Evaluation of fan-beam kilovoltage computed tomography image quality on a novel biological-guided radiotherapy platform

Zhuang, Tingliang; Gibbard, G.; Duan, Xinhui; Tan, Jun; Park, Yang; Lin, Mu‐Han; Sun, Zhenan; Oderinde, O.M.; Lu, Weiguo; Reynolds, Robert G.; Godley, A.; Pompoš, A.; Tang, Dan; Garant, Aurélie; Iyengar, Puneeth; Timmerman, Robert; Jiang, Steve B; Cai, Bin

doi:10.1016/j.phro.2023.100438

Cited by 3 publications

(2 citation statements)

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“…The X1 system is equipped with a high-quality 16-slice fan beam kVCT with 50 cm field of view (FOV) that can produce reconstructed CT images with 1.25 mm slice thickness with 90 cm maximum length. 7 The system uses a binary MLCs with 64 leaves with 6.25 mm width at isocenter that can transition 100 times/s. Beam generation system has two clinical jaw settings, 1 and 2 cm in the IEC-Y direction (superior/inferior).…”

Section: Introductionmentioning

confidence: 99%

Commissioning of a novel PET‐Linac for biology‐guided radiotherapy (BgRT)

Surucu,

Ashraf,

Romero

et al. 2024

Medical Physics

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BackgroundBiology‐guided radiotherapy (BgRT) is a novel radiotherapy delivery technique that utilizes the tumor itself to guide dynamic delivery of treatment dose to the tumor. The RefleXion X1 system is the first radiotherapy system developed to deliver SCINTIX® BgRT. The X1 is characterized by its split arc design, employing two 90‐degree positron emission tomography (PET) arcs to guide therapeutic radiation beams in real time, currently cleared by FDA to treat bone and lung tumors.PurposeThis study aims to comprehensively evaluate the capabilities of the SCINTIX radiotherapy delivery system by evaluating its sensitivity to changes in PET contrast, its adaptability in the context of patient motion, and its performance across a spectrum of prescription doses.MethodsA series of experimental scenarios, both static and dynamic, were designed to assess the SCINTIX BgRT system's performance, including an end‐to‐end test. These experiments involved a range of factors, including changes in PET contrast, motion, and prescription doses. Measurements were performed using a custom‐made ArcCHECK insert which included a 2.2 cm spherical target and a c‐shape structure that can be filled with a PET tracer with varying concentrations. Sinusoidal and cosine4 motion patterns, simulating patient breathing, was used to test the SCINTIX system's ability to deliver BgRT during motion‐induced challenges. Each experiment was evaluated against specific metrics, including Activity Concentration (AC), Normalized Target Signal (NTS), and Biology Tracking Zone (BTZ) bounded dose‐volume histogram (bDVH) pass rates. The accuracy of the delivered BgRT doses on ArcCHECK and EBT‐XD film were evaluated using gamma 3%/2 mm and 3%/3 mm analysis.ResultsIn static scenarios, the X1 system consistently demonstrated precision and robustness in SCINTIX dose delivery. The end‐to‐end delivery to the spherical target yielded good results, with AC and NTS values surpassing the critical thresholds of 5 kBq/mL and 2, respectively. Furthermore, bDVH analysis consistently confirmed 100% pass rates. These results were reaffirmed in scenarios involving changes in PET contrast, emphasizing the system's ability to adapt to varying PET avidities. Gamma analysis with 3%/2 mm (10% dose threshold) criteria consistently achieved pass rates > 91.5% for the static tests. In dynamic SCINTIX delivery scenarios, the X1 system exhibited adaptability under conditions of motion. Sinusoidal and cosine4 motion patterns resulted in 3%/3 mm gamma pass rates > 87%. Moreover, the comparison with gated stereotactic body radiotherapy (SBRT) delivery on a conventional c‐arm Linac resulted in 93.9% gamma pass rates and used as comparison to evaluate the interplay effect. The 1 cm step shift tests showed low overall gamma pass rates of 60.3% in ArcCHECK measurements, while the doses in the PTV agreed with the plan with 99.9% for 3%/3 mm measured with film.ConclusionsThe comprehensive evaluation of the X1 radiotherapy delivery system for SCINTIX BgRT demonstrated good agreement for the static tests. The system consistently achieved critical metrics and delivered the BgRT doses per plan. The motion tests demonstrated its ability to co‐localize the dose where the PET signal is and deliver acceptable BgRT dose distributions.

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Section: Introductionmentioning

confidence: 99%

Commissioning of a novel PET‐Linac for biology‐guided radiotherapy (BgRT)

Surucu,

Ashraf,

Romero

et al. 2024

Medical Physics

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show abstract

“…Most developments have been driven by various needs in diagnostic radiology to enable an individual optimisation of CT acquisition and image reconstruction for each clinical case. The widespread clinical adoption of these CT innovations in radiotherapy (RT), however, is often delayed in time or has not even been pursued, because a change in CT workflows can affect the entire treatment chain, including therapeutic decision-making, tumour and organ segmentation, treatment planning, image-guided patient positioning [10] , as well as plan adaptation. Improvements of single tasks within an RT workflow through CT innovations are often deferred or downgraded in priority for the sake of simplicity, susceptibility to error, and generality of the whole workflow.…”

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confidence: 99%