Escolar Documentos
Profissional Documentos
Cultura Documentos
Britt Nygaard, Harald Valen and Ellen Wasb Haukeland University Hospital, Bergen, Norway
2007:
Trilogy with RapidArc option
2008:
Scandidos Delta4 QA tool Aria upgrade: RapidArc on the Trilogy and 23iX
Autumn 2009:
Course in Bellinzona and Zug Stay-and-learn in Copenhagen Eclipse AAA configuration Machine QA and patient QA procedures
2010:
Decisions, decisions.. Which category of patients? Learning RapidArc doseplanning in Eclipse 1st patient on 14th of June 2nd on 22nd of November
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Quality control
Commisioning tests as suggested by Memorial Sloan-Kettering CC and Varian
A picket fence test during RapidArc 7 adjacent fields with varying Dose rate & Gantry speed 4 adjacent fields with varying MLC speed & Gantry speed
Analyse results
Dose rate and Gantry speed variation (Test2)
Analyse results
Dynalog files
Log planned and actual leaf positions and leaf speed vs. time Log gantry speed vs. Time How TrueBeam
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Patient QA
Delta4
Daily dose correction Run and measure Verification plan Pass / Fail criteria
Dose deviation
> 85% within 3% deviation
Distance to agreement
> 98% with DTA 3mm
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More patient QA
Independent dose calculation Point check of dose Control of monitor units
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Less MU and less risk for secondary cancer A category that is easy to create acceptable and standardized plans for
Prostate intermediate risk
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Less MU and less risk for secondary cancer A category that is easy to create acceptable and standardized plans for
Prostate intermediate risk
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Dose deviation
> 85% within 3% deviation
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5 fields IMRT:
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IMRT
RA
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RA today: (2.4 Gy sem.ves. and integrated boost 2.7 Gy prostate) x 25 = 67.5 Gy (EQD2= 81 Gy if /=1.5)
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Gamma: 2mm 2%
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Prostate high risk: 2 Gy to the lymph nodes, integrated boost; 2.4 Gy sem.ves. and 2.7 Gy prost, 25 fractions
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IMRT
RA
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IMRT
RA
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Dose to rectum
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IMRT
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Future:
We would like to treat our high risk protate with LN with two arcs
Prerequisite: RA plan equal or better than IMRT (PTV and rectum)
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