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Initial assessment of tumor tracking with a gimbaled linac system in clinical circumstances: A patient simulation study

2013; Elsevier BV; Volume: 106; Issue: 2 Linguagem: Inglês

10.1016/j.radonc.2012.12.015

1879-0887

Tom Depuydt, Kenneth Poels, Dirk Verellen, Benedikt Engels, C. Collen, C. Haverbeke, Thierry Gevaert, Nico Buls, Gert Van Gompel, Truus Reynders, Michaël Duchateau, Koen Tournel, M. Boussaer, Femke Steenbeke, Frederik Vandenbroucke, Mark De Ridder,

Digital Radiography and Breast Imaging

To have an initial assessment of the Vero Dynamic Tracking workflow in clinical circumstances and quantify the performance of the tracking system, a simulation study was set up on 5 lung and liver patients.The preparatory steps of a tumor tracking treatment, based on fiducial markers implanted in the tumor, were executed allowing pursuit of the tumor with the gimbaled linac and monitoring X-rays acquisition, however, without activating the 6 MV beam. Data were acquired on workflow time-efficiency, tracking accuracy and imaging exposure.The average time between the patient entering the treatment room and the first treatment field was about 9 min. The time for building the correlation model was 3.2 min. Tracking errors of 0.55 and 0.95 mm (1σ) were observed in PAN/TILT direction and a 2D range of 3.08 mm. A skin dose was determined of 0.08 mGy/image, with a source-to-skin distance of 900 mm and kV exposure of 1 mAs. On average 1.8 mGy/min kV skin dose was observed for 1 Hz monitoring.The Vero tracking solution proved to be fully functional and showed performance comparable with other real-time tracking systems.