Performance assessment of two motion management systems for frameless stereotactic radiosurgery
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ORIGINAL ARTICLE
Performance assessment of two motion management systems for frameless stereotactic radiosurgery Hao Wang1,2 · Zhiyong Xu1 · Kevin Grantham2 · Yongkang Zhou3 · Taoran Cui2 · Yin Zhang2 · Bo Liu2 · Xiao Wang2 · Irina Vergalasova2 · Meral Reyhan2 · Joseph Weiner2 · Shabbar F. Danish4 · Ning Yue2 · Ke Nie2 Received: 6 July 2020 / Accepted: 24 August 2020 © The Author(s) 2020
Abstract Background/Purpose Frameless stereotactic radiosurgery (SRS) requires dedicated systems to monitor patient motion in order to avoid inaccurate radiation delivery due to involuntary shifts. The purpose of this study is to assess the accuracy and sensitivity of two distinct motion monitoring systems used for frameless SRS. Methods A surface image-guided system known as optical surface monitoring system (OSMS), and a fiducial marker-based system known as high definition motion management (HDMM) as part of the latest Gamma Knife Icon® were compared. A 3D printer-based cranial motion phantom was developed to evaluate the accuracy and sensitivity of these two systems in terms of: (1) the capability to recognize predefined shifts up to 3 cm, and (2) the capability to recognize predefined speeds up to 3 cm/s. The performance of OSMS, in terms of different reference surfaces, was also evaluated. Results Translational motion could be accurately detected by both systems, with an accuracy of 0.3 mm for displacement up to 1 cm, and 0.5 mm for larger displacements. The reference surface selection had an impact on OSMS performance, with flat surface resulting in less accuracy. HDMM was in general more sensitive when compared with OSMS in capturing the motion, due to its faster frame rate, but a delay in response was observed with faster speeds. Both systems were less sensitive in detection of superior-inferior motion when compared to lateral or vertical displacement directions. Conclusion Translational motion can be accurately and sensitively detected by OSMS and HDMM real-time monitoring systems. However, performance variations were observed along different motion directions, as well as amongst the selection of reference images. Caution is needed when using real-time monitoring systems for frameless SRS treatment.
Keywords OSMS · Nose marker monitoring · SRT · System performance
Introduction
Hao Wang and Zhiyong Xu contributed equally. Ke Nie
[email protected] 1
Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
2
Department of Radiation Oncology, Rutgers—Cancer Institute of New Jersey, Rutgers-Robert Wood Johnson Medical School, 195 Little Albany St., New Brunswick, NJ, USA
3
Department of Radiation Oncology, Zhongshan Hospital, Shanghai, China
4
Department of Neurosurgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
Stereotactic radiosurgery (SRS) was originally developed with frame-based fixation for single fraction high-dose delivery [1, 2]. Although rigid patient immobilization allows for high precision of target localization, thus, a
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