Pei Hailong X-RAD 225CX/SMART COMMISSIONING, QA AND FACILITIES MANAGEMENT

HT Safety Interlock for Door Service Access Door Control Electronics Cabinet Routine Access Door Radiation Warning Light U-arm and Drive Assembly Load-bearing Gantry Ring CsI:Tl a-Si:H Detector NDT X-ray Tube (5- 225kVp) Detector- protecting Shutter and Drive Assembly X-Rad 225Cx: Interior View X-RAD SmART Small Animal IGRT Mouse

X-RAD SmART PILOT Software Pilot X-RAD and PilotCal Software -Developed by Radiation Physics Experts at Princess Margaret Cancer Center -Full Suite of System Control Software Pilot X-RAD -System Control Software -Registered Accounts, Studies, Specimens for all system researchers -For use in all experimental scenarios -Control of system motion -Image Acquisition (Fluoroscopy, CBCT, BLI, etc.) -Delivery of Treatment Plans through Control Files PilotCal -System Calibration Software (Physics “Guts”) -Separate software platform away from control software – important for limiting access -Full Suite of necessary calibrations (FPD Calibration, Geometric Calibration, BLI Calibration, etc.) -Control of system plans, presets for each experiment

X-RAD SmART PILOT Application Fluoroscopic Image Guidance

CBCT Image Guidance X-RAD SmART PILOT Application

Multiple Mouse Imaging X-RAD SmART Small Animal IGRT

X-RAD SmART SmART Plan Treatment Planning

X-RAD SmART Typical Dose Rates CollimatorDose Rate None (Full Field 10 cm x 10 cm)6.56 Gy/min 40 mm x 40 mm Square5.34 Gy/min 10 mm x 20 mm Rectangle5.06 Gy/min 15 mm Circular4.66 Gy/min 10 mm Circular4.56 Gy/min 5 mm Circular4.43 Gy/min 2.5 mm Circular4.08 Gy/min 4500W High Power System 225 kVp, 20 mA, 0.3 mm Cu Filter 0.5 cm Below Surface

X-RAD SmART SmART Plan Treatment Planning

X-RAD SmART SmART Plan Treatment Planning

X-RAD SmART SmART Plan Treatment Planning

X-RAD SmART SmART Plan Treatment Planning

X-RAD SmART Radiobiological Applications Mouse Orthotopic Lung Tumors (Liege) Glioblastoma radiotherapy resistance (Liege) Hippocampal Sparing Brain Irradiation (Duke) Erectile dysfunction due to radiation damage (Duke) Head and Neck Cancer + Mucositis (Duke) Central Nervous System – Radiation Tissue Necrosis and subsequent cognitive impairment (Duke) Development of Dual Energy CT on the system (Maastricht) Targeted Glioblastoma irradiation and tumor response tracking (Maastricht) Inverse Planning Development in SmART Plan (Maastricht) Partial Lung Irradiation (Maastricht) Targeted Lung Irradiation (UTSW) Measuring genetic differences in primary and recurring medulloblastoma (Toronto – Nature Paper) Measuring RBE advantages to surrounding healthy tissue structures of complex irradiations in cervical tumor irradiations (Toronto) Measurement in Damage to tumor vasculature during partial brain irradiation using confocal microscopy (Toronto) Impact of combining RT with anti-angiogenic therapy (Sunitinib) in imaging biomarker dynamics (Toronto) Measuring changes to Tumor vasculature during spinal cord irradiation using a multi-parametric imaging system (Toronto) Measuring effects of radiation on Rabbit mandibular tumors

Typical Dose Characteristics: Depth dose for 225 kVp (HVL=0.9mm Cu) & 100 kVp (HVL=2.8mm Al) 100 kV p, 2.8 mm Al HVL 225 kVp, 0.9 mm Cu HVL TG61 Calibration Results Research courtesy of Patricia Lindsay, PhD & UHN, Toronto X-RAD SmART Small Animal IGRT