RT was delivered using a Varian Trilogy™ Linac. During RT, a 3D surface imaging system (AlignRT® Beam-Hold; VisionRT Ltd, London, UK) was used to achieve a stable, reproducible breath-hold position, track real-time patient motion in six degrees-of-freedom, and automatically gate radiation delivery. Video goggles/tablet visualization were used to provide the patient with visual feedback and coaching (Figure 2 ) for DIBH reproducibility and stability.26 (link),27 (link) A 30 to 45 minute in-room appointment time (which included patient dressing and undressing, set-up, daily imaging, DIBH practice, and subsequent gated RT delivery) was allotted for treatment Day 1 to allow a DIBH/AlignRT practice period prior to radiation delivery. For subsequent treatment days, a 20 to 30 minute in-room appointment time was allocated, which is double the 10 to 15 minute time allocated for conventional FB radiation delivery.
Trilogy linac
Manufactured by Agilent Technologies
Sourced in United States
The Trilogy Linac is a linear accelerator designed for use in medical and research applications. It is capable of generating high-energy electron and photon beams for various purposes. The Trilogy Linac is a product of Agilent Technologies, a leading provider of analytical instruments and solutions for a wide range of industries.
Automatically generated - may contain errors
Lab products found in correlation
As1000 flat panel detector, by Agilent Technologies (2 mentions)
120 leaf millennium multileaf collimator mlc, by Agilent Technologies (2 mentions)
Eclipse 10, by Agilent Technologies (2 mentions)
Clinac 2100, by Agilent Technologies (1 mentions)
Eclipse 13, by Agilent Technologies (1 mentions)
Millennium 120 mlc, by Agilent Technologies (1 mentions)
Matrixx, by IBA Dosimetry (1 mentions)
11 protocols using trilogy linac
1
Breath-Hold Radiation Therapy with AlignRT
2
Simulated Prostate Cancer Radiation Therapy
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The patients were simulated using Combifix (CIVCO, Orange City, IA, USA) and treated by RA RT with Trilogy Linac (Varian Medical System, Palo Alto, CA, USA) and for 3D conformal RT with Clinac 2100 (Varian Medical System, Palo Alto, CA, USA).
The clinical target volume (CTV) was composed of the prostate gland with or without the seminal vesicles. The corresponding PTV was defined as CTV + 8 mm margin in each direction, with the exception of the posterior direction.
The clinical target volume (CTV) was composed of the prostate gland with or without the seminal vesicles. The corresponding PTV was defined as CTV + 8 mm margin in each direction, with the exception of the posterior direction.
3
VMAT Plan Dose Verification
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All the VMAT plans (‘standard’ and ‘slowing MLC’ plans) were delivered using a Varian Trilogy® LINAC on the same day. Measurement of each arc was then compared with the corresponding calculated planar dose from the TPS with respect to absolute dose Van Dyk distance-to-agreement (DTA) comparison (dose difference is normalized to global maximum) using 3%/3 mm criteria.22 (link) All measurements were repeated on two consecutive days. The uncertainty was then obtained by evaluating the variation in repeated measurements.
4
Linac-based EPID Performance Evaluation
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Measurements were performed with a Varian Trilogy Linac (Varian Medical Systems, Palo Alto, CA) equipped with a Millennium 120 multileaf collimators (MLC). The EPID detector (Varian aS1000 flat panel detector) was positioned at 150 cm source to detector distance, covering a field size of 40 × 30 cm2 with a resolution of 1024 × 768 pixels. Dark and flood fields were acquired before the experiment. All measurements were performed using 6 MV X-rays and the acquisition software IAS3 (Image Acquisition System 3) and then processed with MATLAB (Math Work, Natick, MA). EPID images were captured using the integrated mode and the backscatter influence of the EPID support arm was removed [7 (link)].
5
Monte Carlo Simulation of Linac Dosimetry
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Running an MC calculation as a secondary MU check protocol is a multistep process involving the creation and transfer of a large number of files. The following is a description of the process for running a calculation, processing the output data and analyzing the results. A schematic of the overall workflow is depicted in Fig. 1 . Using BEAMnrc, a utility in EGSnrc which allows for building a medical accelerator, a Varian Trilogy linac was modeled. Every component in the linac head was modeled based on the dimensions from manufacturer specifications, and assigned a specific material and corresponding density. The machine was configured for 6 MV photon treatments only. Similarly, DOSXYZnrc, an EGSnrc utility used to model dose deposition in a voxelated computed tomography (CT) phantom, was used for calculating patient dose. McGill Monte Carlo Treatment Planning System (McGill University, Montreal, Quebec) provides GUI‐based functionality for changing different parameters of the accelerator (mlc shapes and jaw position generation for specific patient plans) and was used to generate patient‐specific simulation files.
6
Comparative Evaluation of ST-VMAT and SACAO Plans
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Both ST-VMAT and SACAO plans with two full arcs were created for each case in the Eclipse™ 13.5 (Varian Medical Systems, Palo Alto, CA) TPS. Utilizing 6 MV flattening filter free (FFF) photon beams from Varian Trilogy™ LINAC with Millennium™ 120 MLC (Varian Medical Systems, Palo Alto, CA), dose optimization and calculations were done in Eclipse TPS for all of the plans. The isocenter was located at the geometric center of the PTV. Each plan resulted from dual-arc with a gantry and rotation of 179°–181°–179°. The ST-VMAT plans that were optimized with a collimator angle of 5° and 355° for the two arcs (as shown in Figure 1A Figure 1B
7
Integration of Protura 6D Couch with Varian Trilogy Linac
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A Protura 6D couch was retrofitted and integrated to a Trilogy Linac equipped with OBI kV/CBCT (Varian Medical Systems) in 2017. The Protura 6D couch height was 15 to 20 cm and the weight was 84 kg (185 lbs). The readout of couch movement is in submillimeter or 0.1 mm resolution. There were 3 different speeds: slow, medium, and fast (4, 8, 16 mm/s) with a maximum patient load of 200 kg (440 lbs), which is similar to the typical Varian IGRT couch. However, when attached to the Varian Exact pedestal, the Protura weight limit was reduced to 163 or 169 kg (359 or 372 lbs), when using the UCT LE (Universal Couchtop Long Extension), or UCT 1 piece (Universal Couchtop 1 piece), respectively. Figure 1 shows the translational and rotational ranges of the couch. The crosshair of an LAP laser system (LAP Laser, Boynton, Florida) was used as the initial alignment reference for all tests that followed. A HexaCHECK MIMI phantom (Standard Imaging, Middleton, Wisconsin) and a custom-made cube (see section “Isocenter verification with a custom 6D QA phantom”) were used in the QA of the Protura system. A set of 30 × 30 cm2 solid water (Gammex RMI; Sun Nuclear Corp, Melbourne, Florida) slabs and an A12 ion chamber (Standard Imaging) were used in the couch transmission measurement as buildup material, and a regular ruler with millimeter resolution and digital water levels were also used.
8
Varian Trilogy Linac EPID Dosimetry Protocol
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The linac used in the study was a Varian Trilogy Linac (Varian Medical Systems, Palo Alto, CA) equipped with a Millennium 120 multileaf collimator (MLC). The EPID detector (Varian aS1000 flat panel detector) was located 50 cm below the isocentre and covered a field size of 40 cm × 30 cm with a resolution of 1024 × 768 pixels. Dark and flood fields were acquired before the experiment. All measurements were performed using 6 MV X-rays, and the acquisition software was Image Acquisition System 3 (IAS3). The MC environment used is PRIMO (version 0.3.64.1800).
9
Comparative Evaluation of Advanced Radiotherapy Techniques
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Hybrid IMRT/VMAT, IMRT, and VMAT plans were designed for each patient. The prescribed dose to the PTV was 66 Gy in 33 fractions. The plans were normalized to cover 95% of the PTV with 100% of the prescribed dose. The optimization objectives and constraints shown in Table 1 were the same for the three techniques. Eclipse 10.0 (Varian, Palo Alto, CA) treatment planning system was used for all treatment planning, utilizing 6 MV photon beams generated from Varian Trilogy linac equipped with a 120 leaf Millennium Multileaf Collimator (MLC).
10
Multimodal Radiation Therapy Planning
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Hybrid IMRT/VMAT, IMRT, and VMAT plans were designed for each patient. Dose prescription included 70 Gy to PTV70, 59.4 Gy to PTV59.4, and 54 Gy to PTV54 with the plan normalization to cover 95% of the PTV54 with 100% of the prescribed dose. Eclipse 10.0 (Varian, Palo Alto, CA) treatment planning system was used for treatment planning, utilizing 6 MV photon beams generated from Varian Trilogy linac equipped with a 120-leaf Millennium Multileaf Collimator (MLC).
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