An MRI‐compatible patient rotation system — design, construction, and first organ deformation results

Whelan, Brendan; Liney, Gary; Dowling, Jason; Rai, Robba; Holloway, Lois; McGarvie, Leigh A.; Feain, Ilana; Bartoň, Michael; Berry, Megan; Wilkins, Rob; Keall, Paul J.

doi:10.1002/mp.12065

Cited by 30 publications

(43 citation statements)

References 28 publications

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“…Immobilization improves with increasing airbag pressure as expected, though vertical displacement due to gravity cannot be entirely avoided. Real‐time image guidance could be used to measure and compensate for the vertical displacement, as well as for internal organ deformation due to gravity …”

Section: Resultsmentioning

confidence: 56%

“…This situation does not represent the real use case, where patients undergoing horizontal rotation will be subject to varying amounts of vertical displacement (shown in Fig. ) and internal organ deformation due to gravity . Three essential steps would need to be taken to deliver the 3D conformal treatments described in this manuscript to human patients.…”

Section: Discussionmentioning

confidence: 99%

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Development and commissioning of a full‐size prototype fixed‐beam radiotherapy system with horizontal patient rotation

et al. 2019

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Purpose Compared to conventional linacs with rotating gantries, a fixed‐beam radiotherapy system could be smaller, more robust and more cost‐effective. In this work, we developed and commissioned a prototype x‐ray radiotherapy system utilizing a fixed vertical radiation beam and horizontal patient rotation. Methods The prototype system consists of an Elekta Synergy linac with gantry fixed at 0° and a custom‐built patient rotation system (PRS). The PRS was designed to immobilize patients and safely rotate them about the horizontal axis. The interlocks and emergency stops of the linac and PRS were connected. Custom software was developed to monitor the system status, control the motion of the PRS and modify treatment plans for the fixed‐beam configuration. Following installation, the prototype system was commissioned for three‐dimensional (3D) conformal therapy based on guidelines specified in AAPM TG‐45 and TG‐142, with modifications for the fixed‐beam geometry made where necessary. Results The system and control software was tested in a variety of machine states and executed motion, stop and beam gating commands as expected. Interlocks and emergency stops of the linac and PRS were found to correctly stop PRS motion and both kV and MV radiation beams when triggered. For 3D conformal treatments, the prototype system met all AAPM TG‐45 and TG‐142 specifications for geometric and dosimetric accuracy. Motion of the PRS was within 0.6 ± 0.3 mm and 0.10° ± 0.07° of input values for translation and rotation respectively. The axis of rotation of the PRS was coincident with the radiation beam axis to less than 1 mm. End‐to‐end treatment verification for 6 MV conformal treatments showed less than 2% difference between planned and delivered dose for all fields. Conclusion In this work, we have developed and commissioned a radiotherapy system that utilizes a fixed vertical radiation beam and horizontal patient rotation. This system is a proof‐of‐concept prototype for a fixed‐beam treatment system without a rotating gantry. Fixed‐beam systems that are smaller and more cost‐effective could help in improving global access to radiotherapy.

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Section: Resultsmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Development and commissioning of a full‐size prototype fixed‐beam radiotherapy system with horizontal patient rotation

et al. 2019

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“…[23][24][25][26][27][28] As such, it is not unreasonable to hypothesise that anatomic deformation resulting from rotation could be adapted for. In modern radiotherapy, it is becoming increasingly common to measure and adapt for patient motion, and there is already a great deal of research focused on increasing this capacity.…”

Section: Discussionmentioning

confidence: 99%

“…In modern radiotherapy, it is becoming increasingly common to measure and adapt for patient motion, and there is already a great deal of research focused on increasing this capacity. [23][24][25][26][27][28] As such, it is not unreasonable to hypothesise that anatomic deformation resulting from rotation could be adapted for. However, if patient rotation is to be clinically adopted, future studies will have to quantify patient deformation under rotation, and develop techniques to deliver high-quality radiotherapy in the presence of such deformation.…”

Section: Discussionmentioning

confidence: 99%

Patient reported outcomes of slow, single arc rotation: Do we need rotating gantries?

et al. 2017

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“…4 . 14 A previous publication by Whelan et al 2 showed that rotating a carefully immobilised healthy volunteer by increments of 45°around the craniocaudal axis produced pelvic tissue deformations sufficient to require the adoption of 'an adaptive radiotherapy technique' to ensure accurate delivery of the planned treatment. .do not rotate the lying patient.…”

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confidence: 99%

Patient rotation during linac‐based photon electron radiotherapy

Kairn

2018

J Med Imag Rad Onc

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An MRI‐compatible patient rotation system — design, construction, and first organ deformation results

Cited by 30 publications

References 28 publications

Development and commissioning of a full‐size prototype fixed‐beam radiotherapy system with horizontal patient rotation

Development and commissioning of a full‐size prototype fixed‐beam radiotherapy system with horizontal patient rotation

Patient reported outcomes of slow, single arc rotation: Do we need rotating gantries?

Patient rotation during linac‐based photon electron radiotherapy

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