Quality assurance for the clinical implementation of kilovoltage intrafraction monitoring for prostate cancer VMAT
Purpose: Kilovoltage intrafraction monitoring (KIM) is a real‐time 3D tumor monitoring system for cancer radiotherapy. KIM uses the commonly available gantry‐mounted x‐ray imager as input, making this method potentially more widely available than dedicated real‐time 3D tumor monitoring systems. KIM...
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| Veröffentlicht in: | Medical physics (Lancaster) 2014-11, Vol.41 (11), p.111712-n/a |
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| creator | Ng, J. A. Booth, J. T. O'Brien, R. T. Colvill, E. Huang, C.‐Y. Poulsen, P. R. Keall, P. J. |
| description | Purpose:
Kilovoltage intrafraction monitoring (KIM) is a real‐time 3D tumor monitoring system for cancer radiotherapy. KIM uses the commonly available gantry‐mounted x‐ray imager as input, making this method potentially more widely available than dedicated real‐time 3D tumor monitoring systems. KIM is being piloted in a clinical trial for prostate cancer patients treated with VMAT (NCT01742403). The purpose of this work was to develop clinical process and quality assurance (QA) practices for the clinical implementation of KIM.
Methods:
Informed by and adapting existing guideline documents from other real‐time monitoring systems, KIM‐specific QA practices were developed. The following five KIM‐specific QA tests were included: (1) static localization accuracy, (2) dynamic localization accuracy, (3) treatment interruption accuracy, (4) latency measurement, and (5) clinical conditions accuracy. Tests (1)–(4) were performed using KIM to measure static and representative patient‐derived prostate motion trajectories using a 3D programmable motion stage supporting an anthropomorphic phantom with implanted gold markers to represent the clinical treatment scenario. The threshold for system tolerable latency is |
| doi_str_mv | 10.1118/1.4898119 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_22317945</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1621214723</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4569-3468b2c7f580af5e65efdb7a4514f35701deb689378e2c0f94db8e77576ad7e53</originalsourceid><addsrcrecordid>eNp1kTtvFTEQRi0EIpdAwR9Almig2OC3d8so4iUlAqRAa3m948TgtS-2F3T_PXsf0FFNMWeOvplB6DklF5TS_g29EP3QUzo8QBsmNO8EI8NDtCFkEB0TRJ6hJ7V-J4QoLsljdMYk10QxtUHly2JjaDtsa12KTQ6wzwW3e8AuhhScjTjM2wgzpGZbyAlnj3-EmH_l2Owd4JBasb5Yd2jOOYWWS0h3B8-25LqOrbK9uuBvN5e3T9Ejb2OFZ6d6jr6-e3t79aG7_vT-49XldeeEVEPHhepH5rSXPbFegpLgp1FbIanwXGpCJxhVP3DdA3PED2Iae9BaamUnDZKfo5dH7xohmOpCA3fvckrgmmGMUz2IPfXqSK1Rfy5Qm5lDdRCjTZCXaqhilFGhGV_R10fUrVvVAt5sS5ht2RlKzP4RhprTI1b2xUm7jDNM_8i_l1-B7gj8DhF2_zeZm88H4R-gSpFT</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1621214723</pqid></control><display><type>article</type><title>Quality assurance for the clinical implementation of kilovoltage intrafraction monitoring for prostate cancer VMAT</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>Alma/SFX Local Collection</source><creator>Ng, J. A. ; Booth, J. T. ; O'Brien, R. T. ; Colvill, E. ; Huang, C.‐Y. ; Poulsen, P. R. ; Keall, P. J.</creator><creatorcontrib>Ng, J. A. ; Booth, J. T. ; O'Brien, R. T. ; Colvill, E. ; Huang, C.‐Y. ; Poulsen, P. R. ; Keall, P. J.</creatorcontrib><description>Purpose:
Kilovoltage intrafraction monitoring (KIM) is a real‐time 3D tumor monitoring system for cancer radiotherapy. KIM uses the commonly available gantry‐mounted x‐ray imager as input, making this method potentially more widely available than dedicated real‐time 3D tumor monitoring systems. KIM is being piloted in a clinical trial for prostate cancer patients treated with VMAT (NCT01742403). The purpose of this work was to develop clinical process and quality assurance (QA) practices for the clinical implementation of KIM.
Methods:
Informed by and adapting existing guideline documents from other real‐time monitoring systems, KIM‐specific QA practices were developed. The following five KIM‐specific QA tests were included: (1) static localization accuracy, (2) dynamic localization accuracy, (3) treatment interruption accuracy, (4) latency measurement, and (5) clinical conditions accuracy. Tests (1)–(4) were performed using KIM to measure static and representative patient‐derived prostate motion trajectories using a 3D programmable motion stage supporting an anthropomorphic phantom with implanted gold markers to represent the clinical treatment scenario. The threshold for system tolerable latency is <1 s. The tolerances for all other tests are that both the mean and standard deviation of the difference between the programmed trajectory and the measured data are <1 mm. The (5) clinical conditions accuracy test compared the KIM measured positions with those measured by kV/megavoltage (MV) triangulation from five treatment fractions acquired in a previous pilot study.
Results:
For the (1) static localization, (2) dynamic localization, and (3) treatment interruption accuracy tests, the mean and standard deviation of the difference are <1.0 mm. (4) The measured latency is 350 ms. (5) For the tests with previously acquired patient data, the mean and standard deviation of the difference between KIM and kV/MV triangulation are <1.0 mm.
Conclusions:
Clinical process and QA practices for the safe clinical implementation of KIM, a novel real‐time monitoring system using commonly available equipment, have been developed and implemented for prostate cancer VMAT.</description><identifier>ISSN: 0094-2405</identifier><identifier>EISSN: 2473-4209</identifier><identifier>DOI: 10.1118/1.4898119</identifier><identifier>PMID: 25370626</identifier><language>eng</language><publisher>United States: American Association of Physicists in Medicine</publisher><subject>07 ISOTOPES AND RADIATION SOURCES ; 60 APPLIED LIFE SCIENCES ; ACCURACY ; Algorithms ; cancer ; CLINICAL TRIALS ; Clinical Trials as Topic ; COMPARATIVE EVALUATIONS ; Computer software ; Cone beam computed tomography ; Dosimetry ; GOLD ; Humans ; IMPLEMENTATION ; kilovoltage intrafraction monitoring ; Kinematics ; Male ; Medical imaging ; MONITORING ; Movement ; Multileaf collimators ; NEOPLASMS ; patient monitoring ; PATIENTS ; PHANTOMS ; Pilot Projects ; POTENTIALS ; Probability ; Prospective Studies ; PROSTATE ; Prostate - diagnostic imaging ; prostate cancer ; Prostatic Neoplasms - radiotherapy ; QUALITY ASSURANCE ; Quality assurance in radiotherapy ; Quality Assurance, Health Care ; radiation therapy ; RADIOTHERAPY ; Radiotherapy - methods ; Radiotherapy Planning, Computer-Assisted - methods ; Radiotherapy, Intensity-Modulated - methods ; real‐time localization ; real‐time systems ; Reproducibility of Results ; Software ; SUPPORTS ; Therapeutic applications, including brachytherapy ; Three dimensional image processing ; TOLERANCE ; Tomography, X-Ray Computed - methods ; TRAJECTORIES ; tumours ; VMAT ; X RADIATION</subject><ispartof>Medical physics (Lancaster), 2014-11, Vol.41 (11), p.111712-n/a</ispartof><rights>2014 American Association of Physicists in Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4569-3468b2c7f580af5e65efdb7a4514f35701deb689378e2c0f94db8e77576ad7e53</citedby><cites>FETCH-LOGICAL-c4569-3468b2c7f580af5e65efdb7a4514f35701deb689378e2c0f94db8e77576ad7e53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1118%2F1.4898119$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1118%2F1.4898119$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25370626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22317945$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Ng, J. A.</creatorcontrib><creatorcontrib>Booth, J. T.</creatorcontrib><creatorcontrib>O'Brien, R. T.</creatorcontrib><creatorcontrib>Colvill, E.</creatorcontrib><creatorcontrib>Huang, C.‐Y.</creatorcontrib><creatorcontrib>Poulsen, P. R.</creatorcontrib><creatorcontrib>Keall, P. J.</creatorcontrib><title>Quality assurance for the clinical implementation of kilovoltage intrafraction monitoring for prostate cancer VMAT</title><title>Medical physics (Lancaster)</title><addtitle>Med Phys</addtitle><description>Purpose:
Kilovoltage intrafraction monitoring (KIM) is a real‐time 3D tumor monitoring system for cancer radiotherapy. KIM uses the commonly available gantry‐mounted x‐ray imager as input, making this method potentially more widely available than dedicated real‐time 3D tumor monitoring systems. KIM is being piloted in a clinical trial for prostate cancer patients treated with VMAT (NCT01742403). The purpose of this work was to develop clinical process and quality assurance (QA) practices for the clinical implementation of KIM.
Methods:
Informed by and adapting existing guideline documents from other real‐time monitoring systems, KIM‐specific QA practices were developed. The following five KIM‐specific QA tests were included: (1) static localization accuracy, (2) dynamic localization accuracy, (3) treatment interruption accuracy, (4) latency measurement, and (5) clinical conditions accuracy. Tests (1)–(4) were performed using KIM to measure static and representative patient‐derived prostate motion trajectories using a 3D programmable motion stage supporting an anthropomorphic phantom with implanted gold markers to represent the clinical treatment scenario. The threshold for system tolerable latency is <1 s. The tolerances for all other tests are that both the mean and standard deviation of the difference between the programmed trajectory and the measured data are <1 mm. The (5) clinical conditions accuracy test compared the KIM measured positions with those measured by kV/megavoltage (MV) triangulation from five treatment fractions acquired in a previous pilot study.
Results:
For the (1) static localization, (2) dynamic localization, and (3) treatment interruption accuracy tests, the mean and standard deviation of the difference are <1.0 mm. (4) The measured latency is 350 ms. (5) For the tests with previously acquired patient data, the mean and standard deviation of the difference between KIM and kV/MV triangulation are <1.0 mm.
Conclusions:
Clinical process and QA practices for the safe clinical implementation of KIM, a novel real‐time monitoring system using commonly available equipment, have been developed and implemented for prostate cancer VMAT.</description><subject>07 ISOTOPES AND RADIATION SOURCES</subject><subject>60 APPLIED LIFE SCIENCES</subject><subject>ACCURACY</subject><subject>Algorithms</subject><subject>cancer</subject><subject>CLINICAL TRIALS</subject><subject>Clinical Trials as Topic</subject><subject>COMPARATIVE EVALUATIONS</subject><subject>Computer software</subject><subject>Cone beam computed tomography</subject><subject>Dosimetry</subject><subject>GOLD</subject><subject>Humans</subject><subject>IMPLEMENTATION</subject><subject>kilovoltage intrafraction monitoring</subject><subject>Kinematics</subject><subject>Male</subject><subject>Medical imaging</subject><subject>MONITORING</subject><subject>Movement</subject><subject>Multileaf collimators</subject><subject>NEOPLASMS</subject><subject>patient monitoring</subject><subject>PATIENTS</subject><subject>PHANTOMS</subject><subject>Pilot Projects</subject><subject>POTENTIALS</subject><subject>Probability</subject><subject>Prospective Studies</subject><subject>PROSTATE</subject><subject>Prostate - diagnostic imaging</subject><subject>prostate cancer</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>QUALITY ASSURANCE</subject><subject>Quality assurance in radiotherapy</subject><subject>Quality Assurance, Health Care</subject><subject>radiation therapy</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy - methods</subject><subject>Radiotherapy Planning, Computer-Assisted - methods</subject><subject>Radiotherapy, Intensity-Modulated - methods</subject><subject>real‐time localization</subject><subject>real‐time systems</subject><subject>Reproducibility of Results</subject><subject>Software</subject><subject>SUPPORTS</subject><subject>Therapeutic applications, including brachytherapy</subject><subject>Three dimensional image processing</subject><subject>TOLERANCE</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>TRAJECTORIES</subject><subject>tumours</subject><subject>VMAT</subject><subject>X RADIATION</subject><issn>0094-2405</issn><issn>2473-4209</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kTtvFTEQRi0EIpdAwR9Almig2OC3d8so4iUlAqRAa3m948TgtS-2F3T_PXsf0FFNMWeOvplB6DklF5TS_g29EP3QUzo8QBsmNO8EI8NDtCFkEB0TRJ6hJ7V-J4QoLsljdMYk10QxtUHly2JjaDtsa12KTQ6wzwW3e8AuhhScjTjM2wgzpGZbyAlnj3-EmH_l2Owd4JBasb5Yd2jOOYWWS0h3B8-25LqOrbK9uuBvN5e3T9Ejb2OFZ6d6jr6-e3t79aG7_vT-49XldeeEVEPHhepH5rSXPbFegpLgp1FbIanwXGpCJxhVP3DdA3PED2Iae9BaamUnDZKfo5dH7xohmOpCA3fvckrgmmGMUz2IPfXqSK1Rfy5Qm5lDdRCjTZCXaqhilFGhGV_R10fUrVvVAt5sS5ht2RlKzP4RhprTI1b2xUm7jDNM_8i_l1-B7gj8DhF2_zeZm88H4R-gSpFT</recordid><startdate>201411</startdate><enddate>201411</enddate><creator>Ng, J. A.</creator><creator>Booth, J. T.</creator><creator>O'Brien, R. T.</creator><creator>Colvill, E.</creator><creator>Huang, C.‐Y.</creator><creator>Poulsen, P. R.</creator><creator>Keall, P. J.</creator><general>American Association of Physicists in Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>201411</creationdate><title>Quality assurance for the clinical implementation of kilovoltage intrafraction monitoring for prostate cancer VMAT</title><author>Ng, J. A. ; Booth, J. T. ; O'Brien, R. T. ; Colvill, E. ; Huang, C.‐Y. ; Poulsen, P. R. ; Keall, P. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4569-3468b2c7f580af5e65efdb7a4514f35701deb689378e2c0f94db8e77576ad7e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>07 ISOTOPES AND RADIATION SOURCES</topic><topic>60 APPLIED LIFE SCIENCES</topic><topic>ACCURACY</topic><topic>Algorithms</topic><topic>cancer</topic><topic>CLINICAL TRIALS</topic><topic>Clinical Trials as Topic</topic><topic>COMPARATIVE EVALUATIONS</topic><topic>Computer software</topic><topic>Cone beam computed tomography</topic><topic>Dosimetry</topic><topic>GOLD</topic><topic>Humans</topic><topic>IMPLEMENTATION</topic><topic>kilovoltage intrafraction monitoring</topic><topic>Kinematics</topic><topic>Male</topic><topic>Medical imaging</topic><topic>MONITORING</topic><topic>Movement</topic><topic>Multileaf collimators</topic><topic>NEOPLASMS</topic><topic>patient monitoring</topic><topic>PATIENTS</topic><topic>PHANTOMS</topic><topic>Pilot Projects</topic><topic>POTENTIALS</topic><topic>Probability</topic><topic>Prospective Studies</topic><topic>PROSTATE</topic><topic>Prostate - diagnostic imaging</topic><topic>prostate cancer</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>QUALITY ASSURANCE</topic><topic>Quality assurance in radiotherapy</topic><topic>Quality Assurance, Health Care</topic><topic>radiation therapy</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy - methods</topic><topic>Radiotherapy Planning, Computer-Assisted - methods</topic><topic>Radiotherapy, Intensity-Modulated - methods</topic><topic>real‐time localization</topic><topic>real‐time systems</topic><topic>Reproducibility of Results</topic><topic>Software</topic><topic>SUPPORTS</topic><topic>Therapeutic applications, including brachytherapy</topic><topic>Three dimensional image processing</topic><topic>TOLERANCE</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>TRAJECTORIES</topic><topic>tumours</topic><topic>VMAT</topic><topic>X RADIATION</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ng, J. A.</creatorcontrib><creatorcontrib>Booth, J. T.</creatorcontrib><creatorcontrib>O'Brien, R. T.</creatorcontrib><creatorcontrib>Colvill, E.</creatorcontrib><creatorcontrib>Huang, C.‐Y.</creatorcontrib><creatorcontrib>Poulsen, P. R.</creatorcontrib><creatorcontrib>Keall, P. J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>Medical physics (Lancaster)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ng, J. A.</au><au>Booth, J. T.</au><au>O'Brien, R. T.</au><au>Colvill, E.</au><au>Huang, C.‐Y.</au><au>Poulsen, P. R.</au><au>Keall, P. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quality assurance for the clinical implementation of kilovoltage intrafraction monitoring for prostate cancer VMAT</atitle><jtitle>Medical physics (Lancaster)</jtitle><addtitle>Med Phys</addtitle><date>2014-11</date><risdate>2014</risdate><volume>41</volume><issue>11</issue><spage>111712</spage><epage>n/a</epage><pages>111712-n/a</pages><issn>0094-2405</issn><eissn>2473-4209</eissn><abstract>Purpose:
Kilovoltage intrafraction monitoring (KIM) is a real‐time 3D tumor monitoring system for cancer radiotherapy. KIM uses the commonly available gantry‐mounted x‐ray imager as input, making this method potentially more widely available than dedicated real‐time 3D tumor monitoring systems. KIM is being piloted in a clinical trial for prostate cancer patients treated with VMAT (NCT01742403). The purpose of this work was to develop clinical process and quality assurance (QA) practices for the clinical implementation of KIM.
Methods:
Informed by and adapting existing guideline documents from other real‐time monitoring systems, KIM‐specific QA practices were developed. The following five KIM‐specific QA tests were included: (1) static localization accuracy, (2) dynamic localization accuracy, (3) treatment interruption accuracy, (4) latency measurement, and (5) clinical conditions accuracy. Tests (1)–(4) were performed using KIM to measure static and representative patient‐derived prostate motion trajectories using a 3D programmable motion stage supporting an anthropomorphic phantom with implanted gold markers to represent the clinical treatment scenario. The threshold for system tolerable latency is <1 s. The tolerances for all other tests are that both the mean and standard deviation of the difference between the programmed trajectory and the measured data are <1 mm. The (5) clinical conditions accuracy test compared the KIM measured positions with those measured by kV/megavoltage (MV) triangulation from five treatment fractions acquired in a previous pilot study.
Results:
For the (1) static localization, (2) dynamic localization, and (3) treatment interruption accuracy tests, the mean and standard deviation of the difference are <1.0 mm. (4) The measured latency is 350 ms. (5) For the tests with previously acquired patient data, the mean and standard deviation of the difference between KIM and kV/MV triangulation are <1.0 mm.
Conclusions:
Clinical process and QA practices for the safe clinical implementation of KIM, a novel real‐time monitoring system using commonly available equipment, have been developed and implemented for prostate cancer VMAT.</abstract><cop>United States</cop><pub>American Association of Physicists in Medicine</pub><pmid>25370626</pmid><doi>10.1118/1.4898119</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Medical physics (Lancaster), 2014-11, Vol.41 (11), p.111712-n/a |
| issn | 0094-2405 2473-4209 |
| language | eng |
| recordid | cdi_osti_scitechconnect_22317945 |
| source | MEDLINE; Access via Wiley Online Library; Alma/SFX Local Collection |
| subjects | 07 ISOTOPES AND RADIATION SOURCES 60 APPLIED LIFE SCIENCES ACCURACY Algorithms cancer CLINICAL TRIALS Clinical Trials as Topic COMPARATIVE EVALUATIONS Computer software Cone beam computed tomography Dosimetry GOLD Humans IMPLEMENTATION kilovoltage intrafraction monitoring Kinematics Male Medical imaging MONITORING Movement Multileaf collimators NEOPLASMS patient monitoring PATIENTS PHANTOMS Pilot Projects POTENTIALS Probability Prospective Studies PROSTATE Prostate - diagnostic imaging prostate cancer Prostatic Neoplasms - radiotherapy QUALITY ASSURANCE Quality assurance in radiotherapy Quality Assurance, Health Care radiation therapy RADIOTHERAPY Radiotherapy - methods Radiotherapy Planning, Computer-Assisted - methods Radiotherapy, Intensity-Modulated - methods real‐time localization real‐time systems Reproducibility of Results Software SUPPORTS Therapeutic applications, including brachytherapy Three dimensional image processing TOLERANCE Tomography, X-Ray Computed - methods TRAJECTORIES tumours VMAT X RADIATION |
| title | Quality assurance for the clinical implementation of kilovoltage intrafraction monitoring for prostate cancer VMAT |
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