Frameless stereotactic radiosurgery (fSRS) end-to-end test with EBT-XD gafchromic film.

Frame-based stereotactic radiosurgery (SRS) has been widely used to treat functional disorders, vascular lesions, and primary benign and malignant tumors. Recently, SRS is being increasingly used to treat solitary brain metastases. However, due to its highly invasive nature, frame-based SRS is being gradually replaced by frameless SRS (fSRS). fSRS aims at improving patient comfort and achieving stable patient immobilization with non-invasive means and accurate target localization with image guidance technique. Owing to its inherent complexity and high risk, it is imperative to perform a comprehensive and rigorous end-to-end test prior to its clinical implementation. In this paper, we present our experience and results of fSRS end-to-end test with the latest EBT-XD Gafchromic film for a Varian Trilogy linear accelerator.