Commissioning and initial stereotactic ablative radiotherapy experience with Vero

Timothy D. Solberg, Paul M. Medin, Ezequiel Ramirez, Chuxiong Ding, Ryan D. Foster, John Yordy

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The purpose of this study is to describe the comprehensive commissioning process and initial clinical performance of the Vero linear accelerator, a new radiotherapy device recently installed at UT Southwestern Medical Center specifically developed for delivery of image-guided stereotactic ablative radiotherapy (SABR). The Vero system utilizes a ring gantry to integrate a beam delivery platform with image guidance systems. The ring is capable of rotating ± 60° about the vertical axis to facilitate noncoplanar beam arrangements ideal for SABR delivery. The beam delivery platform consists of a 6 MV C-band linac with a 60 leaf MLC projecting a maximum field size of 15 × 15 cm2 at isocenter. The Vero planning and delivery systems support a range of treatment techniques, including fixed beam conformal, dynamic conformal arcs, fixed gantry IMRT in either SMLC (step-and-shoot) or DMLC (dynamic) delivery, and hybrid arcs, which combines dynamic conformal arcs and fixed beam IMRT delivery. The accelerator and treatment head are mounted on a gimbal mechanism that allows the linac and MLC to pivot in two dimensions for tumor tracking. Two orthogonal kV imaging subsystems built into the ring facilitate both stereoscopic and volumetric (CBCT) image guidance. The system is also equipped with an always-active electronic portal imaging device (EPID). We present our commissioning process and initial clinical experience focusing on SABR applications with the Vero, including: (1) beam data acquisition; (2) dosimetric commissioning of the treatment planning system, including evaluation of a Monte Carlo algorithm in a specially-designed anthropomorphic thorax phantom; (3) validation using the Radiological Physics Center thorax, head and neck (IMRT), and spine credentialing phantoms; (4) end-to-end evaluation of IGRT localization accuracy; (5) ongoing system performance, including isocenter stability; and (6) clinical SABR applications.

Original languageEnglish (US)
Pages (from-to)205-225
Number of pages21
JournalJournal of Applied Clinical Medical Physics
Volume15
Issue number2
StatePublished - 2014

Fingerprint

Radiotherapy
radiation therapy
delivery
thorax
gantry cranes
arcs
Thorax
Head
Credentialing
Imaging techniques
Planning
Equipment and Supplies
planning
Particle Accelerators
Linear accelerators
rings
Physics
platforms
gimbals
pivots

Keywords

  • Commissioning
  • Image-guided radiotherapy
  • Stereotactic ablative radiotherapy (SABR)
  • Stereotactic body radiation therapy (SBRT)

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Instrumentation

Cite this

Commissioning and initial stereotactic ablative radiotherapy experience with Vero. / Solberg, Timothy D.; Medin, Paul M.; Ramirez, Ezequiel; Ding, Chuxiong; Foster, Ryan D.; Yordy, John.

In: Journal of Applied Clinical Medical Physics, Vol. 15, No. 2, 2014, p. 205-225.

Research output: Contribution to journalArticle

Solberg, Timothy D. ; Medin, Paul M. ; Ramirez, Ezequiel ; Ding, Chuxiong ; Foster, Ryan D. ; Yordy, John. / Commissioning and initial stereotactic ablative radiotherapy experience with Vero. In: Journal of Applied Clinical Medical Physics. 2014 ; Vol. 15, No. 2. pp. 205-225.
@article{00a96db897dc4939aab2716584d48581,
title = "Commissioning and initial stereotactic ablative radiotherapy experience with Vero",
abstract = "The purpose of this study is to describe the comprehensive commissioning process and initial clinical performance of the Vero linear accelerator, a new radiotherapy device recently installed at UT Southwestern Medical Center specifically developed for delivery of image-guided stereotactic ablative radiotherapy (SABR). The Vero system utilizes a ring gantry to integrate a beam delivery platform with image guidance systems. The ring is capable of rotating ± 60° about the vertical axis to facilitate noncoplanar beam arrangements ideal for SABR delivery. The beam delivery platform consists of a 6 MV C-band linac with a 60 leaf MLC projecting a maximum field size of 15 × 15 cm2 at isocenter. The Vero planning and delivery systems support a range of treatment techniques, including fixed beam conformal, dynamic conformal arcs, fixed gantry IMRT in either SMLC (step-and-shoot) or DMLC (dynamic) delivery, and hybrid arcs, which combines dynamic conformal arcs and fixed beam IMRT delivery. The accelerator and treatment head are mounted on a gimbal mechanism that allows the linac and MLC to pivot in two dimensions for tumor tracking. Two orthogonal kV imaging subsystems built into the ring facilitate both stereoscopic and volumetric (CBCT) image guidance. The system is also equipped with an always-active electronic portal imaging device (EPID). We present our commissioning process and initial clinical experience focusing on SABR applications with the Vero, including: (1) beam data acquisition; (2) dosimetric commissioning of the treatment planning system, including evaluation of a Monte Carlo algorithm in a specially-designed anthropomorphic thorax phantom; (3) validation using the Radiological Physics Center thorax, head and neck (IMRT), and spine credentialing phantoms; (4) end-to-end evaluation of IGRT localization accuracy; (5) ongoing system performance, including isocenter stability; and (6) clinical SABR applications.",
keywords = "Commissioning, Image-guided radiotherapy, Stereotactic ablative radiotherapy (SABR), Stereotactic body radiation therapy (SBRT)",
author = "Solberg, {Timothy D.} and Medin, {Paul M.} and Ezequiel Ramirez and Chuxiong Ding and Foster, {Ryan D.} and John Yordy",
year = "2014",
language = "English (US)",
volume = "15",
pages = "205--225",
journal = "Journal of Applied Clinical Medical Physics",
issn = "1526-9914",
publisher = "American Institute of Physics Publising LLC",
number = "2",

}

TY - JOUR

T1 - Commissioning and initial stereotactic ablative radiotherapy experience with Vero

AU - Solberg, Timothy D.

AU - Medin, Paul M.

AU - Ramirez, Ezequiel

AU - Ding, Chuxiong

AU - Foster, Ryan D.

AU - Yordy, John

PY - 2014

Y1 - 2014

N2 - The purpose of this study is to describe the comprehensive commissioning process and initial clinical performance of the Vero linear accelerator, a new radiotherapy device recently installed at UT Southwestern Medical Center specifically developed for delivery of image-guided stereotactic ablative radiotherapy (SABR). The Vero system utilizes a ring gantry to integrate a beam delivery platform with image guidance systems. The ring is capable of rotating ± 60° about the vertical axis to facilitate noncoplanar beam arrangements ideal for SABR delivery. The beam delivery platform consists of a 6 MV C-band linac with a 60 leaf MLC projecting a maximum field size of 15 × 15 cm2 at isocenter. The Vero planning and delivery systems support a range of treatment techniques, including fixed beam conformal, dynamic conformal arcs, fixed gantry IMRT in either SMLC (step-and-shoot) or DMLC (dynamic) delivery, and hybrid arcs, which combines dynamic conformal arcs and fixed beam IMRT delivery. The accelerator and treatment head are mounted on a gimbal mechanism that allows the linac and MLC to pivot in two dimensions for tumor tracking. Two orthogonal kV imaging subsystems built into the ring facilitate both stereoscopic and volumetric (CBCT) image guidance. The system is also equipped with an always-active electronic portal imaging device (EPID). We present our commissioning process and initial clinical experience focusing on SABR applications with the Vero, including: (1) beam data acquisition; (2) dosimetric commissioning of the treatment planning system, including evaluation of a Monte Carlo algorithm in a specially-designed anthropomorphic thorax phantom; (3) validation using the Radiological Physics Center thorax, head and neck (IMRT), and spine credentialing phantoms; (4) end-to-end evaluation of IGRT localization accuracy; (5) ongoing system performance, including isocenter stability; and (6) clinical SABR applications.

AB - The purpose of this study is to describe the comprehensive commissioning process and initial clinical performance of the Vero linear accelerator, a new radiotherapy device recently installed at UT Southwestern Medical Center specifically developed for delivery of image-guided stereotactic ablative radiotherapy (SABR). The Vero system utilizes a ring gantry to integrate a beam delivery platform with image guidance systems. The ring is capable of rotating ± 60° about the vertical axis to facilitate noncoplanar beam arrangements ideal for SABR delivery. The beam delivery platform consists of a 6 MV C-band linac with a 60 leaf MLC projecting a maximum field size of 15 × 15 cm2 at isocenter. The Vero planning and delivery systems support a range of treatment techniques, including fixed beam conformal, dynamic conformal arcs, fixed gantry IMRT in either SMLC (step-and-shoot) or DMLC (dynamic) delivery, and hybrid arcs, which combines dynamic conformal arcs and fixed beam IMRT delivery. The accelerator and treatment head are mounted on a gimbal mechanism that allows the linac and MLC to pivot in two dimensions for tumor tracking. Two orthogonal kV imaging subsystems built into the ring facilitate both stereoscopic and volumetric (CBCT) image guidance. The system is also equipped with an always-active electronic portal imaging device (EPID). We present our commissioning process and initial clinical experience focusing on SABR applications with the Vero, including: (1) beam data acquisition; (2) dosimetric commissioning of the treatment planning system, including evaluation of a Monte Carlo algorithm in a specially-designed anthropomorphic thorax phantom; (3) validation using the Radiological Physics Center thorax, head and neck (IMRT), and spine credentialing phantoms; (4) end-to-end evaluation of IGRT localization accuracy; (5) ongoing system performance, including isocenter stability; and (6) clinical SABR applications.

KW - Commissioning

KW - Image-guided radiotherapy

KW - Stereotactic ablative radiotherapy (SABR)

KW - Stereotactic body radiation therapy (SBRT)

UR - http://www.scopus.com/inward/record.url?scp=84896335861&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84896335861&partnerID=8YFLogxK

M3 - Article

VL - 15

SP - 205

EP - 225

JO - Journal of Applied Clinical Medical Physics

JF - Journal of Applied Clinical Medical Physics

SN - 1526-9914

IS - 2

ER -