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Stereotac(c	
  Radiosurgery	
  
(Rota(on	
  #	
  9)	
  
Mentor:	
  Edward	
  C	
  Pennington	
  
(01/19/2010	
  –	
  03/05/2010)	
  
By	
  	
  
Vibha	
  Chaswal,	
  Ph.D.	
  
Contents	
  
Ac(vi(es 	
  	
  
•  Es(ma(on	
  of	
  mechanical	
  accuracy	
  of	
  the	
  floor-­‐
stand	
  
•  End-­‐to-­‐end	
  	
  process	
  tes(ng:	
  Absolute	
  phantom	
  
based	
  QA:	
  Frame-­‐based	
  and	
  Frame-­‐less	
  SRS	
  
•  Small	
  field	
  dosimetry	
  measurements:	
  TMRs,	
  
output	
  factors,	
  profiles,	
  off-­‐axis	
  factors	
  
•  CT	
  to	
  MRI	
  	
  image	
  registra(on	
  
•  SRS	
  treatment	
  planning	
  
•  Pre-­‐treatment	
  SRS	
  floor-­‐stand	
  QA	
  
•  Par(cipa(on	
  in	
  treatment	
  delivery	
  	
  
Mechanical	
  QA:	
  Floor-­‐stand	
  
End-­‐to-­‐End:	
  CT-­‐
Localiza1on	
  
(Frame-­‐based)	
  

TILT	
  and	
  SPIN	
  Adjusted	
  
on	
  Frame.	
  CT-­‐Localiza(on	
  
with	
  (lt	
  and	
  spin	
  
correc(on	
  
Max	
  error:	
  
Ax	
  (0.4	
  mm)	
  
Lat	
  (0.3	
  mm)	
  
A-­‐P	
  (0.5	
  mm)	
  
3D	
  (0.6	
  mm)	
  
Frame-­‐based	
  
End-­‐to-­‐End	
  tes(ng:	
  Floor-­‐stand	
  	
  
isocentric	
  localiza(on	
  	
  
Frame-­‐Less	
  SRS	
  	
  
End-­‐to-­‐End	
  isocentric	
  localiza(on	
  :	
  
SRS	
  Commissioning:	
  
Small	
  field	
  dosimetry	
  
TMR	
  and	
  Out-­‐put	
  measurement	
  set-­‐up	
  

NOT	
  A	
  TRIVIAL	
  AFFAIR	
  !!!!!!!!!	
  
~	
  3.5	
  %	
  lower	
  TMR	
  
And	
  dmax	
  ~	
  1	
  cm	
  
Re-­‐measurement	
  of	
  TMRs	
  
	
  Stereotac1c	
  	
  
Chamber-­‐valida1on	
  
TMR’s	
  s(ll	
  off	
  	
  
but	
  d-­‐max	
  depth	
  =	
  1.5	
  cm	
  
OUT-­‐PUT	
  Factor	
  
measurements	
  
Off-­‐Axis-­‐Factors	
  
Recommenda(on	
  of	
  independent	
  
Physics	
  check	
  on	
  TMR	
  measurements	
  
of	
  small	
  fields.	
  
Iden(fied	
  pit-­‐falls:	
  
SRS	
  stereotac(c	
  chamber	
  response	
  with	
  depth	
  
L-­‐R	
  (lt	
  on	
  the	
  SRS	
  phantom	
  base	
  (resolved	
  with	
  a	
  (ssue	
  propped	
  at	
  led	
  side)	
  
Par(cipa(on	
  
and	
  
observa(on	
  
in	
  SRS	
  work-­‐
flow:	
  
Iden(fica(on	
  
of	
  Physics	
  QA	
  
at	
  all	
  steps	
  
ThankYou!!!!!	
  

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Stereotactic Radiosurgery at UIHC