Dosimetry and tools everday use snc company

Dosimetry and tools

1. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.

Dosimetry for everyday use
Adrian Fleet
SNC Regional Manager- Europe

2. © 2014 Sun Nuclear Corporation. All rights reserved.

3. © 2014 Sun Nuclear Corporation. All rights reserved.

Our Infrastructure
•Built-In Expertise
o>20 experienced members of customer support team including clinical physicists
o>30% of Sun Nuclear is dedicated to Research and Development
o>15 AAPM Task Group memberships including TG-142, TG-016, and TG-100

•Systems
o CE & ISO Quality Management System (QMS)
o9 FDA 510(k) clearances
oThree Radiation Bunkers
–Varian 21EX
»Customer training in the Sun Nuclear Training Center
–Clinac 2100C, 80 leaf MLC (X: 6,15; e: 6,9,12,15, 18)
»Research & Development
–Cobalt 60, 2000 Ci
»Manufacturing tests

•Vertical Integration
oCore competencies include R&D, manufacturing, radiation test, Sales/Marketing

4. © 2014 Sun Nuclear Corporation. All rights reserved.

Sun Nuclear Training Center
•Industry focus on proper training to comply with requirements

•5,000 sq ft facility located in Melbourne, FL
oLecture hall comfortably seats 60
oControl console connected to 65- and 80-inch monitors
oFully commissioned linac and TPS
oBunker modeled after a clinical setting

•First classes to be available in the Fall

5. © 2014 Sun Nuclear Corporation. All rights reserved.

Leading Technology
•The Right Detector for the Right Application
oManufacturer of both diode and ion chamber arrays
oSunPoint® Diode detectors
–Offering smaller volume, better sensitivity, less drift and increased lifetime
•Fast Setup
oPortable and lightweight
oSingle power/data cable
oNo pre-irradiation or warm up required
•Increased Efficiencies
oDevice integrated electrometers
oUser performed array calibration
•Convenient Product Licensing
oUnlimited computer stations per product
license (where applicable)
oInternet downloadable – no waiting
oProduct license files work on all computers
–No computer specific codes

6. © 2014 Sun Nuclear Corporation. All rights reserved.

Independence & Transparency
SNC Data File
•Sun Nuclear software
oSolutions are independent of planning and delivery vendors
–Proper checks and balances
oSun Nuclear owns and maintains all of its own code base
–No “black boxes”
–All algorithms documented in online help
–Ensures prompt customer service

•Sun Nuclear data
oMeasurement based
oOpen format for export and analysis
oOriginal raw and processed data

7. © 2014 Sun Nuclear Corporation. All rights reserved.

Collaboration
•Cooperative Partnerships
o>10 industry partnerships including all major OEMs

8. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.
PROFILER
Family

9. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.

Daily QA
™
3

10. © 2014 Sun Nuclear Corporation. All rights reserved.

•25 Detectors:
oOutput, flatness, symmetry, energy and field size
•No additional buildup required
•Ion chambers and diodes
•Automatic temperature & pressure correction
•Real-time wireless option
•Only one entry into room
•Software included
oWith trend analysis database
An advanced tool for daily quality assurance of a radiation therapy beam

Daily QA
TM
3

11. © 2014 Sun Nuclear Corporation. All rights reserved.

•The Daily QA 3™ uses both ion
chambers & diodes
oRight detector for the right application

•Daily QA 3™ has 25 detectors:
o5 chambers for flatness/symmetry
o4 chambers for electron energy checks
o4 chambers for photon energy checks
o12 diodes for light-radiation
coincidence





Daily QA
TM
3 Detectors

12. © 2014 Sun Nuclear Corporation. All rights reserved.

Pending
QA
Detector
Layout
QA Date
Linac
Setup
Results
Analysis
Panel
QA Button

Daily QA
TM
3 Software – QA Measurement

13. © 2014 Sun Nuclear Corporation. All rights reserved.

Selected
Energy
Accumulated
Detector
Dose
Trend Graph
Tolerance
Line
Results
Analysis
Panel
Trend Button
Selected
Measured

Daily QA
TM
3 Software – QA Trending

14. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.

Patient Specific VMAT/IMRT QA

ArcCHECK
®

with 3DVH
®

15. © 2014 Sun Nuclear Corporation. All rights reserved.

ArcCHECK Design
•1386 diodes in a helical geometry
oPatented detector orientation

•21cm diameter, 21cm length
oCombine feature extends to 36cm length

•Sub mm effective spacing
oWith Merge feature density is doubled

•Virtual Inclinometer
TM
(VI)
oIndependently calculate gantry angle

•4
th
Dimension = Time
oMulti-arc control point analysis
oContinuous measurement
–50ms updates measuring each pulse

•Weight: 16kg


U.S.Patent No.
8,044,359
6,125,335
VI

16. © 2014 Sun Nuclear Corporation. All rights reserved.

Detector Geometry
•Measurements at multiple depths
oEntrance and exit measurements
•Central 10x10 contains ~221 detectors
o442 detectors with ‘Merge’ feature
•Detectors are arranged on a HeliGrid™
oIncreases BEV data density and reduces detector overlap

17. © 2014 Sun Nuclear Corporation. All rights reserved.

•Small size able to “catch” the beam edges accurately

•Reliable response

•Reproducible results

MapCHECK 2 Benefit
SunPoint® Diode Detector Volume

18. © 2014 Sun Nuclear Corporation. All rights reserved.

SunPoint® Diode Detectors
•Reproducibility
Short term: +/- 0.15% (15 consecutive 60 cGy
fields)
Long term: +/- 0.2% (9 month period)
Sensitivity change: < 0.5%/kGy at 6MV,
1.5%/kGy at 10 MeV
User calibrated in only 15 minutes (typically
every 12-18 months)

•Sometimes, smaller is better
More than 4500 times smaller than ion
chambers
Allow TRUE point to point comparison with the
TPS calculated dose
Offer 10 times or more sensitivity than ion
chambers – despite small size
Measure in Absolute Dose with no warm-up
time required

19. © 2014 Sun Nuclear Corporation. All rights reserved.

•ArcCHECK features a versatile central cavity
oMay be used to accommodate different detectors and inserts
oMultiPlug
TM
(left) also accommodates EBT film cassette and up to 25
unique locations including isocenter, measuring every pulse
Central Cavity Options

20. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.

Clinically Relevant
and Patient Specific QA
3DVH
®

21. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.

22. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.
PerFRACTION
™
3D


with
Fraction 0
™
Fraction n
™

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PerFRACTION
™
=

Full Automation

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Why in vivo dosimetry?
“A quantification of the effectiveness of EPID dosimetry and software-based plan
verification systems in detecting incidents in radiotherapy”
Bojechko C, Phillips M, Kalet A, Ford E.C.
Department of Radiation Oncology, University of Washington
Med Phys 42(9), Sept 2015
•C Study over 2.5 years of all failure modes 4437 Patients - 343
incidents rated “potentially severe” or “critical –
•Pre-Tx EPID dosimetry detected 6% of errors (physics calculation
errors, treatment machine error, and corrupted plans) – all modes with
low number of occurrences
•First Fraction in vivo QA detected 74% of all failures – incidents with the
highest occurrence (patient setup, CT dataset errors)
“The most effective EPID-based dosimetry verification is in vivo
measurements during the first fraction”
•All Fraction in vivo QA added the ability to detect other common errors
(movement on the table, treatment machine error, and setup errors)
“In vivo all fraction dosimetry gives an added benefit to 20% of events”
First fraction in vivo

25. © 2014 Sun Nuclear Corporation. All rights reserved.

Fraction 0
TM
/ Fraction n
TM

•Fraction 0
oPre-Treatment
IMRT QA without a
phantom

0 n
Fraction n
In-Vivo verification of
every treatment

26. © 2014 Sun Nuclear Corporation. All rights reserved.

Why PerFRACTION
TM
?
Industry Challenges to overcome to by SNC’s 30 R&D Physicists and
Engineers to ensure a comprehensive and Fully automated solution
for patient treatment QA.
•Take the patient into account =Hundreds of images every day
•Automated
•Independent
•No additional time clinical workflow, and minimal impact to the review
team
•Therapists and Physicists
•Robust
•Able to Determine both Patient and Machine Deviations
oChanges to patient anatomy
oMLC drift
oDifferences in gantry rotation or linac output

27. © 2014 Sun Nuclear Corporation. All rights reserved.

Automation Benefits
•Seamless to your workflow
oAutomatic DICOM data file
capture and per-fraction QA
analysis

oAutomatic Email notification of
per-fraction failures

oAuto Calibration – Automated
EPID panel response
calibration and modeling

•Full Automation supported for:
oVarian, Elekta, Aria and Mosaiq

28. © 2014 Sun Nuclear Corporation. All rights reserved.

Dashboard
•Real-time
summary by
machine.

•Click on any
chart to view
detailed
records.

•Adjustable
timeframes.

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Patient List for Selected Linac
Quickly review the details and status of individual patient treatments.
Drill down further to per-beam results.

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Fraction Results Page

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Clinical Goals
•DVH Goals
•Point Dose Goals
•Planned vs.
Delivered

32. © 2014 Sun Nuclear Corporation. All rights reserved.

Clinical Goals
•DVH Comparisons
•Max/Min/Mean Dose

33. © 2014 Sun Nuclear Corporation. All rights reserved.

Trending – Multiple Patients
Trend multiple patients to discover coincident changes that highlight
potential machine issues.

34. © 2014 Sun Nuclear Corporation. All rights reserved.

Fault Finder
•Potential Source identified

35. © 2014 Sun Nuclear Corporation. All rights reserved.

Delivery Error Sensitivity
1
“Monitoring daily MLC positional errors using trajectory log files and EPID measurements for IMRT and VMAT deliveries,” A. Agnew, et al., 2014 Phys. Med. Biol. 59 N49
2
Varian Field Safety Notice CP-12459, July 2014

36. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.

37. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.
DoseCHECK™
Automated, TPS-Grade Secondary Calculations

38. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.

39. © 2014 Sun Nuclear Corporation. All rights reserved.

The “New Way”
oReturns to the true intent of the second calculation -
verifying patient dose

oInput - RT Plan data from TPS

oReconstructs patient dose in 3D using CCCS algorithm
oDisplays Planned vs. Calculated:
–Point Dose calculations (including points of interest in
plan)
–DVH
–3D Dose comparison
–Clinical Goals/protocols
MU vs Dose Calculation

40. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.
SNC Machine
™
The Essential Machine QA Solution

41. © 2014 Sun Nuclear Corporation. All rights reserved.

Full Automation

42. © 2014 Sun Nuclear Corporation. All rights reserved.

TG-142 & VMAT Test Library
TG-142 Tests

•Image Quality & Accuracy
oCBCT
okV
oMV

•MLC
oPicket Fence
oLog File Positioning & Leaf Speed
oNew Hancock MLC test with absolute
positioning

•Starshot
oGantry
oCouch
oCollimator

•Beam
oLight/Radiation Field Congruence
oField Size
oFlatness
oSymmetry
oMax Penumbra

•Winston-Lutz Radiation Isocenter (3D)
•Winston-Lutz Mechanical Isocenter (3D)

VMAT Tests
•Dose Rate versus Gantry Speed
•Leaf Speed
•Arc Point Dose
•DMLC Point Dose

43. © 2014 Sun Nuclear Corporation. All rights reserved.

SNC Machine Dashboard
•Presents all recently executed tests. Failed tests are highlighted red.
Approve the tests from the dashboard or click the test to drill down and
scrutinize the results.

44. © 2014 Sun Nuclear Corporation. All rights reserved.

Machine Setup
•Tasks are automatically created based on selected options

45. © 2014 Sun Nuclear Corporation. All rights reserved.

46. © 2014 Sun Nuclear Corporation. All rights reserved.

© 2014 Sun Nuclear Corporation. All rights reserved.
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