• The Journal of Korean Society for Radiation Therapy
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• v.29 no.1
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• pp.7-18
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• 2017

Purpose: A QA Set was established to verify the movement accuracy of image-guided 6DoF Couch and to evaluate its usefulness. Materials and Methods: Two sets of linear accelerators equipped with 6DoF Couch and CBCT were used. Using the established QA Set, each CBCT image was obtained over 15 times through the Penta-Guide Phantom installed with off-set shift values along six translational (Translation; TX, TY, TZ) and rotational (Rotation, Pitch; RX, Roll; RY, Yaw; RZ) directions. Using this method, we compared the reference image and the registration image, and we analyzed the error calculated by measuring the positional accuracy of the modified 6DoF Couch. Results: The Air Cavity corresponding to the Pixel of the reference image and the registration image were all contained between 30 and 66, and the revealing high registration accuracy. Error between the modified off-set value of 6DoF Couch and the measured value along translational directions were $0.25{\pm}0.18mm$ in the TX direction, $0.25{\pm}0.25mm$ in the TY direction, and $0.36{\pm}0.2mm$ in the TZ direction. Misalignments along the rotational axis were $0.18{\pm}0.08^{\circ}$ in the RX direction, $0.26{\pm}0.09^{\circ}$ in the RY direction, and $0.11{\pm}0.08^{\circ}$ in the RZ direction, it was corrected precisely for any value. Conclusion: Using the YCC QA Set, we were able to verify the error of 6DoF Couch along both the translational and rotational directions in a very simple method. This system would be useful in performing Daily IGRT QA of 6DoF Couch.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.53-64
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• 2017

Purpose: To evaluate the usefulness of the $HexaPOD^{TM}$ evo RT system(6DoF couch) and the tendency of dose difference according to size of rotational direction error for volumetric rotational modulated radiotherapy(V-MAT) in patients with long target lengths. Therefore, it is suggested to recommend the need for rotational error correction. Materials and Methods: Ten patients with Esophagus cancer or Breast cancer including SCL treated with HexaPOD 6DoF(Six-Degree of Freedom) couch were included in this study. 6DoF couch was used to measure the difference in dose according to the rotation error in the directions of Rx(pitch), Ry(roll), and Rz(yaw). Each rotation error was applied. Positioning variation on x, y and z axis was verified and random variations were made by 6DoF couch with positioning variation. Modified DQA is conducted and point dose and gamma value are analyzed and compared. In addition, after applying the rotation error every $1^{\circ}$ to treatment plans of each target with a diameter of 3 cm, 5, 10, 15, and 20 cm respectively, gamma passing rate is being monitored by its aspect of change according to types and sizes of the target length and rotation error. Results: Mean error of the point dose and Gamma passing rate when the position variation was applied were $2.50{\pm}1.11%$ and $84.1{\pm}7.39%$ in the Rx direction, $2.36{\pm}1.16%$, and $81.0{\pm}8.49%$ in the Ry, $2.35{\pm}1.10%$ and $84.4{\pm}6.99%$ in the Rz direction, respectively. As a result of analysis on gamma passing rate according to types and sizes of the target length and rotation error, the gamma passing rate tended to decrease with increasing rotation error in the Rx and Rz directions except Ry direction. In particular, the lowest gamma passing rate (74.2 %) was in the case of $2.5^{\circ}$ rotation error in Rz direction of the target of 10 cm. Conclusion: The correction of the rotational error is needed for volumetric modulated radiotherapy of the treatment area with a long target length, and the use of 6DoF couch will improve the reproducibility of the patient position and the quality of the treatment.

• The Journal of Korean Society for Radiation Therapy
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• v.32
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• pp.7-15
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• 2020

Purpose: In modern radiotherapy technology, several methods of image guided radiation therapy (IGRT) are used to deliver accurate doses to tumor target locations and normal organs, including CBCT (Cone Beam Computed Tomography) and other devices, ExacTrac System, other than CBCT equipped with linear accelerators. In previous studies comparing the two systems, positional errors were analysed rearwards using Offline-view or evaluated only with a Yaw rotation with the X, Y, and Z axes. In this study, when using CBCT and ExacTrac to perform 6 Degree of the Freedom(DoF) Online IGRT in a treatment center with two equipment, the difference between the set-up calibration values seen in each system, the time taken for patient set-up, and the radiation usefulness of the imaging device is evaluated. Materials and Methods: In order to evaluate the difference between mobile calibrations and exposure radiation dose, the glass dosimetry and Rando Phantom were used for 11 cancer patients with head circumference from March to October 2017 in order to assess the difference between mobile calibrations and the time taken from Set-up to shortly before IGRT. CBCT and ExacTrac System were used for IGRT of all patients. An average of 10 CBCT and ExacTrac images were obtained per patient during the total treatment period, and the difference in 6D Online Automation values between the two systems was calculated within the ROI setting. In this case, the area of interest designation in the image obtained from CBCT was fixed to the same anatomical structure as the image obtained through ExacTrac. The difference in positional values for the six axes (SI, AP, LR; Rotation group: Pitch, Roll, Rtn) between the two systems, the total time taken from patient set-up to just before IGRT, and exposure dose were measured and compared respectively with the RandoPhantom. Results: the set-up error in the phantom and patient was less than 1mm in the translation group and less than 1.5° in the rotation group, and the RMS values of all axes except the Rtn value were less than 1mm and 1°. The time taken to correct the set-up error in each system was an average of 256±47.6sec for IGRT using CBCT and 84±3.5sec for ExacTrac, respectively. Radiation exposure dose by IGRT per treatment was measured at 37 times higher than ExacTrac in CBCT and ExacTrac at 2.468mGy and 0.066mGy at Oral Mucosa among the 7 measurement locations in the head and neck area. Conclusion: Through 6D online automatic positioning between the CBCT and ExacTrac systems, the set-up error was found to be less than 1mm, 1.02°, including the patient's movement (random error), as well as the systematic error of the two systems. This error range is considered to be reasonable when considering that the PTV Margin is 3mm during the head and neck IMRT treatment in the present study. However, considering the changes in target and risk organs due to changes in patient weight during the treatment period, it is considered to be appropriately used in combination with CBCT.