Comprehensive Daily QA: A Comparison between CyberKnife ® System and LinAc Techniques Jacob A. Gersh, PhD DABR Gibbs Cancer Center and Research institute – Greer, SC Spectrum Medical Physics, LLC – Greenville, SC Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
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Comprehensive Daily QA: A Comparison
between CyberKnife ® System and LinAc
Techniques
Jacob A. Gersh, PhD DABR
Gibbs Cancer Center and Research institute – Greer, SC
Spectrum Medical Physics, LLC – Greenville, SC
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Speaker is owner of Spectrum Medical Physics, LLC of Greenville, SC.
Maintains financial and/or consulting relationships with
Standard Imaging
Accuray
Siemens Medical
Integrated Medical Technologies
An honorarium is provided by Accuray for this presentation
Financial Disclosures
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Disclaimer
The views expressed in this presentation are those of the presenters and do
not necessarily reflect the views or policies of Accuray Incorporated or its
subsidiaries. No official endorsement by Accuray Incorporated or any of its
subsidiaries of any vendor, products or services contained in this
presentation is intended or should be inferred.
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Purpose
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Conventional LinAc users have a large assortment of daily QA devices
and software available which provide:
Accuracy
Efficiency
Effortless Trending and Reporting
CyberKnife® System options are limited
Presented is my clinical experience in applying technology and
techniques (many of which have become standard for use with LinAcs) to
the CyberKnife® System, with emphasis on daily QA.
LinAc (Stereotactic TrueBeam)
Quality Assurance Tests
Based on TG-142
Equipment
Standard Imaging QA
BeamChecker+™
Gantry Mount
Flat Panel Imagers (attached to
LinAc)
MV
kV
Winston-Lutz Phantom
CBCT Phantom
CyberKnife® System (M6™ with MLC)
Quality Assurance Tests
Based on TG-135
Does not include recommendations for Iris™ QA and MLC QA
Vendor Recommendations
Equipment
Standard Imaging QA BeamChecker+™
CuttingBoard Fixture
Standard Imaging QA StereoChecker™
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Daily QA
Daily QA
LinAc (Stereotactic TrueBeam)
Safety*
Beam Output
kV and MV Imager Alignment
Field Light and ODI
Laser Alignment
Winston-Lutz (Weekly)
MLC (Weekly)
Dynamic Wedges (Weekly)
CBCT (Weekly)
CyberKnife® System (M6™ with MLC)
Safety*
Beam Output
Alignment (PANDA, AQA™)
Laser Alignment
MLC
Iris™ Variable Aperture Collimator
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Note: Weekly tests are performed during the performance of daily QA
* Safety Tests, while important, and not discussed herein
Daily QA
LinAc (Stereotactic TrueBeam)
Safety*
Beam Output
kV and MV Imager Alignment
Field Light and ODI
Laser Alignment
Winston-Lutz (Weekly)
MLC (Weekly)
Dynamic Wedges (Weekly)
CBCT (Weekly)
CyberKnife® System (M6™ with MLC)
Safety*
Beam Output
Alignment (PANDA, AQA™)
Laser Alignment
MLC
Iris™ Variable Aperture Collimator
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Note: Weekly tests are performed during the performance of daily QA
* Safety Tests, while important, and not discussed herein
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Self-Contained QA System
For Photons and Electrons
Portable and Compact
Wireless and Software-Free
Operation
Available with Gantry Mount
QA BeamChecker+™Standard Imaging, Inc.
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Output Constancy
Flatness
Symmetry
kV Imager Alignment
MV Imager Alignment
Field Light
Crosshair Alignment
ODI Accuracy
Laser Alignment
Dynamic Wedges
LinAc QA Using the QA BeamChecker+™
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Output Constancy
Flatness
Symmetry
kV Imager Alignment
MV Imager Alignment
Field Light
Crosshair Alignment
ODI Accuracy
Laser Alignment
Dynamic Wedges
LinAc QA Using the QA BeamChecker+™
2% Tolerance
(TG-142 Monthly)
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Output Constancy
Flatness
Symmetry
kV Imager Alignment
MV Imager Alignment
Field Light
Crosshair Alignment
ODI Accuracy
Laser Alignment
Dynamic Wedges
LinAc QA Using the QA BeamChecker+™
2% Tolerance
(TG-142 Monthly)
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Output Constancy
Flatness
Symmetry
kV Imager Alignment
MV Imager Alignment
Field Light
Crosshair Alignment
ODI Accuracy
Laser Alignment
Dynamic Wedges
LinAc QA Using the QA BeamChecker+™
2% Tolerance
(TG-142 Monthly)
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Output Constancy
Flatness
Symmetry
kV Imager Alignment
MV Imager Alignment
Field Light
Crosshair Alignment
ODI Accuracy
Laser Alignment
Dynamic Wedges
LinAc QA Using the QA BeamChecker+™
1 mm Tolerance
(TG-142)
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Output Constancy
Flatness
Symmetry
kV Imager Alignment
MV Imager Alignment
Field Light
Crosshair Alignment
ODI Accuracy
Laser Alignment
Dynamic Wedges
LinAc QA Using the QA BeamChecker+™
1 mm Tolerance
(TG-142)
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Output Constancy
Flatness
Symmetry
kV Imager Alignment
MV Imager Alignment
Field Light
Crosshair Alignment
ODI Accuracy
Laser Alignment
Dynamic Wedges
LinAc QA Using the QA BeamChecker+™
1 mm Tolerance
(TG-142)
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Output Constancy
Flatness
Symmetry
kV Imager Alignment
MV Imager Alignment
Field Light
Crosshair Alignment
ODI Accuracy
Laser Alignment
Dynamic Wedges
LinAc QA Using the QA BeamChecker+™
2% Tolerance
(TG-142 Monthly)
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Output Constancy
Flatness
Symmetry
kV Imager Alignment
MV Imager Alignment
Field Light
Crosshair Alignment
ODI Accuracy
Laser Alignment
Dynamic Wedges
LinAc QA Using the QA BeamChecker+™
1 mm Tolerance
(TG-142)
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Output Constancy
Flatness
Symmetry
kV Imager Alignment
MV Imager Alignment
Field Light
Crosshair Alignment
ODI Accuracy
Laser Alignment
Dynamic Wedges
LinAc QA Using the QA BeamChecker+™
1 mm Tolerance
(TG-142)
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Output Constancy
Flatness
Symmetry
kV Imager Alignment
MV Imager Alignment
Field Light
Crosshair Alignment
ODI Accuracy
Laser Alignment
Dynamic Wedges
LinAc QA Using the QA BeamChecker+™
1.5% Tolerance
(Gibbs CC)
Daily QA
LinAc (Stereotactic TrueBeam)
Safety*
Beam Output
kV and MV Imager Alignment
Field Light and ODI
Laser Alignment
Winston-Lutz (Weekly)
MLC (Weekly)
Dynamic Wedges (Weekly)
CBCT (Weekly)
CyberKnife® System (M6™ with MLC)
Safety*
Beam Output
Alignment (PANDA, AQA™)
Laser Alignment
MLC
Iris™ Variable Aperture Collimator
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO
Note: Weekly tests are performed during the performance of daily QA
* Safety Tests, while important, and not discussed herein
CyberKnife® System Output QA Using the QA BeamChecker+™
Presented at the 2017 Annual Meeting of the AAPM – Denver, CO