Abstract

PurposeCharacterize the intra‐fraction motion management (IFMM) system found on the Gamma Knife Icon (GKI), including spatial accuracy, latency, temporal performance, and overall effect on delivered dose.MethodsA phantom was constructed, consisting of a three‐axis translation mount, a remote motorized flipper, and a thermoplastic sphere surrounding a radiation detector. An infrared marker was placed on the translation mount secured to the flipper. The spatial accuracy of the IFMM was measured via the translation mount in all Cartesian planes. The detector was centered at the radiation focal point. A remote signal was used to move the marker out of the IFMM tolerance and pause the beam. A two‐channel electrometer was used to record the signals from the detector and the flipper when motion was signaled. These signals determined the latency and temporal performance of the GKI.ResultsThe spatial accuracy of the IFMM was found to be <0.1 mm. The measured latency was <200 ms. The dose difference with five interruptions was <0.5%.ConclusionThis work provides a quantitative characterization of the GKI IFMM system as required by the Nuclear Regulatory Commission. This provides a methodology for GKI users to satisfy these requirements using common laboratory equipment in lieu of a commercial solution.

Highlights

  • With the inception of the Gamma Knife Icon (GKI; Elekta Instrument AB, Stockholm Sweden), additional functionality has been added to the treatment system, including a cone beam computed tomography (CBCT) and an infrared camera‐based intra‐fraction motion management (IFMM) system allowing for frameless stereotactic radiosurgery

  • The current license guidance from the Nuclear Regulatory Commission (NRC) for GKI dictates on a monthly basis the user will “confirm that the IFMM system is working properly by performing a test without a patient

  • We are currently unaware of any commercial systems or published literature that allow the user to quantitatively test the temporal latency along with the spatial accuracy of the IFMM system as required by the NRC and as is recommended in current published radiation oncology quality assurance guidelines.[8]

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Summary

Introduction

With the inception of the Gamma Knife Icon (GKI; Elekta Instrument AB, Stockholm Sweden), additional functionality has been added to the treatment system, including a cone beam computed tomography (CBCT) and an infrared camera‐based intra‐fraction motion management (IFMM) system allowing for frameless stereotactic radiosurgery. The current license guidance from the Nuclear Regulatory Commission (NRC) for GKI dictates on a monthly basis the user will “confirm that the IFMM system is working properly by performing a test without a patient. We are currently unaware of any commercial systems or published literature that allow the user to quantitatively test the temporal latency along with the spatial accuracy of the IFMM system as required by the NRC and as is recommended in current published radiation oncology quality assurance guidelines.[8]

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