Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Department of Radiotherapy, Belgium; Brainlab AG, Feldkirchen, Germany; Babes Bolyai University, Faculty of Physics, Cluj-Napoca, Romania.
GZA Ziekenhuizen, Sint Augustinus - Iridium Kankernetwerk Antwerpen, VUB, Faculty of Medicine and Pharmacy, Brussels, Belgium.
Radiother Oncol. 2017 Mar;122(3):347-351. doi: 10.1016/j.radonc.2017.01.006. Epub 2017 Jan 20.
Dynamic Wave Arc (DWA) is a system-specific noncoplanar arc technique that combines synchronized gantry-ring rotation with D-MLC optimization. This paper presents the clinical workflow, quality assurance program, and reports the geometric and dosimetric results of the first patient cohort treated with DWA.
The RayStation TPS was clinically integrated on the Vero SBRT platform for DWA treatments. The first 15 patients treated with DWA represent a broad range of treatment sites: breast boost, prostate, lung SBRT and bone metastases, which allowed us to explore the potentials and assess the limitations of the current DWA site-specific template solution. For the DWA verification a variety of QA equipment was used, from 3D diode array to an anthropomorphic end-to-end phantom. The geometric accuracy of each arc was verified with an independent orthogonal fluoroscopy method.
The average beam-on delivery time was 3min, ranging from 1.22min to 8.82min. All patient QAs passed our institutional clinical criteria of gamma index. For both EBT3 film and Delta4 measurements, DWA planned versus delivered dose distributions presented an average agreement above 97%. An overall mean gantry-ring geometric deviation of -0.03°±0.46° and 0.18°±0.26° was obtained, respectively.
For the first time, DWA has been translated into the clinic and used to treat various treatment sides. DWA has been successfully added to the noncoplanar rotational IMRT techniques arsenal, allowing additional flexibility in dose shaping while preserving dosimetrically robust delivery.
动态波弓（DWA）是一种特定于系统的非共面弧形技术，它将同步机架环旋转与 D-MLC 优化相结合。本文介绍了临床工作流程、质量保证计划，并报告了使用 DWA 治疗的第一批患者队列的几何和剂量学结果。
RayStation TPS 在 Vero SBRT 平台上进行了临床整合，用于 DWA 治疗。使用 DWA 治疗的前 15 名患者代表了广泛的治疗部位：乳房提升、前列腺、肺部 SBRT 和骨转移，这使我们能够探索当前 DWA 特定于部位模板解决方案的潜力并评估其局限性。对于 DWA 验证，使用了各种 QA 设备，从 3D 二极管阵列到人体模体。每个弧形的几何精度都使用独立的正交透视方法进行验证。
平均照射输送时间为 3 分钟，范围为 1.22 分钟至 8.82 分钟。所有患者的 QA 均通过了我们机构的临床伽马指数标准。对于 EBT3 胶片和 Delta4 测量，DWA 计划与交付剂量分布的平均一致性均高于 97%。分别获得了总体平均机架环几何偏差为-0.03°±0.46°和 0.18°±0.26°。
DWA 首次被转化为临床并用于治疗各种治疗部位。DWA 已成功添加到非共面旋转调强放疗技术库中，在保持剂量学稳健输送的同时，允许在剂量成形方面具有更大的灵活性。
