Commissioning and quality assurance of an integrated system for patient positioning and setup verification in particle therapy

Andrea Pella, M. Riboldi, B. Tagaste, D. Bianculli, M. Desplanques, G. Fontana, P. Cerveri, M. Seregni, G. Fattori, R. Orecchia, G. Baroni

Research output: Contribution to journalArticle

Abstract

In an increasing number of clinical indications, radiotherapy with accelerated particles shows relevant advantages when compared with high energy X-ray irradiation. However, due to the finite range of ions, particle therapy can be severely compromised by setup errors and geometric uncertainties. The purpose of this work is to describe the commissioning and the design of the quality assurance procedures for patient positioning and setup verification systems at the Italian National Center for Oncological Hadrontherapy (CNAO). The accuracy of systems installed in CNAO and devoted to patient positioning and setup verification have been assessed using a laser tracking device. The accuracy in calibration and image based setup verification relying on in room X-ray imaging system was also quantified. Quality assurance tests to check the integration among all patient setup systems were designed, and records of daily QA tests since the start of clinical operation (2011) are presented. The overall accuracy of the patient positioning system and the patient verification system motion was proved to be below 0.5 mm under all the examined conditions, with median values below the 0.3 mm threshold. Image based registration in phantom studies exhibited sub-millimetric accuracy in setup verification at both cranial and extra-cranial sites. The calibration residuals of the OTS were found consistent with the expectations, with peak values below 0.3 mm. Quality assurance tests, daily performed before clinical operation, confirm adequate integration and sub-millimetric setup accuracy. Robotic patient positioning was successfully integrated with optical tracking and stereoscopic X-ray verification for patient setup in particle therapy. Sub-millimetric setup accuracy was achieved and consistently verified in daily clinical operation.

Original languageEnglish
Pages (from-to)303-314
Number of pages12
JournalTechnology in Cancer Research and Treatment
Volume13
Issue number4
DOIs
Publication statusPublished - 2014

Fingerprint

Patient Positioning
X-Rays
Calibration
Robotics
Therapeutics
Uncertainty
Lasers
Radiotherapy
Ions
Equipment and Supplies

Keywords

  • Particle therapy
  • Patient positioning system
  • Patient verification system
  • Setup validation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Commissioning and quality assurance of an integrated system for patient positioning and setup verification in particle therapy. / Pella, Andrea; Riboldi, M.; Tagaste, B.; Bianculli, D.; Desplanques, M.; Fontana, G.; Cerveri, P.; Seregni, M.; Fattori, G.; Orecchia, R.; Baroni, G.

In: Technology in Cancer Research and Treatment, Vol. 13, No. 4, 2014, p. 303-314.

Research output: Contribution to journalArticle

Pella, A, Riboldi, M, Tagaste, B, Bianculli, D, Desplanques, M, Fontana, G, Cerveri, P, Seregni, M, Fattori, G, Orecchia, R & Baroni, G 2014, 'Commissioning and quality assurance of an integrated system for patient positioning and setup verification in particle therapy', Technology in Cancer Research and Treatment, vol. 13, no. 4, pp. 303-314. https://doi.org/10.7785/tcrt.2012.500386
Pella, Andrea ; Riboldi, M. ; Tagaste, B. ; Bianculli, D. ; Desplanques, M. ; Fontana, G. ; Cerveri, P. ; Seregni, M. ; Fattori, G. ; Orecchia, R. ; Baroni, G. / Commissioning and quality assurance of an integrated system for patient positioning and setup verification in particle therapy. In: Technology in Cancer Research and Treatment. 2014 ; Vol. 13, No. 4. pp. 303-314.
@article{e37e751e62c1442b813bd77e6b9c9310,
title = "Commissioning and quality assurance of an integrated system for patient positioning and setup verification in particle therapy",
abstract = "In an increasing number of clinical indications, radiotherapy with accelerated particles shows relevant advantages when compared with high energy X-ray irradiation. However, due to the finite range of ions, particle therapy can be severely compromised by setup errors and geometric uncertainties. The purpose of this work is to describe the commissioning and the design of the quality assurance procedures for patient positioning and setup verification systems at the Italian National Center for Oncological Hadrontherapy (CNAO). The accuracy of systems installed in CNAO and devoted to patient positioning and setup verification have been assessed using a laser tracking device. The accuracy in calibration and image based setup verification relying on in room X-ray imaging system was also quantified. Quality assurance tests to check the integration among all patient setup systems were designed, and records of daily QA tests since the start of clinical operation (2011) are presented. The overall accuracy of the patient positioning system and the patient verification system motion was proved to be below 0.5 mm under all the examined conditions, with median values below the 0.3 mm threshold. Image based registration in phantom studies exhibited sub-millimetric accuracy in setup verification at both cranial and extra-cranial sites. The calibration residuals of the OTS were found consistent with the expectations, with peak values below 0.3 mm. Quality assurance tests, daily performed before clinical operation, confirm adequate integration and sub-millimetric setup accuracy. Robotic patient positioning was successfully integrated with optical tracking and stereoscopic X-ray verification for patient setup in particle therapy. Sub-millimetric setup accuracy was achieved and consistently verified in daily clinical operation.",
keywords = "Particle therapy, Patient positioning system, Patient verification system, Setup validation",
author = "Andrea Pella and M. Riboldi and B. Tagaste and D. Bianculli and M. Desplanques and G. Fontana and P. Cerveri and M. Seregni and G. Fattori and R. Orecchia and G. Baroni",
year = "2014",
doi = "10.7785/tcrt.2012.500386",
language = "English",
volume = "13",
pages = "303--314",
journal = "Technology in Cancer Research and Treatment",
issn = "1533-0346",
publisher = "Adenine Press",
number = "4",

}

TY - JOUR

T1 - Commissioning and quality assurance of an integrated system for patient positioning and setup verification in particle therapy

AU - Pella, Andrea

AU - Riboldi, M.

AU - Tagaste, B.

AU - Bianculli, D.

AU - Desplanques, M.

AU - Fontana, G.

AU - Cerveri, P.

AU - Seregni, M.

AU - Fattori, G.

AU - Orecchia, R.

AU - Baroni, G.

PY - 2014

Y1 - 2014

N2 - In an increasing number of clinical indications, radiotherapy with accelerated particles shows relevant advantages when compared with high energy X-ray irradiation. However, due to the finite range of ions, particle therapy can be severely compromised by setup errors and geometric uncertainties. The purpose of this work is to describe the commissioning and the design of the quality assurance procedures for patient positioning and setup verification systems at the Italian National Center for Oncological Hadrontherapy (CNAO). The accuracy of systems installed in CNAO and devoted to patient positioning and setup verification have been assessed using a laser tracking device. The accuracy in calibration and image based setup verification relying on in room X-ray imaging system was also quantified. Quality assurance tests to check the integration among all patient setup systems were designed, and records of daily QA tests since the start of clinical operation (2011) are presented. The overall accuracy of the patient positioning system and the patient verification system motion was proved to be below 0.5 mm under all the examined conditions, with median values below the 0.3 mm threshold. Image based registration in phantom studies exhibited sub-millimetric accuracy in setup verification at both cranial and extra-cranial sites. The calibration residuals of the OTS were found consistent with the expectations, with peak values below 0.3 mm. Quality assurance tests, daily performed before clinical operation, confirm adequate integration and sub-millimetric setup accuracy. Robotic patient positioning was successfully integrated with optical tracking and stereoscopic X-ray verification for patient setup in particle therapy. Sub-millimetric setup accuracy was achieved and consistently verified in daily clinical operation.

AB - In an increasing number of clinical indications, radiotherapy with accelerated particles shows relevant advantages when compared with high energy X-ray irradiation. However, due to the finite range of ions, particle therapy can be severely compromised by setup errors and geometric uncertainties. The purpose of this work is to describe the commissioning and the design of the quality assurance procedures for patient positioning and setup verification systems at the Italian National Center for Oncological Hadrontherapy (CNAO). The accuracy of systems installed in CNAO and devoted to patient positioning and setup verification have been assessed using a laser tracking device. The accuracy in calibration and image based setup verification relying on in room X-ray imaging system was also quantified. Quality assurance tests to check the integration among all patient setup systems were designed, and records of daily QA tests since the start of clinical operation (2011) are presented. The overall accuracy of the patient positioning system and the patient verification system motion was proved to be below 0.5 mm under all the examined conditions, with median values below the 0.3 mm threshold. Image based registration in phantom studies exhibited sub-millimetric accuracy in setup verification at both cranial and extra-cranial sites. The calibration residuals of the OTS were found consistent with the expectations, with peak values below 0.3 mm. Quality assurance tests, daily performed before clinical operation, confirm adequate integration and sub-millimetric setup accuracy. Robotic patient positioning was successfully integrated with optical tracking and stereoscopic X-ray verification for patient setup in particle therapy. Sub-millimetric setup accuracy was achieved and consistently verified in daily clinical operation.

KW - Particle therapy

KW - Patient positioning system

KW - Patient verification system

KW - Setup validation

UR - http://www.scopus.com/inward/record.url?scp=84899887296&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899887296&partnerID=8YFLogxK

U2 - 10.7785/tcrt.2012.500386

DO - 10.7785/tcrt.2012.500386

M3 - Article

C2 - 24206209

AN - SCOPUS:84899887296

VL - 13

SP - 303

EP - 314

JO - Technology in Cancer Research and Treatment

JF - Technology in Cancer Research and Treatment

SN - 1533-0346

IS - 4

ER -