• Progress in Medical Physics
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• v.29 no.1
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• pp.8-15
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• 2018

This work reports the acceptance testing and commissioning experience of the Robotic Intensity-Modulated Radiation Therapy (IMRT) M6 system with a newly released $InCise^{TM}2$ Multileaf Collimator (MLC) installed at the Yonsei Cancer Center. Acceptance testing included a mechanical interdigitation test, leaf positional accuracy, leakage check, and End-to-End (E2E) tests. Beam data measurements included tissue-phantom ratios (TPRs), off-center ratios (OCRs), output factors collected at 11 field sizes (the smallest field size was $7.6mm{\times}7.7mm$ and largest field size was $115.0mm{\times}100.1mm$ at 800 mm source-to-axis distance), and open beam profiles. The beam model was verified by checking patient-specific quality assurance (QA) in four fiducial-inserted phantoms, using 10 intracranial and extracranial patient plans. All measurements for acceptance testing satisfied manufacturing specifications. Mean leaf position offsets using the Garden Fence test were found to be $0.01{\pm}0.06mm$ and $0.07{\pm}0.05mm$ for X1 and X2 leaf banks, respectively. Maximum and average leaf leakages were 0.20% and 0.18%, respectively. E2E tests for five tracking modes showed 0.26 mm (6D Skull), 0.3 mm (Fiducial), 0.26 mm (Xsight Spine), 0.62 mm (Xsight Lung), and 0.6 mm (Synchrony). TPRs, OCRs, output factors, and open beams measured under various conditions agreed with composite data provided from the manufacturer to within 2%. Patient-specific QA results were evaluated in two ways. Point dose measurements with an ion chamber were all within the 5% absolute-dose agreement, and relative-dose measurements using an array ion chamber detector all satisfied the 3%/3 mm gamma criterion for more than 90% of the measurement points. The Robotic IMRT M6 system equipped with the $InCise^{TM}2$ MLC was proven to be accurate and reliable.

• Progress in Medical Physics
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• v.27 no.4
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• pp.189-195
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• 2016

This paper aims to verify the clinical feasibility of a custom-made film created by a laser cutting tool for End-to-End (E2E) quality assurance in robotic intensity modulated radiation therapy system. The custom-made film was fabricated from the Gafchromic EBT3 film with the size of $8^{{\prime}{\prime}}{\times}10^{{\prime}{\prime}}$ using a drawing that is identical to the shape and scale of the original E2E film. The drawing was created by using a computer aided design program with the image file, which is obtained by scanning original E2E film. Beam delivery and evaluations were respectively performed with the original film and the custom-made film using fixed-cone collimator on three tracking modes: 6D skull (6DS), Xsight spine (XS), and Xsight lung (XL). The differences between total targeting errors of the original and custom-made films were recorded as 0.17 mm, 0.3 mm, and 0.17 mm at 6DS, XS, and XL tracking modes, respectively. This indicates that the custom-made film could yield nearly equivalent results to those of the original E2E film, given the uncertainties caused by distortions during film scanning and vibrations associated with film cutting. By confirming the clinical feasibility of a custom-made film for E2E testing, it can be expected that economic efficiency of the testing will increase accordingly.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.239-245
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• 2014

Purpose : The purpose of this study is to verify the accuracy of dose delivery according to the pitch and roll rotational setup error with 6D robotic couch in Intensity Modulated Radiation Therapy (IMRT) for pelvic region in patients. Materials and Methods : Trilogy(Varian, USA) and 6D robotic couch(ProturaTM 1.4, CIVCO, USA) were used to measure and analyze the rotational setup error of 14 patients (157 setup cases) for pelvic region. The total 157 Images(CBCT 78, Radiography 79) were used to calculate the mean value and the incidence of pitch and roll rotational setup error with Microsoft Office Excel 2007. The measured data (3 mm, 3%) at the reference angle ($0^{\circ}$) without couch rotation of pitch and roll direction was compared to the others at different pitch and roll angles ($1^{\circ}$, $1.5^{\circ}$, $2^{\circ}$, $2.5^{\circ}$) to verify the accuracy of dose delivery by using 2D array ionization chamber (I'mRT Matrixx, IBA Dosimetry, Germany) and MultiCube Phantom(IBA Dosimetry, Germany). Result from the data, gamma index was evaluated. Results : The mean values of pitch and roll rotational setup error were $0.9^{\circ}{\pm}0.7$, $0.5^{\circ}{\pm}0.6$. The maximum values of them were $2.8^{\circ}$, $2.0^{\circ}$. All of the minimum values were zero. The mean values of gamma pass rate at four different pitch angles ($1^{\circ}$, $1.5^{\circ}$, $2^{\circ}$, $2.5^{\circ}$) were 97.75%, 96.65%, 94.38% and 90.91%. The mean values of gamma pass rate at four different roll angles ($1^{\circ}$, $1.5^{\circ}$, $2^{\circ}$, $2.5^{\circ}$) were 93.68%, 93.05%, 87.77% and 84.96%. when the same angles ($1^{\circ}$, $1.5^{\circ}$, $2^{\circ}$) of pitch and roll were applied simultaneously, The mean values of each angle were 94.90%, 92.37% and 87.88%, respectively. Conclusion : As a result of this study, it was able to recognize that the accuracy of dose delivered is lowered gradually as pitch and roll increases. In order to increase the accuracy of delivered dose, therefore, it is recommended to perform IGRT or correct patient's position in the pitch and roll direction, to improve the quality of treatment.