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Related Experiment Video

Updated: Aug 30, 2025

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System
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A customizable, open-source Winston-Lutz system for multi-target, single isocentre radiotherapy.

P A K Oliver1,2, T R Wood2, L N Baldwin1,2

  • 1University of Alberta, Department of Oncology, Division of Medical Physics, 11560 University Ave, Edmonton, Alberta T6G 1Z2, Canada.

Biomedical Physics & Engineering Express
|September 1, 2022
PubMed
Summary
This summary is machine-generated.

An open-source system verifies radiotherapy targeting accuracy for multiple targets with a single isocenter. This quality assurance tool extends the Winston-Lutz test, ensuring precise treatment delivery.

Keywords:
SRSWinston-Lutz testlinac quality assurancesingle isocentre treatment of multiple targetsstereotactic radiosurgery

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiotherapy Quality Assurance

Background:

  • Single-isocenter, multi-target radiotherapy requires precise targeting accuracy verification.
  • Traditional Winston-Lutz tests are limited to single targets at the isocenter.
  • Existing quality assurance methods may not adequately address multi-target scenarios.

Purpose of the Study:

  • To present an open-source system for verifying targeting accuracy in linac-based, single-isocenter, multi-target radiotherapy.
  • To extend the Winston-Lutz test for multi-target quality assurance.
  • To provide a customizable phantom and software for quality assurance.

Main Methods:

  • Development of a 3D-printed, customizable phantom for various target (BB) positions.
  • Software generation of multi-leaf collimator positions for multi-target Winston-Lutz (MTWL) plan creation.
  • Hough circle detection algorithm for locating BBs on MV images, with modifications for improved accuracy.
  • Validation using synthetic data and comparison with a commercial system for real linac targeting errors.

Main Results:

  • Synthetic data validation showed a mean absolute discrepancy of 0.11 mm (maximum 0.21 mm).
  • Comparison with a commercial system yielded a mean absolute discrepancy of 0.13 mm (maximum 0.43 mm).
  • Repeatability tests among three physicists on two linacs resulted in a mean absolute discrepancy of 0.14 mm (maximum 0.51 mm).

Conclusions:

  • The open-source system successfully verifies targeting accuracy for multi-target, single-isocenter radiotherapy.
  • The system demonstrates comparable accuracy to commercial solutions and good repeatability.
  • This quality assurance tool enhances confidence in the geometric accuracy of complex radiotherapy treatments.