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MV Portal Imaging Versus Optical Surface Imaging for Intra-Fraction Motion Detection in Intracranial Stereotactic Radiosurgery

R Sullivan*, E Covington , R Popple , The University of Alabama at Birmingham, Birmingham, AL


(Sunday, 7/29/2018) 4:00 PM - 4:30 PM

Room: Exhibit Hall | Forum 5

Purpose: To verify the feasibility of using the MV portal imager to monitor intra-fractional motion and compare to the performance of the Optical Surface Monitoring System (OSMS) (Varian Medical Systems, Palo Alto, CA)

Methods: A skull phantom was placed in an open-faced thermoplastic mask and a CT scan obtained. A treatment plan was created and the phantom setup for treatment. Intra-fractional motion was simulated via couch shifts. MV images and OSMS real-time-deltas (RTDs) were acquired at couch angles of 0°, 45°, 315°, and 90° for no simulated shift and ±1 mm in the vertical, longitudinal, and lateral directions. Automatic registration was used to determine the MV image shifts, which were compared to the RTDs detected by OSMS.

Results: The MV image shifts in the lateral/longitudinal directions agreed to within 0.2 mm at all table angles; however, the MV images failed to detect the vertical shift and always reported 0 mm. The OSMS vertical and lateral RTDs were both within 0.1 mm. However, at table angles ±45° and no applied shift, the longitudinal RTDs displayed a systemic offset of 1.1 mm. For ±1 mm applied longitudinal shift, the RTD systemic offset was 0.4 mm. The lateral RTDs were within 0.2 mm at ±45°.

Conclusion: The MV portal imager and OSMS have comparable accuracy in detecting shifts in the lateral direction. Only OSMS was able to detect vertical motion, but displayed a systematic longitudinal offset for table angles ±45°. Additional work is necessary to characterize the OSMS offset for non-zero table angles. Both systems can be used in tandem to ensure accurate shift detection for all directions.

Funding Support, Disclosures, and Conflict of Interest: UAB receives research funding from Varian Medical Systems. R Popple has received speaking honoraria from Varian Medical Systems.


Image Guidance, Stereotactic Radiosurgery, Surface Matching


TH- External beam- photons: intracranial stereotactic/SBRT

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