Kong X, Clausen C, Wang S
Cancer Institute, St John's Hospital, Springfield, IL.
Med Phys. 2012 Jun;39(6Part19):3843. doi: 10.1118/1.4735687.
Clinical experience for configuration, commission and implementation of SmartArc with MOSAIQ R&V system.
SmartArc is Pinnacle's solution for VMAT. On July 2011 we updated to Pinnacle 9.0 and purchased SmartArc. A standalone Eclipse workstation has been used 3 years for VMAT planning. Our clinical setting: Mosaiq 2.2; Varian Trilogy driven by 4DiTC and Varian 21ex driven by sequencer. Some key physics parameters have been studied: machine dose rate; MLC leaf speed; Leaf motion per gantry rotation. Tabletop was created by user to improve the dose accuracy for planning. In-house sandwich phantom was used with MapCheck for planner dose verification. A PTW 0.6cc ion chamber was included for absolute dose comparison.
A copy of current machine data with default highest dose rate is recommended. It is due to after 10th iteration of optimization, the default dose rate will kick in. 2.5cm/s is the constraint for Varian Millennium 120 MLC; a buffer zone of 10% is suggested to reduce the MLC error on treatment. 2.25cm/s is used in our configuration. This results in MLC interlock if not configured correct. Maximum leaf motion per gantry rotation of 0.46cm/degree has to be checked for planning with Mosaiq R&V. Otherwise, undeliverable plan will show up sometimes on 4DiTC.Tabletop was exported as a DICOM structure from Eclipse to Pinnacle; we created a ROI template based on the matched tabletop.QA using in-house phantom for different sites were tested. Results for both planner dose and absolute chamber measurement are satisfactory.
Special attentions need to be paid for dose rate, MLC leaf speed, leaf motion per gantry rotation when configuring SmartArc. Varian 21ex is supported but is slow for clinical delivery. Users need to create your own tabletop to improve planning accuracy. Conventional commission procedures for RapidArc also apply for SmartArc.
介绍SmartArc与MOSAIQ R&V系统配置、调试及实施的临床经验。
SmartArc是Pinnacle公司针对容积调强弧形治疗(VMAT)的解决方案。2011年7月,我们升级到Pinnacle 9.0并购买了SmartArc。一台独立的Eclipse工作站已用于VMAT计划3年。我们的临床环境:Mosaiq 2.2;由4DiTC驱动的瓦里安Trilogy直线加速器和由序列器驱动的瓦里安21ex直线加速器。研究了一些关键物理参数:机器剂量率;多叶准直器(MLC)叶片速度;每机架旋转的叶片运动。用户创建了台面以提高计划的剂量准确性。使用内部夹心体模与MapCheck进行计划者剂量验证。包含一个PTW 0.6cc电离室用于绝对剂量比较。
建议复制当前具有默认最高剂量率的机器数据。这是因为在优化的第10次迭代之后,默认剂量率将生效。2.5厘米/秒是瓦里安Millennium 120 MLC的限制;建议设置10%的缓冲区以减少治疗时的MLC误差。我们的配置中使用的是2.25厘米/秒。如果配置不正确,这会导致MLC互锁。对于使用Mosaiq R&V进行计划,必须检查每机架旋转的最大叶片运动为0.46厘米/度。否则,有时在4DiTC上会出现无法交付的计划。台面从Eclipse作为DICOM结构导出到Pinnacle;我们基于匹配的台面创建了一个感兴趣区域(ROI)模板。使用针对不同部位的内部体模进行了质量保证测试。计划者剂量和绝对电离室测量的结果都令人满意。
配置SmartArc时,需要特别注意剂量率、MLC叶片速度、每机架旋转的叶片运动。支持瓦里安21ex,但临床交付速度较慢。用户需要创建自己的台面以提高计划准确性。快速弧形治疗(RapidArc)的传统调试程序也适用于SmartArc。