Feasibility of patient‐specific quality assurance (PSQA) for real‐time robotic stereotactic body radiotherapy (SBRT) based on tumor motion traces

Author:

Xu Qianyi12,Fan Jiajin1,Vinogradskiy Yevgeniy2,Chawla Ashish K.1,Kubicek Gregory3,Yang Haihua4ORCID,Huynh Kiet1,LaCouture Tamara2,Grimm Jimm5,Nie Wei1

Affiliation:

1. Department of Advanced Radiation Oncology and Proton Therapy Inova Schar Cancer Institute Fairfax Virginia USA

2. Department of Radiation Oncology Thomas Jefferson University Philadelphia Pennsylvania USA

3. Department of Radiation Oncology University of Miami Miami Florida USA

4. Department of Radiation Oncology Taizhou Hospital Taizhou Zhejiang China

5. Department of Radiation Oncology Wellstar Health System Marietta Georgia USA

Abstract

AbstractPurposeTo design a patient specific quality assurance (PSQA) process for the CyberKnife Synchrony system and quantify its dosimetric accuracy using a motion platform driven by patient tumor traces with rotation.MethodsThe CyberKnife Synchrony system was evaluated using a motion platform (MODUSQA) and a SRS MapCHECK phantom. The platform was programed to move in the superior‐inferior (SI) direction based on tumor traces. The detector array housed by the StereoPhan was placed on the platform. Extra rotational angles in pitch (head down, 4.0° ± 0.15° or 1.2° ± 0.1°) were added to the moving phantom to examine robot capability of angle correction during delivery. A total of 15 Synchrony patients were performed SBRT PSQA on the moving phantom. All the results were benchmarked by the PSQA results based on static phantom.ResultsFor smaller pitch angles, the mean gamma passing rates were 99.75% ± 0.87%, 98.63% ± 2.05%, and 93.11% ± 5.52%, for 3%/1 mm, 2%/1 mm, and 1%/1 mm, respectively. Large discrepancy in the passing rates was observed for different pitch angles due to limited angle correction by the robot. For larger pitch angles, the corresponding mean passing rates were dropped to 93.00% ± 10.91%, 88.05% ± 14.93%, and 80.38% ± 17.40%. When comparing with the static phantom, no significant statistic difference was observed for smaller pitch angles (p = 0.1 for 3%/1 mm), whereas a larger statistic difference was observed for larger pitch angles (p < 0.02 for all criteria). All the gamma passing rates were improved, if applying shift and rotation correction.ConclusionsThe significance of this work is that it is the first study to benchmark PSQA for the CyberKnife Synchrony system using realistically moving phantoms with rotation. With reasonable delivery time, we found it may be feasible to perform PSQA for Synchrony patients with a realistic breathing pattern.

Publisher

Wiley

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