Session Item

Adaptive radiotherapy and inter-fraction motion management
Digital Poster
Physics
Evaluation of the new Brainlab Exactrac Dynamic structured light positioning system
Rodrigo Astudillo, Spain
PO-1556

Abstract

Evaluation of the new Brainlab Exactrac Dynamic structured light positioning system
Authors:

Rodrigo Astudillo1, Marina Gutierrez Ruiz2, Jorge Alonso Muriedas1, Samuel Ruiz Arrebola3, Maria Teresa Pacheco Baldor4, Jose Andres Vázquez Rodriguez5, Juan Ignacio Raba Díez3, Veronica Cañon Garcia4, Ana Laura Rivero Perez4, Javier Albendea Roch4, Uriel Alexnder Corro Verde4, Maria Ferri Molina4, Ivan Diaz de Cerio Martinez4, Rosa Fabregat Borrás4

1Hospital Universitario Marqués de Valdecilla, Radiation Oncology Department, Santander, Spain; 2Hospital Universitario Marqués de Valdecill, Radiation Oncology Department, Santander, Spain; 3Hospital Universitario Marqués de Vadecilla, Radiation Oncology Department, Santander, Spain; 4Hospital Universitario Marqués de Vadecilla , Radiation Oncology Department, Santander, Spain; 5Hospital Universitario Marqués de Vadecilla, Radiation Oncology Department, Santander, Spain

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Purpose or Objective

The new Brainlab Exactrac Dynamic system (ED) consists of two kV X-Ray tubes mounted on the floor, two ceiling mounted flat panel detectors and a single ceiling mounted receptacle that contains a structured light (SL) projector, two high resolution cameras and an integrated thermal camera.

The system pre-positions the patient by matching the live 3D surface with the external contour. Then, ED performs final positioning based on stereoscopic X-Ray images. During treatment, ED performs intra-fraction monitoring combining 2D thermal data with 3D surface information.

The aim of this work was to evaluate this SL system as a pre-positioning system. The evaluation of the intra-fraction monitoring system is beyond the scope of this work.

Material and Methods

The ED system incorporated in a Varian TrueBeam STX accelerator was tested using the Brainlab cranial verification phantom with its mid-brain radiopaque sphere.

A simulation scan (slice thickness of 1,25mm) of the phantom was obtained in a General Electric LightSpeed CT, using the Cranial 4Pi Immobilization system. A treatment plan with 0º, 90º, 180º and 270º gantry angles beams collimated by the 15 mm Brainlab circular cone was created in iPlan 4.5 treatment planning system. The isocenter of the plan was placed at the center of the radiopaque sphere.


Repeatability of the surface positioning system was evaluated placing the phantom with the same immobilization as above, letting the system to perform the movements to bring the couch to the treatment position. The procedure was performed five times without moving the phantom between them.

SL system accuracy was determined using a hidden target (HT) test acquiring integrated images with the linac electronic portal image system, once the phantom was positioned at the isocenter, according to the SL system.  The HT test was performed three times. For each HT test the assembly of the phantom and its immobilization system was repeated.

The displacements that stereoscopic KV x-ray and CBCT positioning systems calculate after the surface SL prepositioning of the phantom were registered to obtain the accuracy of the SL system independently. After applying the displacements calculated by each of the systems, a HT test was done to assess their suitability as reference systems.

Results

Results are shown in table 1. SL system repeatability was better than 0,3 mm in all axes. Results of the two independent methods used to measure the accuracy were consistent and showed an accuracy below 1,2mm in the lateral and longitudinal axes, while on the vertical was higher than 3 mm.

The HT test for the CBCT and the stereoscopic kV x-Ray systems showed an accuracy below 0,3 mm in all three axes for both systems. Similar accuracy is referenced in the bibliography.


Conclusion

The ED SL system is repeatable and accurate to pre-position the patient at the isocenter. Nevertheless, it is necessary internal information from CBCT or kV X-Ray images to achieve submillimeter accuracy.