title: Image guided particle therapy in CNAO room 2: implementation and clinical validation.
abstract: In this contribution we describe the implementation of a novel solution for image guided particle therapy, designed to ensure the maximal accuracy in patient setup. The presented system is installed in the central treatment room at Centro Nazionale di Adroterapia Oncologica (CNAO, Italy), featuring two fixed beam lines (horizontal and vertical) for proton and carbon ion therapy. Treatment geometry verification is based on robotic in-room imaging acquisitions, allowing for 2D/3D registration from double planar kV-images or 3D/3D alignment from cone beam image reconstruction. The calculated six degrees-of-freedom correction vector is transferred to the robotic patient positioning system, thus yielding automated setup error compensation. Sub-millimetre scale residual errors were measured in absolute positioning of rigid phantoms, in agreement with optical- and laser-based assessment. Sub-millimetre and sub-degree positioning accuracy was achieved when simulating setup errors with anthropomorphic head, thorax and pelvis phantoms. The in-house design and development allowed a high level of system customization, capable of replicating the clinical performance of commercially available products, as reported with preliminary clinical results in 10 patients.
authors.affiliation: Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy. Electronic address: giovanni.fattori@polimi.it.
authors.forename: G
authors.initials: G
authors.lastname: Fattori
authors.affiliation: Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Riboldi
authors.affiliation: Centro Nazionale di Adroterapia Oncologica (CNAO), Strada Campeggi 53, 27100 Pavia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pella
authors.affiliation: Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Peroni
authors.affiliation: Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Cerveri
authors.affiliation: Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; Centro Nazionale di Adroterapia Oncologica (CNAO), Strada Campeggi 53, 27100 Pavia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Desplanques
authors.affiliation: Centro Nazionale di Adroterapia Oncologica (CNAO), Strada Campeggi 53, 27100 Pavia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Fontana
authors.affiliation: Centro Nazionale di Adroterapia Oncologica (CNAO), Strada Campeggi 53, 27100 Pavia, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Tagaste
authors.affiliation: Centro Nazionale di Adroterapia Oncologica (CNAO), Strada Campeggi 53, 27100 Pavia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Valvo
authors.affiliation: Centro Nazionale di Adroterapia Oncologica (CNAO), Strada Campeggi 53, 27100 Pavia, Italy; Istituto Europeo di Oncologia (IEO), Via Ripamonti 435, 20141 Milano, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Orecchia
authors.affiliation: Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; Centro Nazionale di Adroterapia Oncologica (CNAO), Strada Campeggi 53, 27100 Pavia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Baroni
mesh_terms: D054893:Cone-Beam Computed Tomography; D006801:Humans; D019047:Phantoms, Imaging; D061089:Radiotherapy, Image-Guided / Q000295:instrumentation*; D050397:Radiotherapy, Intensity-Modulated
keywords: Accuracy measurement; CBCT; IGRT; Image registration; Optical imaging; Robotic imaging