title: A quality assurance method with submillimeter accuracy for stereotactic linear accelerators.
abstract: The Stereotactic Alignment for Linear Accelerator (S. A. Linac) system is developed to conveniently improve the alignment accuracy of a conventional linac equipped with stereotactic cones. From the Winston-Lutz test, the SAlinac system performs three-dimensional (3D) reconstruction of the quality assurance (QA) ball coordinates with respect to the radiation isocenter, and combines this information with digital images of the laser target to determine the absolute position of the room lasers. A handheld device provides near-real-time repositioning advice to enable the user to align the QA ball and room lasers to within 0.25 mm of the centroid of the radiation isocenter. The results of 37 Winston-Lutz tests over 68 days showed that the median 3D QA ball alignment error was 0.09 mm, and 97% of the time the 3D error was ≤ 0.25 mm. All 3D isocentric errors in the study were 0.3 mm or less. The median x and y laser alignment coordinate error was 0.09 mm, and 94% of the time the x and y laser error was ≤ 0.25 mm. A phantom test showed that the system can make submillimeter end-to-end accuracy achievable, making a conventional linac a "Submillimeter Knife".
authors.affiliation: Department of Radiation Oncology, Cooper University Hospital, Camden, NJ, USA. Grimm-Jimm@CooperHealth.edu
authors.forename: Jimm
authors.initials: J
authors.lastname: Grimm
authors.forename: Shu-Ya Lisa
authors.initials: SY
authors.lastname: Grimm
authors.forename: Indra J
authors.initials: IJ
authors.lastname: Das
authors.forename: Yunping
authors.initials: Y
authors.lastname: Zhu
authors.forename: Inhwan
authors.initials: I
authors.lastname: Yeo
authors.forename: Jinyu
authors.initials: J
authors.lastname: Xue
authors.forename: Larry
authors.initials: L
authors.lastname: Simpson
authors.forename: Dayee
authors.initials: D
authors.lastname: Jacob
authors.forename: Abhirup
authors.initials: A
authors.lastname: Sarkar
mesh_terms: D006801:Humans; D007091:Image Processing, Computer-Assisted; D007834:Lasers; D011786:Quality Control; D016634:Radiosurgery / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013238:Stereotaxic Techniques