WE-AB-BRB-10: Filmless QA of CyberKnife MLC-Collimated and Iris-Collimated Fields




Current methods of CK field shape QA is based on the use of radiochromic film. Though accurate results can be attained, these methods are prone to error, time consuming, and expensive. The techniques described herein perform similar QA using the FOIL Detector (Field, Output, and Image Localization). A key feature of this in-house QA solution, and central to this study, is an aSi flat-panel detector which provides the user with the means to perform accurate, immediate, and quantitative field analysis.


The FOIL detector is automatically aligned in the CK beam using fiducial markers implanted within the detector case. Once the system is aligned, a treatment plan is delivered which irradiates the flat-panel imager using the field being tested. The current study tests each of the clinically-used fields shaped using the Iris variable-aperture collimation system using a plan which takes 6 minutes to deliver. The user is immediately provided with field diameter and beam profile, as well as a comparison to baseline values. Additionally, the detector is used to acquire and analyze leaf positions of the InCise multi-leaf collimation system.


Using a 6-minute plan consisting of 11 beams of 25MU-per-beam, the FOIL detector provided the user with a quantitative analysis of all clinically-used field shapes. The FOIL detector was also able to clearly resolve field edge junctions in a picket fence test, including slight over-travel of individual leaves as well as inter-leaf leakage.


The FOIL system provided comparable field diameter and profile data when compared to methods using film; providing results much faster and with 5% of the MU used for film. When used with the MLC system, the FOIL detector provided the means for immediate quantification of the performance of the system through analysis of leaf positions in a picket fence test field.

Author is the President/Owner of Spectrum Medical Physics, LLC, a company which maintains contracts with Siemens Healthcare and Standard Imaging, Inc.