Technical performance and quality assurance of the CyberKnife® S7™ system

Q1 Health Professions

Radiation Medicine and Protection Pub Date : 2025-08-01 DOI:10.1016/j.radmp.2025.06.001

Hanshun Gong, Shaojuan Wu, Jinglin Sun, Shanshan Gu, Pengfei Xu, Xiangkun Dai, Zhongjian Ju

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Abstract

Objective

To analyze the acceptance testing items of the CyberKnife® S7™ system and evaluate its technical performance and quality assurance (QA).

Methods

A comprehensive test was conducted on the CyberKnife® S7™ system, which is equipped with a linear accelerator, X-ray imaging, a fixed collimator, an Iris™ collimator, an InCise2™ multileaf collimator (MLC), iDMS® data management system, and the Accuray Precision® treatment planning system (TPS) and safety mechanisms. End-to-end (E2E) testing was conducted to assess the overall projection accuracy of the CyberKnife S7 system, with relevant parameters recorded. In addition, quality control during clinical application was analyzed, including the verification results of 72 patients obtained using SRS MapCHECK®.

Results

The 6 MV X-ray beam exhibited radiation quality and off-axis ratio curves within normal ranges, dose stability and linearity deviations both were below 1.0%. The transmission factors of the fixed and Iris collimators were <0.2%. Repeatability tests for the 5 mm and 60 mm apertures of the Iris collimator met acceptance criteria. The alignment deviation between the laser and radiation beam centers fell within the standard of <1 mm. The maximum leakage of the MLC complied with the ≤0.5% standard. All three criteria for the leaf positioning accuracy tests were satisfied. The maximum deviation in overall projection accuracy for the fixed, Iris, and MLC collimators was 0.90 mm. Across 83 automated quality assurance (AQA) tests, the average deviation was 0.42 mm. Regarding tracking methods, E2E testing for Xsight lung tracking using fixed and Iris collimators showed the maximum deviations, with averages of 0.59 mm and 0.74 mm, respectively. In contrast, the MLC system showed the highest deviation for Xsight spine tracking, with an average of 0.7 mm. Based on the 2%/2 mm γ analysis criteria with a threshold of 10%, the γ pass rate for quality control results of 72 patients was 97.65% ± 2.36%.

Conclusion

All acceptance testing results of the CyberKnife® S7™ system met the established standards, confirming its reliability and readiness for clinical deployment. Rigorous quality control during clinical application is importance to ensuring the system's ability to deliver precise and effective treatments. This will safeguard patient outcomes and advance the standardization of patients care in radiotherapy.

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射波刀S7系统的技术性能和质量保证

目的分析射波刀®S7™系统的验收测试项目，评价其技术性能和质量保证（QA）。方法对配备直线加速器、x射线成像、固定准直器、Iris准直器、InCise2多叶准直器（MLC）、iDMS®数据管理系统、Accuray Precision®治疗计划系统（TPS）和安全机构的射波刀S7™系统进行综合测试。进行端到端（E2E）测试，评估射波刀S7系统的整体投影精度，并记录相关参数。此外，还分析了临床应用过程中的质量控制，包括使用SRS MapCHECK®对72例患者的验证结果。结果6 MV x射线束的辐射质量和离轴比曲线在正常范围内，剂量稳定性和线性偏差均在1.0%以下。固定准直器和虹膜准直器的透射率均为0.2%。5毫米和60毫米孔径的虹膜准直器的重复性测试符合验收标准。激光器与辐射光束中心的对准偏差在1mm以内。MLC的最大泄漏量符合≤0.5%的标准。叶片定位精度试验的三个指标均满足。固定、虹膜和MLC准直器整体投影精度的最大偏差为0.90 mm。在83个自动化质量保证（AQA）测试中，平均偏差为0.42 mm。在跟踪方法方面，使用固定准直器和虹膜准直器进行Xsight肺部跟踪的E2E测试偏差最大，平均偏差分别为0.59 mm和0.74 mm。相比之下，MLC系统显示Xsight脊柱跟踪的最大偏差，平均为0.7 mm。根据2%/2 mm γ分析标准，阈值为10%，72例患者质控结果γ合格率为97.65%±2.36%。结论：CyberKnife®S7™系统的所有验收测试结果均符合既定标准，证实了其可靠性和临床部署的就绪性。临床应用过程中严格的质量控制对于确保系统提供精确有效治疗的能力至关重要。这将保障患者的预后，并促进患者放射治疗的规范化。

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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