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Initial evaluation of intrafraction motion using frameless CyberKnife VSI system.

Alejandro Floriano1, Icíar Santa-Olalla1, Alberto Sanchez-Reyes1

  • 1Department of Medical Physics, CyberKnife Unit, IMO Group Radiotherapy and Robotic Radiosurgery Center, Madrid, Spain.

Reports of Practical Oncology and Radiotherapy : Journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology
|January 14, 2014
PubMed
Summary

Frameless robotic radiosurgery using the CyberKnife VSI system achieved high accuracy, with intrafraction movement below 0.85 mm. Image acquisition frequency is crucial for maintaining precision in radiosurgery treatments.

Keywords:
AccuracyFramelessIntrafraction movementRobotic radiosurgery

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Neurosurgery

Background:

  • Stereotactic radiosurgery demands high spatial accuracy for effective dose delivery.
  • Frameless radiosurgery, while offering immobilization via thermoplastic masks, may not entirely eliminate intrafraction patient movement.
  • Evaluating the impact of intrafraction movement is critical for ensuring global treatment accuracy in frameless radiosurgery.

Purpose of the Study:

  • To analyze intrafraction movement in patients undergoing frameless robotic radiosurgery.
  • To assess how image acquisition frequency influences overall accuracy in these procedures.

Main Methods:

  • Intrafraction motion was analyzed in 15 patients undergoing intracranial radiosurgery (39 fractions) using the CyberKnife VSI system.
  • Patient position was monitored at intervals of 15-90 seconds to estimate intrafraction movement.
  • The study estimated systematic and random movement components across three translational axes.

Main Results:

  • The 99% displacement error was found to be less than 0.85 mm with the established imaging protocol and immobilization device.
  • Systematic movement components were below 0.05 mm, and random components were below 0.3 mm in all three translational axes.
  • A clear linear time dependence was observed in the random component of movement.

Conclusions:

  • Optimizing X-ray image acquisition timing is essential for achieving the required accuracy in CyberKnife VSI radiosurgery.
  • The study's image acquisition protocol was verified to meet the stringent 1-mm accuracy criterion for radiosurgery procedures.