Abstract
Purpose:Accuray recommends daily evaluation of the treatment localization and delivery systems (TLS/TDS) of the CyberKnife. The vendor‐provided solution is a Winston‐Lutz‐type test that evaluates film shadows from an orthogonal beam pair (known as AQA). Since film‐based techniques are inherently inefficient and potentially inconsistent and uncertain, this study explores a method which provides a comparable test with greater efficiency, consistency, and certainty. This test uses the QAStereoChecker (QASC, Standard Imaging, Inc., Middleton, WI), a high‐resolution flat‐panel detector with coupled fiducial markers for automated alignment. Fiducial tracking is used to achieve high translational and rotational position accuracy.Methods:A plan is generated delivering five circular beams, with varying orientation and angular incidence. Several numeric quantities are calculated for each beam: eccentricity, centroid location, area, major‐axis length, minor‐axis length, and orientation angle. Baseline values were acquired and repeatability of baselines analyzed. Next, errors were induced in the path calibration of the CK, and the test repeated. A correlative study was performed between the induced errors and quantities measured using the QASC. Based on vendor recommendations, this test should be able to detect a TLS/TDS offset of 0.5mm.Results:Centroid shifts correlated well with induced plane‐perpendicular offsets (p < 0.01). Induced vertical shifts correlated best with the absolute average deviation of eccentricities (p < 0.05). The values of these metrics which correlated with the threshold of 0.5mm induced deviation were used as individual pass/fail criteria. These were then used to evaluate induced offsets which shifted the CK in all axes (a clinically‐realistic offset), with a total offset of 0.5mm. This test provided high and specificity and sensitivity.Conclusion:From setup to analysis, this filmless TLS/TDS test requires 4 minutes, as opposed to 15–20 minutes for film‐based methods. The techniques introduced can potentially isolate errors in individual joints of the CK robot.Spectrum Medical Physics, LLC of Greenville, SC has a consulting contract with Standard Imaging of Middleton, WI
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