Integrating cine EPID, dynamic delivery, and the off-axis Winston-Lutz test to enhance quality control in multiple brain metastasis stereotactic radiotherapy.

Fiche publication

Date publication

mars 2024

Journal

Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)

Auteurs

Membres identifiés du Cancéropôle Est :
Dr RETIF Paul

Tous les auteurs :
Retif P, Djibo Sidikou A, Waltener A, Letellier R, Al Salah A, Pfletschinger E, Taesch F, Verrecchia-Ramos E, Michel X

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/38547546

Résumé

Stereotactic radiotherapy (SRT) has transformed cancer treatment, especially for brain metastases. Ensuring accurate SRT delivery is crucial, with the Winston-Lutz test being an important quality control tool. Off-axis Winston-Lutz (OAWL) tests are designed for accuracy assessment, but most are limited to fixed angles and hampered by local-field shifts caused by suboptimal Multi-Leaf Collimator (MLC) positioning. This study introduces a new OAWL approach for quality control in multi-brain-metastasis SRT. Utilizing cine Electronic Portal Imaging Device (EPID) images, it can be used with dynamic conformal arc (DCA) therapy. However, dynamic OAWL (DOAWL) is prone to more local-field shifts due to dynamic MLC movements. A two-step DOAWL is proposed: step 1 calculates local-field shifts using dynamic MLC movements in the beam-eye view data from the Treatment Planning System (TPS), while step 2 processes cine EPID images with an OAWL algorithm to isolate true deviations.