Department of Radiation Oncology Henry Ford Health System Publishing Title: Evaluation of the Systematic Accuracy of Cutting Edge Technology for Stereotactic Radiosurgery Treatment  Session title: Physics 1 - Innovative Planning and Delivery Strategies Date/Time: 2014-09-16 13:00 Location: Room D-1 Monitor number: 3 Ning Wen Department of Radiation Oncology Henry Ford Health System 2799 W. Grand Blvd Detroit, MI48202

The Edge system at Henry Ford E: 6XFFF, 10XFFF 2.5XFFF, HD120MLC OSMS x 3 IR camera Calypso x 3 PerfectPitch® 6D Couch MV Detector aS1200, 43x43 cm2 Calypso

EDGE E2E Phantom (Prototype) Outer cube dimensions: 15 x 15 x 15 cm3, density 0.45 g/cm3 Trackable using kV, MV radiographic imaging (16x 5mm diameter BB’s made of ceramics Al2O3) CBCT (densities: 0.25, 0.45, 1.05 and 1.42 g/cm3) Calypso (Beacon® transponders are not removable) OSMS Interchangable inner cubes (7 x 7 x 7 cm3) Single film plane for all 3 orthogonal isocenter planes, density=1.05 g/cm3 Two orthogonal film planes, density=1.05 g/cm3 5 mm diameter tungsten BB in center (W-L test) Mechanical accuracy < 5/100 mm Image Courtesy from Varian

Winston Lotz Test Results Gantry Rotation Gantry-Collimator-Couch Rotation

Multiple Targets Single Isocenter Test Auto + Manual Auto   Central BB 56.5 mm BB 65 mm BB 92 mm BB Mean 0.30 0.44 0.52 0.47 Std 0.08 0.19 0.13 0.15 Max 0.71 0.84 0.65 Min 0.17 0.14 0.43 0.25   Central BB 56.5 mm BB 65 mm BB 92 mm BB Mean 0.56 0.51 0.62 0.63 Std 0.24 0.43 0.35 Max 0.84 0.80 1.18 Min 0.16 0.20 0.05

Summary Coincidence of isocenters of the imaging systems and Linac is within 1 mm. The localization accuracy of the Edge platform can achieve submillimeter level. The targeting accuracy for multiple lesions with shared isocenter is promising. However lesion size and the distance from the isocenter should be evaluated before planning. Other factors (CT, MR, imaging fusion, contour, tumor motion) should be considered in the SRS/SBRT treatment.