijiao Wu, Hao Du, Yi Yue, Haizhen Li, Junyu Zhou, Shun Yu, Songmao |
| AuthorAffiliation | 1 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute , Beijing , China 2 Institute of Medical Technology, Peking University Health Science Center , Beijing , China |
| AuthorAffiliation_xml | – name: 1 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute , Beijing , China – name: 2 Institute of Medical Technology, Peking University Health Science Center , Beijing , China |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34222005$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1118/1.3681967 10.1201/9780429489402 10.1088/1361-6560/ab8534 10.1002/acm2.12072 10.1016/j.ijrobp.2015.07.815 10.1002/acm2.12064 10.1016/j.prro.2011.04.005 10.1118/1.4960369 10.37206/104 10.1186/s13014-015-0381-0 10.1118/1.3438081 10.1016/j.meddos.2015.12.003 10.1016/S0360-3016(97)00567-1 10.1002/acm2.12723 10.1002/mp.12950 10.1002/acm2.12183 10.1227/NEU.0b013e3182647ad5 10.1118/1.3190392 10.1016/j.prro.2013.01.004 |
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| Keywords | image guided radiotherapy positioning guidance surface imaging quality assurance robotic couch |
| Language | English |
| License | Copyright © 2021 Zhou, Li, Du, Yu, Wang, Wu and Yue. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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| References | Kang (B9) 2019; 20 Clivio (B11) 2015; 10 Barnes (B12) 2017; 18 Willoughby (B6) 2012; 39 Barnes (B13) 2017; 18 Klein (B5) 2009; 36 Mancosu (B15) 2016; 41 Hoisak (B20) 2020 Yin (B4) 2009 Benedict (B1) 2010; 37 Pan (B17) 2012; 71 Pham (B19) 2014; 3 Cerviño (B18) 2012; 2 Cook (B7) 2016; 43 Stanley (B16) 2017; 18 Yu (B8) 2018; 45 Barnes (B14) 2017; 18 Yan (B2) 1998; 41 Jaffray (B3) 2013; 3 Capaldi (B10) 2020; 65 |
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| Title | Development and Longitudinal Analysis of Plan-Based Streamlined Quality Assurance on Multiple Positioning Guidance Systems With Single Phantom Setup |
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