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Transition From CyberKnife Based SRS Program to Linac Based Frameless SRS Program: A Community Based Hospital Experience

D Workie1 , P Mone2*, C Coleman3 , G Ray4 , R Caroll5 , J Linder6 , A Jordan7 , (1) Sinai Hospital, Baltimore, MD, (2) Sinai Hospital of Baltimore, Baltimore, MD, (3) Sinai hospital of Baltimore, Baltimore, MD, (4) Sinai Hospital of Baltimore, Baltimore, MD, (5) Sinai Hospital of Baltimore, Baltimore, MD, (6) Sinai Hospital of Baltimore, Baltimore, MD, (7) Sinai Hospital of Baltimore, Baltimore,

Presentations

(Sunday, 7/14/2019)  

Room: ePoster Forums

Purpose: The project intent is to transit from CyberKnife based SRS/SBRT program to Linac based frameless SRS and SBRT program in a community hospital setting.

Methods: The clinic has strong experience with CyberKnife based SRS/SBRT procedures. The clinic decision to replace an older Linac with EDGE® Radiosurgery System and phasing-out the CyberKnife system comes with its challenges of moving the clinic from CyberKnife based SRS/SBRT program to Linac based frameless SRS and SBRT program. Such a transition requires great team work and steep learning curve. For this purpose, in addition to staff training, the following End-to-End Phantom studies were performed: 1) In-house phantom studies using Calibrated Ionization Chambers inserted into different simple solid phantoms. A CT scan of each phantom was generated and the Ionization Chambers active volumes were contoured as a target in the Eclipse™ planning system. VMAT, Dynamic Conformal Arcs, and Circular Arc plans were generated in Eclipse™ planning system. Each phantom was positioned on the treatment couch and initial target treatment ISO positions were achieved using Optical Surface Monitoring System (when necessary). For each phantom CBCT image was then taken and final treatment position was achieved. For each study the chamber was then connected to an electrometer and delivered plans readings were noted. 2) Third party End-to-End Verification. RPC Single-Beam SRS Phantom, RPC SRS Head Phantom, and RPC Lung phantom studies were performed following RPC procedures.

Results: The average absolute dose delivered to the in-house phantom targets was in agreement within 2.0% of the planning dose. The RPC phantom studies results were within the criteria set by RPC.

Conclusion: This work gave the confidence to our clinic to move from CyberKnife based SRS/SBRT program to an efficient frameless SRS and SBRT program. The clinic has now Linac based frameless SRS and SBRT treatment procedures and workflows.

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