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 language | English |
|---|---|
| Pages (from-to) | 303-314 |
| Number of pages | 12 |
| Journal | Technology in Cancer Research and Treatment |
| Volume | 13 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2014 |
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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 journal › Article
}
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
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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 -