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WE-G-BRB-03:关于使用DAVID系统检测颌骨校准偏差

WE-G-BRB-03: On the Detectability of Jaw Decalibrations with the DAVID System.

作者信息

Poppe B, Looe H, Harder D

机构信息

Carl von Ossietzky University and Pius-Hospital, Oldenburg.

Georg-August University, Göttingen.

出版信息

Med Phys. 2012 Jun;39(6Part28):3967. doi: 10.1118/1.4736189.

Abstract

PURPOSE

To evaluate if the recently described problems with the calibration of jaws at Varian linear accelerators can be detected with the DAVID system.

METHODS

Recently Varian Clinac field size issues resulted in a widespread medical device correction notice, stating that incorrect jaw positioning due to excessive connector resistances may result in clinically relevant deviations from the intended field size. Since field size checks via the light field, separately for each administered field segment, are not practicable, it might be helpful to know that an independent, permanently active field size surveillance system is routinely used in our department since four years. The DAVID system (PTW-Freiburg, Germany) is a translucent multiwire transmission ionisation chamber, placed in the linac accessory holder. Each detection wire of the chamber is positioned in theprojection of the midline of the associated MLC leaf pair, resulting in a signal proportional to the leaf pair aperture. High lateral resolution has been achieved by a deconvolution software (Looe et al, PMB 55, 2010, 3981- 3992). MLC decalibrations are detected by comparison between measured and reference signal profiles.

RESULTS

The side wings of the DAVID system signal profiles are sensibly influenced by the position of the backup jaw blocks limiting the field size in the direction at right angles to the MLC travel direction. Systematic variation of the backup jaw positions for several field sizes and IMRT plans has revealed high sensitivity of the signal profile side wings with respect to jaw decalibrations.

CONCLUSIONS

The DAVID system is able to detect, without any delay, suddenly appearing jaw decalibrations down to positioning errors less than 1mm. Use of the DAVID system provides the independent and permanent surveillance of correct field sizes including the position of the backup jaws, making checks of light-field congruence for each field segment unnecessary.

摘要

目的

评估DAVID系统能否检测出Varian直线加速器最近所描述的钳口校准问题。

方法

最近Varian Clinac射野尺寸问题导致了一份广泛发布的医疗器械纠正通知,指出由于连接器电阻过大导致的钳口定位不正确可能会导致与预期射野尺寸存在临床相关偏差。由于通过光野分别对每个照射野段进行射野尺寸检查不切实际,了解到我们科室四年来一直常规使用一个独立的、永久运行的射野尺寸监测系统可能会有所帮助。DAVID系统(德国PTW - 弗莱堡公司)是一个置于直线加速器附件支架中的半透明多丝传输电离室。电离室的每根检测丝位于相关MLC叶片对中线的投影位置,从而产生与叶片对孔径成比例的信号。通过反卷积软件(Looe等人,《物理医学与生物学》55卷,2010年,3981 - 3992页)已实现了高横向分辨率。通过比较测量信号轮廓和参考信号轮廓来检测MLC校准偏差。

结果

DAVID系统信号轮廓的侧翼受到备用钳口挡块位置的显著影响,备用钳口挡块在与MLC行进方向成直角的方向上限制射野尺寸。对几种射野尺寸和调强放疗计划的备用钳口位置进行系统变化研究,结果显示信号轮廓侧翼对钳口校准偏差具有高灵敏度。

结论

DAVID系统能够立即检测出突然出现的钳口校准偏差,直至定位误差小于1毫米。使用DAVID系统可对包括备用钳口位置在内的正确射野尺寸进行独立且永久的监测,无需对每个照射野段的光野一致性进行检查。

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