Pre-treatment verification for IMRT / IGRT and Rotational therapy

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In OmniPro-I mrt Vivo treatment software verification Pre-treatment verification for IMRT / IGRT and Rotational therapy Introduction Introduction Introduction Introtro Intro Intro The rapid development of advanced treatment techniques and planning places higher demands on the verification of the dose delivered to the patient. In Vivo Dosimetry is an essential element in the quality assurance program used in today s radiotherapy department. In several European countries In Vivo Dosimetry has become mandatory, based on the directive Medical Exposure Directive 97/43/ Euratom, which recommends that In Vivo Dosimetry is performed. Furthermore In Vivo Dosimetry is used to control the total accumulated dose in cases where the treatment planning system is less accurate, such as in total body irradiation (TBI), in the build-up region and in risk organs in the head and neck region. Furthermore In Vivo Dosimetry is used to control the total accumulated dose in cases where the treatment planning system is less accurate, such as in total body irradiation (TBI), in the build-up region and in risk organs in the head and neck region. The rapid development of advanced treatment techniques and planning places higher demands on the verification of the dose delivered to the patient. In Vivo Dosimetry is an essential element in the quality assurance program used in today s radiotherapy department. In several European countries In Vivo Dosimetry has become mandatory, based on the directive Medical Exposure Directive 97/43/ Euratom, which recommends that In Vivo Dosimetry is performed. The rapid development of advanced treatment techniques and planning places higher demands on the verification of the dose delivered to the patient. In Vivo Dosimetry is an essential element in the quality assurance program used in today s radiotherapy department. In several European countries In Vivo Dosimetry has become mandatory, based on the directive Medical Exposure Directive 97/43/ Euratom, which recommends that In Vivo Dosimetry is performed. Furthermore In Vivo Dosimetry is used to control the total accumulated dose in cases where the treatment planning system is less accurate, such as in total body irradiation (TBI), in the build-up region and in risk organs in the head and neck region.

Efficiency at work OmniPro-I mrt is an intuitive, user friendly application software for complete plan verification and QA of IMRT / IGRT and Rotational treatments. OmniPro-I mrt incorporates the latest software technology with extensive and flexible import and export functionalities. It compares TPS planned data with measured 2D data from the I mrt MatriXX and MatriXX Evolution, EPID or film exposed e.g. in the I mrt Phantom. Easy parameter set-up allows fast, real-time verification of measured vs planned treatments. Various types of 1D, 2D and 3D visualization and mathematical comparison techniques of dynamic treatment deliveries vs plan are included. Customizable macro settings enable optimal efficiency and integration in the workflow. The software comprises efficient functions for storage and retrieval of data for e.g. print-out, export or reimbursement purposes. Use cases: IMRT / IGRT / Rotational delivery vs plan verification Step & Shoot and dynamic field verification Linac QA (symmetry, flatness, penumbra) Analysis of individual segments and composed IMRT fields Light vs radiation field congruence Real-time visualization of the measured 2D delivery Time based analysis e.g. Linac start-up behavior Multiple profile analysis Rotational therapy interface: angular dependence optimization dose per frame as a function of the gantry angle 2 IBA DOSIMETRY IMRT / IGRT

Pre-treatment verification in only 4 steps STEP 1 TPS import STEP 3 Visual comparison Mathematical analysis STEP 2 Measurement I mrt MatriXX MatriXX Evolution Film EPID STEP 4 Archive, Report, Export 3 IBA DOSIMETRY IMRT / IGRT

10 features (V 1.7) to further increase efficiency and accuracy ➊ Macros Macros are the easiest way to extend the use of OmniPro-I mrt: Automate and customize frequently used commands, e.g. rescale, shift, smooth, etc. Apply to single or multiple data sets Save as text fi les including a macro name Call by hotkeys or Macro menu Intuitive macro setup via graphical user interface Example Macro A Correct origin Smooth Convert grid Turn array A Additional features: ➎ The Film Control Panel polation method for ADC-to-Dose curve Renewed version of the fi lm control panel for composite plan dosimetry with radiochromic or gafchromic fi lms and archiving of fi lms. Direct calibration of the ADC-to-Dose (Gy, cgy, mgy ) using calibration pattern (A) Advanced new interpolation method for ADC-to-Dose curve (B) Correction of the scanner artifacts using the correction method recommended by the supplier of gafchromic fi lms B C ➏ ➐ ➑ MatriXX measurement: Data display during movie mode measurement Advanced print report: Cursor on the images, Gamma-values, fl exible line width and other information Improved ergonomics of the user interface 4 IBA DOSIMETRY IMRT / IGRT

➋ Advanced interpolation method Fermi Fit As interpolation method either the linear interpolation or the Fermi Fit can be selected. The Fermi Fit is used to fi t the measurements at the fi eld edges to the expected shape of the fi eld penumbra: Calculation of fi eld width and penumbra Also applicable for multiple profi le analysis Determination of MLC leaf positions Factory ➌ MatriXX user-uniformity-calibration Fast and easy MatriXX user-uniformity-calibration: In addition to the existing Factory Co60 Uniformity Calibration, the MatriXX user can apply a user uniformity calibration on site Factory Co60 uniformity calibration Clinic ➒ ➓ Flexible extended DICOM i/f: DICOM Listener runs as a Windows service even if OmniPro-I mrt is not started Import of DICOM directory Export of data as DICOM RT Image Running on Microsoft Windows Vista TM * * Some accessories might not be Microsoft Windows Vista TM compatible (e.g. Film scanner) ➍ Rotational Therapy application RapidArc, VMAT and Hi-Art MatriXX Evolution and MULTICube Optimal fl exibility and highest accuracy Measurement of the gantry angle to: optimize the angular dependence compute dose per frame as a function of the gantry angle User uniformity calibration User absolute calibration 5 IBA DOSIMETRY IMRT / IGRT

Maximize efficiency, minimize errors Visual comparison 1D profi le comparison & analysis 2D isodose comparison using dynamic isodoses Verifi cation of planned vs measured, measured vs measured and planned vs planned data 1D, 2D and 3D data visualization: profi les, isodose contours, 2D/3D dose distributions and histograms for data sets and results Advanced isodose set-up with template fi les Synchronized zoom function Extensive cursor analysis functions such as distance, position, angle etc. ROI analysis Automated mathematical analysis Absolute dose verifi cation Verifi cation of planned vs measured, measured vs measured and planned vs planned data Basic mathematics: sum (absolute) difference multiplication division Advanced mathematics: correlation DTA (distance to agreement) extended Gamma method (threshold, gamma angle, optimized algorithm) ROI analysis Rescaling, Automatic Origin Correction, Shifting, Turning, Smoothing, Flipping, Cutting, Adding Constant Values, Changing Plane, Converting Grid User-defi ned fi lters for image processing (e.g. edge detection, sharpen, gaussian blur) Multi profi le analysis (e.g. for MLC check) Archive, Report, Export Export and import of generic ASCII fi les, TIFF (16 bit grayscale), lossless JPG and confi gurable raw binary, RFA-300 beam data, data export to OmniPro-Advance via opg. Export of single or multiple profi les to OmniPro-Accept via ASCII Copy & Paste (e.g. to Microsoft Excel, Word, Notepad) Export of MatriXX images to the TomoTherapy system (e.g. TIFF-Files) Print single views Advanced print report: Cursor on the images, Gamma-values, flexible line width and other information Export of data as DICOM RT images 6 IBA DOSIMETRY IMRT / IGRT

Interfacing flexibility to suit your needs TPS import Import of planned 2D and 3D dose from all TPS supporting DICOM RT (from network and fi les) RTOG (ASCII and binary) formats proprietary formats (e.g. BrainLAB, CMS, Plato, CadPlan) Import of fl uence maps from various TPS e.g. CadPlan, Pinnacle, CMS, BrainLAB, Eclipse (via DICOM RT plan compensator) EPID data via iviewgt browser EPID data via DICOM interface (optional) Import data from TomoTherapy system (DICOM, ASCII) Flexible extended DICOM interface: DICOM Listener runs as a Windows Service even if OmniPro-I mrt is not started import of DICOM directory import & export of data as DICOM RT images Film scanner types Film data from Vidar, Kodak (Lumisys), 16 bit grayscale TIFF images and DICOM CR Scanner and fi lm calibration routines Scanners: Vidar VXR-16, VXR-16 DosimetryPRO, DosimetryPRO Advantage/Kodak (Lumisys) Film Digitizer (e.g. Kodak CR, Agfa) via import of DICOM CR fi les Support of gafchromic fi lms including extraction of one RGB channel Phantoms Two phantoms are available: MULTICube for Rotational Therapy (MatriXX Evolution, fi lm) I mrt Phantom for IMRT Film Dosimetry 2D digital systems Two versions are available: I mrt MatriXX for IMRT / IGRT treatment verifi cation MatriXX Evolution for IMRT / IGRT and Rotational treatment verifi cation EPID OmniPro-I mrt can import DICOM data from all current EPID systems 7 IBA DOSIMETRY IMRT / IGRT

Minimum computer requirements Operating system: Processor: Memory: Hard disk: Monitor and graphics: Ports: Film scanners supported: Import of planned data: Microsoft Windows (XP, Vista TM * 32-bit) Technical data is subject to change without prior notice. Pentium (or equivalent), 1.8 GHz or better 2 GB RAM (recommended for real-time intensity mode) with at least 160 MB available, recommended 40 GB for data archiving supporting a resolution of 1024 x 768 pixel at True Colour (32-bit) available Ethernet connection (RJ-45 for MatriXX) interface to film scanner, USB 2.0 Vidar TM VXR-16, VXR-16 DosimetryPRO, DosimetryPRO Advantage, Kodak (Lumisys)**, Flatbed scanners (via import of 48 bit colour tif data) and CR scanners (Kodak, Agfa) via import of DICOM CR files CadPlan (dose / fluence), CMS (dose / fluence), BrainLAB (dose / fluence), Plato (dose), Pinnacle (fluence) and from all TPS that support DICOM RT or RTOG formats * Some accessories might not be Microsoft Windows Vista TM compatible (e.g. Film scanner) **Some devices may not be supported by Windows 2000, XP, Vista TM Manufacturer: Sweden IBA Dosimetry AB P.O. Box 1004 751 40 Uppsala Tel.: +46 18 18 07 00 Fax: +46 18 12 75 52 Germany IBA Dosimetry GmbH Bahnhofstr. 5 90592 Schwarzenbruck Tel.: +49 9128 607 0 Fax: +49 9128 607 10 USA IBA Dosimetry America 3150 Stage Post Drive, Suite 110 Bartlett, TN 38133 Tel.: +1 901 386 2242 Fax: +1 901 382 9453 P-07-002-581-002_OmniPro-I mrt 1.7 software Brochure 2009-08-12 IBA 2009 / All rights reserved China IBA Dosimetry China No.6, Xing Guang Er Jie Beijing OPTO-mechatronics Industrial Park (OIP), Tongzhou District Beijing 101111 Tel.: +86 10 8080 9288 Fax: +86 10 8080 9299 0413 www.iba-dosimetry.com info@iba-dosimetry.com