Clinical implementation and patient-specific quality assurance solutions for real-time target tracking and dynamic delivery in Radixact synchrony.

IF 2 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Christian D Trujillo-Bastidas, Michael J Taylor, Gloria M Díaz-Londoño
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引用次数: 0

Abstract

Background: The installation and testing of the first Radixact with Synchrony system in Colombia marked a significant milestone in Latin America's medical landscape. There was a need to devise a robust quality assurance protocol to comprehensively evaluate both dose delivery and motion tracking accuracy. However, testing experiences under clinical conditions have not been extensively reported. Additionally, there are limited recommended measuring devices for Synchrony evaluation.

Purpose: To validate and implement an alternative setup for dynamic-PSQA while testing Synchrony's functionality under clinical scenarios, including real-patient motion traces, and to provide guidance to new centers undergoing clinical implementation of Helical Synchrony.

Methods: This approach involves using the Iba miniPhantomR with strategically placed fiducial markers for configuring Gafchromic-films and array-based setups. When paired with the CIRS Dynamic Platform, this enables an innovative dynamic setup with trackable features for Synchrony delivery testing. Assessment scenarios, including compensation (M1S1) and no-motion compensation (M1S0), were evaluated using 2D-gamma pass rate analysis with multiple clinical gamma criteria. The Synchrony-Simulation feature was used to assess pre-treatment performance and capture the patient's target motion pattern. Synchrony for common clinical cases with patient's motion-traces was validated.

Results: The results for M1S0 and M1S1 demonstrated consistency with previous studies evaluating Synchrony functionality. Analysis using different gamma criteria unveiled dosimetric differences and impacts across various motion ranges. The application of effective kV-dose subtraction for array-based methods is of upmost importance when evaluating dynamic-PSQA with stringent gamma-criteria. However, no significant kV-dose impact on EBT3-Film was detectable.

Conclusion: Two implemented configurations for dynamic-PSQA setups were validated and successfully integrated into our clinic. We addressed both the benefits and limitations of array-based and film-based methods. The functionality and limitations of Synchrony were evaluated using the proposed setups. The potential utility of Synchrony-Simulation, along with the proposed patient-case classification table, can offer valuable support for new users during the clinical implementation of Synchrony treatments.

在 Radixact 同步系统中,为实时目标跟踪和动态输送提供临床实施和患者特定质量保证解决方案。
背景:在哥伦比亚安装和测试第一套带有同步功能的 Radixact 系统标志着拉丁美洲医疗领域的一个重要里程碑。有必要制定一个强有力的质量保证协议,以全面评估剂量输送和运动跟踪的准确性。然而,临床条件下的测试经验尚未得到广泛报道。目的:验证并实施动态 PSQA 的替代设置,同时在临床场景下测试 Synchrony 的功能,包括患者的真实运动轨迹,并为正在临床实施螺旋同步的新中心提供指导:这种方法包括使用 Iba miniPhantomR,在其上战略性地放置靶标,以配置 Gafchromic 膜和基于阵列的设置。与 CIRS 动态平台搭配使用时,可实现具有可跟踪功能的创新动态设置,用于同步传输测试。评估方案包括补偿(M1S1)和无运动补偿(M1S0),采用二维伽马通过率分析和多种临床伽马标准进行评估。同步模拟功能用于评估治疗前性能和捕捉患者的目标运动模式。对常见临床病例与患者运动轨迹的同步性进行了验证:结果:M1S0 和 M1S1 的结果与之前评估 Synchrony 功能的研究结果一致。使用不同伽马标准进行的分析揭示了不同运动范围的剂量学差异和影响。在使用严格的伽马标准评估动态-PSQA 时,基于阵列的方法应用有效的 kV 剂量减去是最重要的。然而,EBT3-Film 没有检测到明显的 kV 剂量影响:我们验证了两种动态-PSQA 设置的实施配置,并成功地将其应用于临床。我们探讨了基于阵列的方法和基于胶片的方法的优点和局限性。使用所建议的设置对 Synchrony 的功能和局限性进行了评估。Synchrony-Simulation的潜在效用以及建议的患者病例分类表,可在临床实施Synchrony治疗期间为新用户提供有价值的支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.60
自引率
19.00%
发文量
331
审稿时长
3 months
期刊介绍: Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission. JACMP will publish: -Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500. -Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed. -Technical Notes: These should be no longer than 3000 words, including key references. -Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents. -Book Reviews: The editorial office solicits Book Reviews. -Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics. -Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic
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