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Phantom Patient for Stereotactic End-to-End Verification Model 038 ™ SRS/SRT STEREOTACTIC END-TO-END VERIFICATION FOR COMPREHENSIVE TESTING OF STEREOTACTIC RADIOSURGERY SYSTEMS * nanoDotTM Trademark for Landauer, Inc., Glenwood, IL 60425 SRS commissioning and treatment verification Stereotactic Radiosurgery (SRS) necessitates a high degree of accuracy in target localization and dose delivery. Small errors can result in significant under treatment of portions of the tumor volume and overdose of nearby normal tissues. The CIRS Stereotactic End-toEnd Verification Phantom “STEEV” provides a means to check every step the patient will undergo in the treatment process— from diagnostic imaging with CT, MRI and PET, to treatment plan verification. Accurate patient simulation STEEV’s anthropomorphic exterior allows for use of multiple positioning and fixation devices as used in clinical application. Internal details such as cortical and trabecular bone, brain, spinal cord, teeth, sinuses and SCAN PLAN LOCALIZE TREAT trachea provide the most realistic clinical simulation to evaluate the challenging effects of complex intra- and extra-cranial anatomies. Geometric and organic target inserts provide means for comprehensive image QA, geometric machine QA and TPS QA for increased confidence in system performance. Dose measurements at isocenter and off isocenter positions STEEV accommodates a variety of interchangeable tissue-equivalent inserts suitable for small field dosimetry including: micro- and pin-point ion chambers, film, MOSFET, TLD, OSL (nanoDot TM*) and 3D gel. When used in concert with the various imaging inserts, STEEV provides the most comprehensive end to end testing and QA solution for SRS systems. 2428 Almeda Avenue Suite 316 • Norfolk, Virginia 23513 • USA • Tel: 757.855.2765 • WWW.CIRSINC.COM Nederland België / Belgique T +31 (0)24 648 86 88 T +32 (0)3 309 32 09 [email protected] www.gotoPEO.com Improve the accuracy of target dose delivery and treatment plan verification in radiosurgery and radiotherapy MULTI-MODALITY IMAGING OPTIONS DOSIMETRY OPTIONS Ion Chamber Target Dosimetry Kit (038-03-CVXX-XX) Kit includes a brain equivalent cubic insert with spherical target Ø 30 mm (contrast +5%) located at ISO center. The target aligns to phantom's external CT/MRI fiducial markers. The insert is machined to accommodate small volume Ion chambers suitable for small field dosimetry per customer specification. Kit also includes a brain equivalent cavity plug with BB fiducial (Ø2.5 mm, ceramic) positioned at chamber volume ISO center to assist with localization during image acquisition. Target geometry matches MRI/PET/CT Spherical Target Insert (038-11) for assessment of multiple modalities in treatment planning. Two brain-equivalent spacer inserts provide for easy adjustment of target insert by up to 3cm in the PA direction. CT LINEARITY OPTION Multiple OSL Dosimetry Target Insert (038-08) The Multiple-OSL Dosimetry Target Insert enables 2D point-to-point dosimetry in two orthogonal directions both inside the target and penumbra using Landauer nanoDots. By arranging in 3 orthogonal directions, the insert also enables 3D dosimetry. Model 038-08 consists of a brain-equivalent cubic insert with a 30 mm diameter spherical target with +5% contrast. The insert receives 27 OSL dosimeters through the center plane of the sphere. The cube is assembled using four offset pinholes that allow consistent assembly and OSL orientation. External marks on both halves make it easy to align and close. MRI/PET/CT ISO Center Rectangular Insert (038-15) The insert can be filled with MRI or PET compatible liquids. It features a Ø3.2 mm ceramic BB fiducial at ISO center aligned to the phantoms external CT/ MRI fiducials. The insert generates adequate MRI signal strength to resolve the external phantom fiducials and can be used alone or in combination with other imaging inserts to evaluate fusion functions of treatment planning systems. Electron Density Cube with Removable Ø 1" Vial for Real Water Electron Density Plug (038-09) The brain-equivalent cubic insert includes a waterequivalent electron density plug surrounding a removable 1” diameter vial for water or other liquids. The insert can accommodate any of the standard electron density plugs offered with CIRS Electron Density Phantom (Model 062M). Additional plugs, including high-density options, can be purchased separately. The Electron Density Cube is useful for refining CT number to electron density calibrations. OUR MOST COMPREHENSIVE, REALISTIC, END-TO-END SRS/SRT TESTING TOOL Variable Position Ion Chamber Dosimetry Kit (038-04-CVXX-XX) Kit provides a unique variability of ion chamber locations inside the head and neck. Two cavities are drilled in Inferior-Superior direction thru the neck and align with a hole in the provided brain-equivalent cubic insert. Insert can accommodate any small-volume ion chamber and includes spacer plugs for incremental chamber positioning. The anterior cavity runs adjacent to trachea and the posterior cavity runs through spinal cord, C5-C7 vertebras. This allows for dosimetry in challenging, high dose-gradient regions of interest throughout the brain, neck and spine. Single Film Dosimetry Target Insert (038-05) The brain-equivalent cubic insert includes a Ø30 mm spherical target (+5% contrast) and receives a single piece of radiochromic film through the center plane of the sphere. The cube can be positioned in 3 orthogonal directions with a target volume thru all stages of the treatment process. • Perform End-to-End testing for commissioning as directed by AAPM TG-101 • Verify patient positioning using frame/frameless systems, head and shoulder masks or other positioning fixation devices • Verify patient treatment plan in critical regions • Perform geometric machine QA - Winston-Lutz isocenter verification tests and localization/repositioning with couch shift Film Stack Insert (605-FC) The Film Stack cubic insert accommodates 13 radiochromic films with 4 mm spacing for quasi-3D dosimetry. The cube features groves that enable easy orientation of film scans in the TPS. • Perform IGRT QA procedure for X-ray and onboard kV and MV imagers including CBCT POSITIONING & LOCALIZATION OPTION MRI/PET/CT Spherical Target Rectangular Insert (038-11) This insert provides an MRI/PET/CT image reconstruction test tool. Its precise Ø30 mm spherical tumor internal volume allows for assessment of image and reconstruction integrity when images are moved among different imaging systems. Together with the “matching target” in the Ion Chamber Target Dosimetry Kit (038-3-CVXX-XX), it enables enhanced end-to-end testing of image acquisition, planning and delivery. • Assess image fusion, image transfer QA, accuracy verification and TPS testing with Multi-modality imaging capabilities (CT, MRI and PET) Winston Lutz Cube with Ø5 mm Centroid & Offset Targets (038-10) TThe brain-equivalent cubic insert contains a 5 mm diameter tungsten BB at the centroid and an additional 5 mm BB that is offset from center in three orthogonal planes at x-y-z distances of 15 mm, 20 mm, and 25 mm respectively. The insert facilitates isocenter verification (Winston Lutz) and couch shift localization/repositioning. The insert can be used by itself or inside the head for “blind” Winston Lutz tests. • TPS Deformable Image registration algorithm accuracy QA TLD Dosimetry Insert (038-06) The TLD Dosimetry Insert allows 2D and 3D dose verification using TLDs. The insert consists of a brain-equivalent cube drilled in a 1 cm X 1cm grid pattern of 5mm diameter through holes. Each hole is filled with a 5mm diameter brain-equivalent solid plug for use with TLDs. TLD can be positioned between plugs at the desired depth within each hole. Tissue-equivalent plugs cast to precisely receive TLD chips, rods, bars and cubes are available separately. Gel Dosimetry Cassette Insert (605-GC) The Gel Dosimetry Cassette Insert comprises a brain-equivalent cube that receives a disposable gel container (CIRS Model B6) desiged for small volume 3D dosimetry. The container is approximately 5cm diameter x 5cm long. Model 038-12 contains an organic shaped target of 25cc internal volume. In Model 038-13 the same organic target shape is isotropically reduced to a 12.5cc internal volume. Both targets contain the same central position relative to the phantom’s external MRI/ CT fiducials. The target volumes and rectangular volumes can be filled individually through separate fill ports using MRI or PET compatible liquids. “...cumulative system accuracy for the procedure [SBRT] can be significant and needs to be characterized through an end-to-end test using phantoms with measurement detectors and imaging.” AAPM TG-101 report Stereotactic body radiation therapy MRI/PET/CT Organic Target Rectangular Insert (038-12 & 038-13): Two MRI/PET/CT Organic Target Inserts are available for experimental testing of TPS deformable registration and transformation algorithms. The Model 038 STEEV 3D DISTORTION OPTION MRI/PET/CT Spatial 3D Distortion Rectangular Insert (038-14) This insert contains a 3D grid (10 x 10 spacing) of Ø 1 mm high contrast wire (~600HU). The insert can be filled with MRI or PET compatible liquids. It provides a single, precise tool to check image fusion and image distortion across multiple modalities. CT Axial Retouch MR TSE-T1 SPECIFICATIONS MODEL 038 INCLUDES QTY QTY PART NO. 1 038-15 DESCRIPTION PART NO. DESCRIPTION 1 038 Stereotactic Radiosurgery Head 1 605-SS1 Brain Equivalent Spacer (63.4 x 63.4 x 10 mm) 1 Neck Alignment Plate 1 605-SS2 Brain Equivalent Spacer (63.4 x 63.4 x 20 mm) 1 Rubber Clamp 1 605-SS4 Brain Equivalent Spacer (63.4 x 63.4 x 63.4 mm) 1 Foam-lined Case 1 Solid Ø 12.5 mm (posterior chamber access plug 1 User Guide 1 Solid Ø 12.5 mm anterior chamber access plug with MRI/CT fiducial - 48-Month Warranty MRI/CT ISO Center rectangular insert MODEL 038 OPTIONAL ACCESSORIES QTY PART NO. DESCRIPTION 1 038-01 Shoulders (addtional 100 mm width) 1 038-02 ABS Vacuum formed cradle 1 038-03CVXXXX Ion Chamber Dosimetry Kit: (1) 63.5 mm Cube with Ø30 mm Spherical Target Cavity, (2) Ø12.7mm Sleeves for adapting Ion cavity, ((1) Solid plug with Ø 2.5 mm aluminum oxide BB in ISO center, (1) Solid plug 1 038-04CVXXXX Variable Ion Chamber Position Dosimetry Kit: (1) 63.5 mm Cube with cavity thru hole, (2) Ø12.5 mm Sleeves for adapting Ion cavity, (1) Solid cavity plug with Ø 2.5 mm aluminum oxide BB in ISO center, (1) Solid cavity plug, (1)Spacer plug set to accommodate cavity at different positions 1 605-FC Film Stack 1 038-05 Film Cube for Single Film Dosimetry with Ø30 mm target 1 038-06 TLD Dosimetry Cube 1 038-08 Multiple-OSL Dosimetry Target Insert 1 605-GC Gel Dosimetry Cassette (includes B6 Gel Container) 1 038-09 Electron Density Cube with Real Water Electron Density plug (Water Equivalent Material Surrounding Removable Ø 1" Vial) 1 038-10 Winston Lutz Cube with Centroid & Offset Ø5mm targets 1 038-11 MRI/CT/PET Target Cube with Ø30mm target 1 038-12 MRI/CT/PET Target Cube with 25 cc Organic target 1 038-13 MRI/CT/PET Target Cube with 12.5 cc Organic target ©2013 Computerized Imaging Reference Systems, Inc. All/ rights reserved. België Belgique Nederland All brand names, product names or trademarks belong to their respective T +31 (0)24 648 86subject 88 T notice. +32 (0)3 309 32 09 holders. Specifications to change without Publication: 038 DS 071614 Computerized Imaging Reference Systems Inc. has been certified by UL DQS Inc. to (ISO) 9001-2008. Certificate Registration No.10000905-QM08. [email protected] www.gotoPEO.com