title: Utilization of optical tracking to validate a software-driven isocentric approach to robotic couch movements for proton radiotherapy.
abstract: OBJECTIVE
  An optical tracking and positioning system (OTPS) was developed to validate the software-driven isocentric (SDI) approach to control the six-degrees-of-freedom movement of a robotic couch.
  
  
  METHODS
  The SDI approach to movements rotating around a predefined isocenter, referred to as a GeoIso, instead of a mechanical pivot point was developed by the robot automation industry. With robotic couch-sag corrections for weight load in a traditional SDI approach, movements could be accurately executed for a GeoIso located within a 500 mm cubic volume on the couch for treatments. The accuracy of SDI movement was investigated using the OTPS. The GeoIso was assumed to align with the proton beam isocenter (RadIso) for gantry at the reference angle. However, the misalignment between GeoIso and RadIso was quantitatively investigated by measuring the displacements at various couch angles for a target placed at the RadIso at an initial couch angle. When circular target displacements occur on a plane, a relative isocenter shift (RIS) correction could be applied in the SDI movement to minimize target displacements. Target displacements at a fixed gantry angle without and with RIS correction were measured for 12 robotic couches. Target displacements for various gantry angles were performed on three couches in gantry rooms to study the gantry-induced RadIso shift. The RIS correction can also be applied for the RadIso shift. A new SDI approach incorporating the RIS correction with the couch sag is described in this study. In parallel, the accuracy of SDI translation movements for various weight loads of patients on the couch was investigated during positioning of patients for proton prostate treatments.
  
  
  RESULTS
  For a fixed gantry angle, measured target displacements without RIS correction for couch rotations in the horizontal plane varied from 4 to 20 mm. However, measured displacements perpendicular to couch rotation plane were about 2 mm for all couches. Extracted misalignments of GeoIso and RadIso in the horizontal plane were about 10 mm for one couch and within 3 mm for the rest of couches. After applying the RIS correction, the residual target displacements for couch rotations were within 0.5 mm to RadIso for all couches. For various gantry angles, measured target location for each angle was within 0.5 mm to its excepted location by the preset RadIso shift. Measured target displacements for ± 30° of couch rotations were within 0.5 mm for gantry angles at 0° and 180°. Overall, nearly 85% of couch movements were within 0.5 mm in the horizontal plane and 0.7 mm vector distance from required displacements.
  
  
  CONCLUSIONS
  The authors present an optical tracking methodology to quantify for software-driven isocentric movements of robotic couches. By applying proper RIS correction for misaligned GeoIso and RadIso for each couch, and the RadIso shifts for a moving gantry, residual target displacements for isocentric couch movements around the actual RadIso can be reduced to submillimeter tolerance.
authors.affiliation: ProCure Proton Therapy Center, Oklahoma City, Oklahoma 73142.
authors.forename: Wen C
authors.initials: WC
authors.lastname: Hsi
authors.affiliation: ProCure Training and Development Center, Bloomington, Indiana 47404.
authors.forename: Aaron
authors.initials: A
authors.lastname: Law
authors.affiliation: ProCure Training and Development Center, Bloomington, Indiana 47404.
authors.forename: Andreas N
authors.initials: AN
authors.lastname: Schreuder
authors.affiliation: ProCure Proton Therapy Center, Oklahoma City, Oklahoma 73142.
authors.forename: Omar A
authors.initials: OA
authors.lastname: Zeidan
mesh_terms: D006801:Humans; D008297:Male; D061848:Optical Imaging / Q000295:instrumentation / Q000379:methods*; D056888:Patient Positioning / Q000295:instrumentation* / Q000379:methods; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D061766:Proton Therapy / Q000295:instrumentation* / Q000379:methods*; D012371:Robotics / Q000379:methods*; D012399:Rotation; D012984:Software