Dosimetric and Mechanical Stability of CyberKnife  Robotic Radiosurgery Unit: 5 Years’ Clinical Experience

Biltekin, Fatih

doi:10.5505/tjo.2016.1434

Cited by 4 publications

(5 citation statements)

References 20 publications

(22 reference statements)

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“…Change in output trending upward over time (due to changes within the monitor chambers), after the first few months following commissioning is common and has been reported on previously 28–31 . The stability of the ZAP‐X output from the time that the unit was in clinical use, is similar to what has been reported for other SRS treatment units (∼2%–5%) 30–36 . Change in our ZAP‐X beam energy over 2 years was within ± 1.0% and the change in beam profiles (acquired in a water tank for annual QA) was within 1% compared to the post processed beam data entered into the TPS, within the ± 2% tolerance for both recommended in TG‐135 8 for robotic radiosurgery.…”

Section: Discussionsupporting

confidence: 77%

“…[28][29][30][31] The stability of the ZAP-X output from the time that the unit was in clinical use, is similar to what has been reported for other SRS treatment units (∼2%-5%). [30][31][32][33][34][35][36] Change in our ZAP-X beam energy over 2 years was within ± 1.0% and the change in beam profiles (acquired in a water tank for annual QA) was within 1% compared to the post processed beam data entered into the TPS, within the ± 2% tolerance for both recommended in TG-135 8 for robotic radiosurgery. The beam energy was lower by 0.5% percentage compared to the original baseline values following linac replacement in early 2020, and therefore not re-baselined.…”

Section: Discussionmentioning

confidence: 51%

“…Average total targeting errors observed for the ZAP‐X are similar to those reported for E2E tests performed on other SRS systems. Targeting errors of 0.4–0.5 mm have been reported for E2E tests on the CK system using the 6D skull tracking algorithm 26,32,38 while mean 2D E2E targeting errors of 0.429 mm (maximum: 0.718 mm) and 0.225 mm (maximum: 0.284 mm) have been reported for framed and frameless GK 39 …”

Section: Discussionmentioning

confidence: 99%

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Machine performance and stability of the first clinical self‐shielded stereotactic radiosurgery system: Initial 2‐year experience

Srivastava

Sorensen

Jani

et al. 2022

J Applied Clin Med Phys

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This study provides insight into the overall system performance, stability, and delivery accuracy of the first clinical self‐shielded stereotactic radiosurgery (SRS) system. Quality assurance procedures specifically developed for this unit are discussed, and trends and variations over the course of 2‐years for beam constancy, targeting and dose delivery are presented. Absolute dose calibration for this 2.7 MV unit is performed to deliver 1 cGy/MU at dmax = 7 mm at a source‐to‐axis‐distance (SAD) of 450 mm for a 25 mm collimator. Output measurements were made with 2‐setups: a device that attaches to a fixed position on the couch (daily) and a spherical phantom that attaches to the collimating wheel (monthly). Beam energy was measured using a cylindrical acrylic phantom at depths of 100 (D10) and 200 (D20) mm. Beam profiles were evaluated using Gafchromic film and compared with TPS beam data. Accuracy in beam targeting was quantified with the Winston‐Lutz (WL) and end‐to‐end (E2E) tests. Delivery quality assurance (DQA) was performed prior to clinical treatments using Gafchromic EBT3/XD film. Net cumulative output adjustments of 15% (pre‐clinical), 9% (1st year) and 3% (2nd year) were made. The mean output was 0.997 ± 0.010 cGy/MU (range: 0.960–1.046 cGy/MU) and 0.993 ± 0.029 cGy/MU (range: 0.884–1.065 cGy/MU) for measurements with the daily and monthly setups, respectively. The mean relative beam energy (D10/D20) was 0.998 ± 0.004 (range: 0.991–1.006). The mean total targeting error was 0.46 ± 0.17 mm (range: 0.06–0.98 mm) for the WL and 0.52 ± 0.28 mm (range: 0.11–1.27 mm) for the E2E tests. The average gamma pass rates for DQA measurements were 99.0% and 90.5% for 2%/2 mm and 2%/1 mm gamma criteria, respectively. This SRS unit meets tolerance limits recommended by TG‐135, MPPG 9a., and TG‐142 with a treatment delivery accuracy similar to what is achieved by other SRS systems.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Machine performance and stability of the first clinical self‐shielded stereotactic radiosurgery system: Initial 2‐year experience

Srivastava

Sorensen

Jani

et al. 2022

J Applied Clin Med Phys

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“…The rationale behind step 1 and 3 described in Section 2.D is that the CyberKnife is proven to be very stable by many centers . The possibility of a sudden and large drift of the robot mastering is very low during routine operation and treatment.…”

Section: Discussionmentioning

confidence: 99%

A novel method for monitoring the constancy of beam path accuracy in CyberKnife

Yang

Wong

Lam

et al. 2019

J Applied Clin Med Phys

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The aim of current work was to present a novel evaluation procedure implemented for checking the constancy of beam path accuracy of a CyberKnife system based on ArcCHECK. A tailor‐made Styrofoam with four implanted fiducial markers was adopted to enable the fiducial tracking during beam deliveries. A simple two‐field plan and an isocentric plan were created for determining the density override of ArcCHECK in MultiPlan and the constancy of beam path accuracy respectively. Correlation curves for all diodes involved in the study were obtained by analyzing the dose distributions calculated by MultiPlan after introducing position shifts in anteroposterior, superoinferior, and left–right directions. The ability of detecting systematic position error was also evaluated by changing the position of alignment center intentionally. The one standard deviation (SD) result for reproducibility test showed the RMS of 0.054 mm and the maximum of 0.263 mm, which was comparable to the machine self‐test result. The mean of absolute value of position errors in the constancy test was measured to 0.091 mm with a SD of 0.035 mm, while the root‐mean‐square was 0.127 mm with a SD of 0.034 mm. All introduced systematic position errors range from 0.3 to 2 mm were detected successfully. Efficient method for evaluating the constancy of beam path accuracy of CyberKnife has been developed and proven to be sensitive enough for detecting a systematic drift of robotic manipulator. Once the workflow is streamlined, our proposed method will be an effective and easy quality assurance procedure for medical physicists.

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“…There is also a module for analysing water tank data and comparing to a baseline. TQA has been validated by various authors (Choi et Accuray AQA and E2E for cyberknife Automatic quality assurance (AQA) and E2E are supplied by accuray for use with the CyberKnife robotic radiosurgery system (Subedi et al 2015, Biltekin et al 2016, Fuerwerger et al 2016. The AQA is an imaging system reproducibility test, recommended daily.…”

Section: Accuray Essential and Advanced Tomotherapy Qa (Tqa)mentioning

confidence: 99%

IPEM topical report: results of a 2022 UK survey on the use of linac manufacturer integrated quality control (MIQC)

Pearson,

Barnes,

Brown

et al. 2023

Phys. Med. Biol.

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In recent years Radiotherapy linear accelerator (linac) vendors have developed their own integrated quality control (QC) systems. Such manufacturer-integrated-quality-control (MIQC) has the potential to improve both the quality and efficiency of linac QC but is currently being developed and utilised in the absence of specific best-practice guidance. An Institute of Physics and Engineering in Medicine working party was commissioned with a view to develop guidance for the commissioning and implementation of MIQC. This study is based upon a survey of United Kingdom (UK) radiotherapy departments performed by the working party. The survey was distributed to all heads of radiotherapy physics in the UK and investigated availability and uptake, community beliefs and opinions, utilisation, user experience and associated procedures. The survey achieved a 95% response rate and demonstrated strong support (>95%) for its use and further development. MIQC systems are available in 79% of respondents’ centres, and are in clinical use in 66%. The most common MIQC system was Varian MPC, in clinical use in 58% of responding centres, with CyberKnife AQA\E2E in 11%, TomoTherapy TQA in 8% and no users of Elekta Machine QA. A majority of users found their MIQC to be easy to use, reliable, and had five or more years of experience. Most users reported occasions of discrepancy in results between MIQC and conventional testing, but the majority considered this acceptable, indicating a false reporting frequency of quarterly or less. MIQC has shown value in preventative maintenance and early detection of machine deviations. There were inconsistent approaches in the utilisation and commissioning tests performed. Fewer than half of users perform QC of MIQC. 45% of responders have modified their QC processes with the introduction of MIQC, via replacement of conventional tests or reduction in their frequency. Future guidance is recommended to assist in the implementation of MIQC.

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Dosimetric and Mechanical Stability of CyberKnife Robotic Radiosurgery Unit: 5 Years’ Clinical Experience

Cited by 4 publications

References 20 publications

Machine performance and stability of the first clinical self‐shielded stereotactic radiosurgery system: Initial 2‐year experience

Machine performance and stability of the first clinical self‐shielded stereotactic radiosurgery system: Initial 2‐year experience

A novel method for monitoring the constancy of beam path accuracy in CyberKnife

IPEM topical report: results of a 2022 UK survey on the use of linac manufacturer integrated quality control (MIQC)

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