Stereotactic Radiosurgery at UIHC

•

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Miami Cancer Institute

Health & Medicine Technology Business

Stereotac(c
Radiosurgery

(Rota(on
#
9)

Mentor:
Edward
C
Pennington

(01/19/2010
–
03/05/2010)

By

Vibha
Chaswal,
Ph.D.

Ac(vi(es

•  Es(ma(on
of
mechanical
accuracy
of
the
ﬂoor-‐
stand

•  End-‐to-‐end

process
tes(ng:
Absolute
phantom

based
QA:
Frame-‐based
and
Frame-‐less
SRS

•  Small
ﬁeld
dosimetry
measurements:
TMRs,

output
factors,
proﬁles,
oﬀ-‐axis
factors

•  CT
to
MRI

image
registra(on

•  SRS
treatment
planning

•  Pre-‐treatment
SRS
ﬂoor-‐stand
QA

•  Par(cipa(on
in
treatment
delivery

End-‐to-‐End:
CT-‐
Localiza1on

(Frame-‐based)

TILT
and
SPIN
Adjusted

on
Frame.
CT-‐Localiza(on

with
(lt
and
spin

correc(on

Max
error:

Ax
(0.4
mm)

Lat
(0.3
mm)

A-‐P
(0.5
mm)

3D
(0.6
mm)

Frame-‐based

End-‐to-‐End
tes(ng:
Floor-‐stand

isocentric
localiza(on

Frame-‐Less
SRS

End-‐to-‐End
isocentric
localiza(on
:

SRS
Commissioning:

Small
ﬁeld
dosimetry

TMR
and
Out-‐put
measurement
set-‐up

NOT
A
TRIVIAL
AFFAIR
!!!!!!!!!

Re-‐measurement
of
TMRs

Stereotac1c

Chamber-‐valida1on

TMR’s
s(ll
oﬀ

but
d-‐max
depth
=
1.5
cm

Recommenda(on
of
independent

Physics
check
on
TMR
measurements

of
small
ﬁelds.

Iden(ﬁed
pit-‐falls:

SRS
stereotac(c
chamber
response
with
depth

L-‐R
(lt
on
the
SRS
phantom
base
(resolved
with
a
(ssue
propped
at
led
side)

Par(cipa(on

and

observa(on

in
SRS
work-‐
ﬂow:

Iden(ﬁca(on

of
Physics
QA

at
all
steps

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Stereotactic Radiosurgery at UIHC

1. Stereotac(c Radiosurgery (Rota(on # 9) Mentor: Edward C Pennington (01/19/2010 – 03/05/2010) By Vibha Chaswal, Ph.D.

2. Contents

3. Ac(vi(es •  Es(ma(on of mechanical accuracy of the floor-‐ stand •  End-‐to-‐end process tes(ng: Absolute phantom based QA: Frame-‐based and Frame-‐less SRS •  Small field dosimetry measurements: TMRs, output factors, profiles, off-‐axis factors •  CT to MRI image registra(on •  SRS treatment planning •  Pre-‐treatment SRS floor-‐stand QA •  Par(cipa(on in treatment delivery

4. Mechanical QA: Floor-‐stand

5. End-‐to-‐End: CT-‐ Localiza1on (Frame-‐based) TILT and SPIN Adjusted on Frame. CT-‐Localiza(on with (lt and spin correc(on Max error: Ax (0.4 mm) Lat (0.3 mm) A-‐P (0.5 mm) 3D (0.6 mm)

6. Frame-‐based End-‐to-‐End tes(ng: Floor-‐stand isocentric localiza(on

7. Frame-‐Less SRS End-‐to-‐End isocentric localiza(on :

8. SRS Commissioning: Small ﬁeld dosimetry TMR and Out-‐put measurement set-‐up NOT A TRIVIAL AFFAIR !!!!!!!!!

9. ~ 3.5 % lower TMR And dmax ~ 1 cm

10.

11. Re-‐measurement of TMRs Stereotac1c Chamber-‐valida1on

12. TMR’s s(ll oﬀ but d-‐max depth = 1.5 cm

13. OUT-‐PUT Factor measurements

14. Oﬀ-‐Axis-‐Factors

15.

16. Recommenda(on of independent Physics check on TMR measurements of small ﬁelds. Iden(ﬁed pit-‐falls: SRS stereotac(c chamber response with depth L-‐R (lt on the SRS phantom base (resolved with a (ssue propped at led side)

17. Par(cipa(on and observa(on in SRS work-‐ ﬂow: Iden(ﬁca(on of Physics QA at all steps

18.

19. ThankYou!!!!!

Stereotactic Radiosurgery at UIHC

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