iviewdose Confidence and assurance in dose delivery

Transcription

1 iviewdose Confidence and assurance in dose delivery As radiotherapy techniques advance and treatment plans become more complex, involving escalated doses and increasingly conformal deliveries, the need for intelligent checking methods is essential. In-vivo dosimetry using iviewdose from Elekta uses EPID images containing information about dose and position to highlight potential errors at every stage of the treatment process from planning to treatment delivery. iviewdose has been developed for both pre-treatment and in-vivo dose comparison using a fast back-projection algorithm which provides dose reconstruction within the patient (or phantom) in multiple (3D) or single (2D) planes parallel to the EPID 1. With the demands of busy radiotherapy departments in mind, iviewdose performs analysis in the background to prevent any impact on the clinical workflow

2 The challenge of complex treatments Complicated treatment techniques such as IMRT & VMAT are now widely used to deliver a high dose to the tumor while minimizing the dose to surrounding healthy tissue In order to achieve accurate dose delivery, a great deal of attention has to be paid to quality assurance (QA) of all steps in the planning and delivery process 1 [1] I Olaciregui-Ruiz et. al. Automatic in vivo portal dosimetry of all treatments, Phys Med Biol, 58 (2013) No

3 iviewdose Workspace iviewdose - a comprehensive treatment verification tool that: Delivers confidence and assurance by detecting gross errors arising within the treatment process including errors resulting from changes to patient anatomy. Makes efficient use of time and resources by utilizing equipment that is already an integral part of the linac and with little impact on clinical workflow Actively indicates the need for further analysis with an easy-to-interpret configurable traffic light alert system Scalable clinical implementation supporting both pre-treatment and in-vivo dosimetry for all treatment modalities, including IMRT and VMAT Allows compliance with national and international guidelines 2

4 Assuring intended treatment delivery Gross error detection iviewdose provides an effective and easy to use solution for the detection of gross errors in radiotherapy. - no additional dose - EPID data capture during treatment delivery - Intuitive alert notification Rapid intervention Providing an essential safety net for radiation therapy iviewdose alerts the physicist to any deviation in the analysis. Investigative tools within the software allow interrogation of the analysis. Inspection tools include - Plan Dose, EPID Reconstructed Dose & Gamma Analysis viewers - EPID image viewer - Dose Profile viewer - Image probe with coordinate inspection values - User defined pre-set auto association alert parameters Sample report 3

5 End-to-end verification of the treatment process iviewdose provides end to end verification of the entire treatment process, with the potential to detect more errors 1. Studies show that this method provides an important safety net for advanced treatments such as IMRT and VMAT 1,2,3. The types of errors iviewdose will detect include: - systematic machine errors - random machine errors - treatment planning errors and plan deliverability - dose calculation errors - anatomical changes in the patient - errors in data transfer - set up deviations and obstructions iviewdose is an independent check, autonomous from the Treatment Planning System (TPS) 3. Enhancing workflows and convenience Low impact on clinical workflow iviewdose connects to the existing iviewgt image acquisition system on Elekta linear accelerators. The radiation therapist simply needs to deploy the MV detector panel for image data acquisition 4 Automatic analysis and off-line review iviewdose automatically compares the delivered reconstructed dose to the planned dose distributions using Gamma Analysis. User-defined alert criteria include Time saving Analysis and report generation is automatic within iviewdose. Intuitive alert notification allows for rapid assessment and acceptance of each report. Reports can reviewed and edited at any time within MOSAIQ 5 Investigative activities can be focused towards clinically relevant deviations from plan. Demonstrating compliance Rapid confirmation that the planned dose was delivered within tolerance. Reports stored in MOSAIQ provide an audit trail. iviewdose helps radiotherapy departments fulfil legal requirements in several countries and meets local and international regulatory recommendations and requirements. Proven performance iviewdose was developed in collaboration with leading experts in the field of treatment verification at The Netherlands Cancer Institute Antoni van Leeuwenhoek (NKI-AVL). Benefiting from over 6 years clinical experience & thousands of patients at NKI-AVL, iviewdose core algorithm is also being evaluated and adopted by a consortium of experts from leading centres around the world. A complete assurance package iviewdose forms part of a comprehensive suite of products available from Elekta to ensure the consistent safe delivery of radiotherapy to patients. It is easy and familiar to use, remaining independent of the treatment planning system in order to provide accurate and meaningful treatment verification. - Gamma Mean - Gamma 1% - % Gamma 1 - % Dose Difference at DRP 4

6 ABOUT ELEKTA Elekta s purpose is to invent and develop effective solutions for the treatment of cancer and brain disorders. Our goal is to help our customers deliver the best care for every patient. Our oncology and neurosurgery tools and treatment planning systems are used in more than 6,000 hospitals worldwide. They help treat over 100,000 patients every day. The company was founded in 1974 by Professor Lars Leksell, a physician. Today, with its headquarters in Stockholm, Sweden, Elekta employs around 4,000 people in more than 30 offices across 24 countries. The company is listed on NASDAQ OMX Stockholm. References: [1] I Olaciregui-Ruiz, R Rozendaal et al (2013) Automatic in-vivo portal dosimetry of all treatments. Phys. Med. Biol, 58 (2013) [2] B Mijnheer, B, Olaciregui-Ruiz, I, Rozendaal, R et al. (2013) 3D EPID-based in-vivo dosimetry for IMRT and VMAT. Presented at the 7th International Conference on 3D Radiation Dosimetry. Journal of Physics: Conference Series 444: [3] Wendling, M, McDermott, LN, Mans, A et al (2009) A simple backprojection algorithm for 3D in-vivo EPID dosimetry of IMRT treatments. Med. Phys. 36: [4] Requires iviewgt r3.4.1 enabled in ICOM mode. [5] Requires MOSAIQ r2.62 with Document Import License enabled. Art. No :16. Elekta. All rights reserved. No part of this documents may be reproduced in any form without written permission from the copyright holder. All trademarks of Elekta products are the property of Elekta.