A Study of Motion Tracking Accuracy of Robotic Radiosurgery Using a Novel CCD Camera Based End-to-end Test System Lei Wang 1, Brett Nelson 2,Youming Yang 1 1. Department of Radiation Oncology, Stanford University Medical School 2. Logos Systems Int l, Scotts Valley, CA
2 Purpose To assess the motion tracking (Synchrony) accuracy for CyberKnife using a scintillator/ccd camera based phantom.
3 A Scintillator/CCD System: XRV124 Logos Systems Int l, Scotts Valley, CA Beam by beam delivery accuracy( 0.3mm) Sensitivity to beam spot size (<0.2mm) Lei Wang et al. presented at RSS meeting 2014 3
4 Material and Method: Treatment Planning 1. XRV124 phantom was first scanned at 1.25 mm slice thickness. 2. The CT was transferred to the treatment planning system (Multiplan v5.3) 3. Two plans were created with Anterior and Lateral beams : Plan #1, 10mm, 20mm, 35mm, 45mm, 200 MU per beam. Plan #2, 10mm,1000 MU per beam.
5 Material and Method: Treatment Delivery 1 2 3 4 1. The phantom was placed on the CIRS motion platform (CIRS 008PL motion platform). 2. The treatment was delivered on a CyberKnife M6 system. 3. The XRV-124 CCD camera recorded the integrated image or video during the delivery (10frame/sec). 4. Fiducial tracking and Synchrony was used.
6 Material and Method: Two Tests XRV in integrating mode: tracking stability and reproducibility Plan #1 Sine wave 6 Static delivery, 3 Synchrony delivery. Targeting accuracy and beam shape consistency was assessed. XRV in video mode: tracking accuracy with different motion Plan #2 1)No motion; 2)a typical patient breathing pattern; 3)a Sine wave; 4) a Sine wave with 15 degree phase shift. Log-files were fetched from CyberKnife system for marker motion. Measure beam position was aligned with marker motion. Motion is Sup-Inf only. Amplitude: 2cm, T=4 sec.
Distance to Static Average (mm) 7 Results: Targeting Accuracy (Plan #1) Targeting accuracy: Synchrony vs. Static Delivery (Sine movement in Z direction, 2cm, 4.5 sec cycle) 0.20 0.15 0.10 0.05 0.00-0.05-0.10-0.15-0.20 within ±0.2 0 2 4 6 8 10 Syn Delta x Syn Delta Y Syn Delta Z Sta Delta x Sta Delta Y Sta Delta Z Static Delivery: 1-6 Average Δr =0.14±0.05 Synchrony:7-9
Delta Diameter (mm) 8 Results: Beam Diameter Consistency (Plan #1) Difference of Measured AP Beam Diameter to Static Average (Sine movement in Z direction, 2cm, 4.0 sec breathing cycle) 0.08 0.06 0.04 0.02 0.00-0.02-0.04-0.06-0.08-0.10-0.12 within ±0.1 0 2 4 6 8 10 Sta 10mm Sta 20mm Sta 35mm Sta 45mm Syn 10mm Syn 20mm Syn 35mm Syn 45mm Static Delivery: 1-6 Average Δd =0.03±0.02 Synchrony:7-9 Average Δd = 0.03±0.01 Diameter = FWHM
X_Width/ Z_Width Ratio 9 Results: Beam Shape Consistency (Plan #1) 1.050 1.045 1.040 1.035 1.030 1.025 1.020 1.015 1.010 1.005 AP Beam Shape Consistency (Sine movement in Z direction, 2cm, 4.0 sec breathing cycle) 0 2 4 6 8 10 Sta 10mm Sta 20mm Sta 35mm Sta 45mm Syn 10mm Syn 20mm Syn 35mm Syn 45mm Static Delivery: 1-6 X_Width/Z_Width =1.026±0.007 Width=FWHM Synchrony:7-9 X_Width/Z_Width= 1.027±0.005
Results: Dose Integration From Video (AP beam, Plan #2) Measured X and Z positions agree within 0.25mm Irreg_Lung Sine/Phase shift Sine Static X Width Z Width 2D Width X Width/Z Width Irreg 11.393 11.189 11.3762 1.018 Sine/15 degree phase shift 10.881 11.520 11.3278 0.944 Sine/no phase shift 11.263 11.077 11.3342 1.017 Static 11.438 11.231 11.4224 1.018 Field width is defined as FWHM of the profile. 10
Results: Position Deviation (from Average) vs. Time (AP Field) (Plan#2) Sine/ φ0, σ(δz)=0.17mm, σ(δx)= 0.16mm Δ Max=0.4 mm Irregular Lung, σ(δz)=0.26mm, σ(δx)= 0.13mm Δ Max=1.2 mm 11
12 Results: Position Deviation (from Average) vs. Time (AP Field) (Plan #2) Sine/φ15, σ(δz)=2.13mm, σ(δx)= 0.14mm Δ Max=5 mm Dual poly model was used.
Results: Position Deviation (from Average) vs. Time (Lat Field)(Plan#2) Irregular Lung, σ(δz)=0.26mm, σ(δy)= 0.17mm Δ Max=1 mm Sine/φ15, σ(δz)=2.44mm, σ(δy)= 0.26mm Δ Max=6 mm Sine/ φ0, σ(δz)=0.18mm, σ(δy)= 0.15mm Δ Max=0.5 mm Static, σ(δz)=0.03mm, σ(δy)= 0.03mm Δ Max=0.2 mm Measured average positions agree within 0.46mm 13
14 Conclusion The XRV-124 system is able to provide 4D targeting accuracy for Cyberknife delivery with Synchrony. The experimental results showed overall submillimeter tracking accuracy of Cyberknife Synchrony on a moving phantom with good target to marker correlation (including irregular pattern). The tracking error increased significantly when phase shift was introduced.
Thank you! 15