COMPASS Clinical Proof June 2012 What is IMOMA? IMOMA – Instituto de Medicina Oncológica y Molecular de Asturias – is a private institution created by Corporación Masaveu, Cajastur and Medicina Asturiana with a clear mission: fight against cancer. IMOMA aims to provide patients facing this disease best class and state-of-the-art solutions to prevent and combat cancer. Its medical activity is based on three mainstays: personalized treatments, integration of advances in molecular biology in the clinical protocols and use of the latest radiotherapy techniques. Starting activities in October 2011, the new IMOMA Radiotherapy Center is equipped with a last generation LINAC: "TrueBeam™ STx powered by Novalis® ", the result of cooperative work of Varian Medical Systems and Brainlab. IMOMA has three state-of-the-art treatment planning systems: Philips Pinnacle 3, Varian Eclipse™ and Brainlab iPlan® . Thanks to those valuable assets we perform cutting-edge techniques like IGRT, IMRT, VMAT (SmartArc® and RapidArc® ), frame and frameless image guided Stereotactic Radiosurgery, 4D CT and respiratory gating, 6D correction using Brainlab’s robotic couch, and Stereotactic Body Radiotherapy, allowing us to provide the best available radiotherapy treatments. Clinical experience with COMPASS. The Medical Physics Department relies on IBA Dosimetry technology, incorporating in our center several quality control solutions as Blue Phantom2, StarTrack, MatriXX, OmniPro-I´mRT and COMPASS for commissioning and further development of these complex techniques. "From a physicist point of view, the process of commissioning and testing three different treatment planning systems is very demanding. We must measure in all different conditions and make a thorough verification program. The COMPASS system can be used in this task because it provides a very solid calculation algorithm, requires very simple input data and the commissioning process is very fast and easy to use.” Alberto Pérez-Rozos Chief of the Medical Physics Department IMOMA – Centro Médico de Asturias [email protected] "Verification of IMRT and VMAT treatments is performed with the COMPASS system, and fluencies are measured with MatriXX. Thus, TPS dose calculation, integrity of data, and LINAC capabilities can be verified in a single procedure.” “The safety provided by COMPASS, along with time saving in the three mentioned verification points, plus automated analysis of the histograms, has made COMPASS an indispensable tool in our clinical routine. COMPASS allows us easy verification of any influence of uncertainty in dose volume histograms and 3D dose distributions, serving also as an evaluation tool of our three TPS." TrueBeam, Eclipse and RapidArc are trademarks or registered trademarks of Varian Medical Systems Inc. in the U.S. and/or other countries. Novalis and iPlan are trademarks or registered trademarks by Brainlab AG in the U.S. and/or other countries. Pinnacle3 and SmartArc are trademarks or registered trademarks by Philips Healthcare in the U.S. and/or other countries. RT-CA-E-Compass_CT_Oviedo-Rev.1-0612 | © IBA 2012 / All rights reserved IBA Dosimetry GmbH Bahnhofstraße 5 | 90592 Schwarzenbruck | Deutschland | Tel.: + 49 9128 607 0 | Fax: + 49 9128 607 10 Register-Ger. Nürnberg, HR B 4262 | WEEE-Reg.-Nr. DE 65960409 | Geschäftsführer: Olivier Legrain, Rob Plompen [email protected] | www.iba-dosimetry.com COMPASS Clinical Proof March 2012 The SoonChunHyang University Hospital in Cheonan, Korea, uses the unique 3D plan verification system COMPASS to verify their Novalis Tx treatments The SoonChunHyang University Hospital took its first footstep as the only general hospital in Chungcheonnamdo in 1982. The hospital currently operates 24 departments and 1000 beds with a crew of more than 1,300 people and 130 faculty members. The Radiation Oncology Department started in 2000 and is equipped with the latest medical facilities such as Novalis Tx treatment machines, Philips Big Bore CT and PET-CT. 80 patients are treated with two LINACs per day. COMPASS is used specifically for the Eclipse TPS for the Novalis Tx machine verification. "COMPASS is the only system that can double check the beam data collection, TPS beam modeling, dose calculation and also machine related errors. COMPASS allows us to compare the 2D fluence segment by segment with more detailed MLC movement information. COMPASS checks accurately complicated plans for SRS, SBRT, IMRT and VMAT patients at the Novalis Tx machine. COMPASS is able to verify the QA result on real 3D patient CT images. It is visual and uses DVH, 3D Gamma index, dose difference etc. The SoonChunHyang We are able to compare the discrepancies for different algorithm results in the inhomogeneity area. University Hospital Chul Kee Min, Ph.D. Clinical Assistant Professor Chief Medical Physicist Department of Radiation Oncology No need to calculate the phantom plan so we save a lot of time. We are able to measure 10 patients during lunch time and do the reconstruction calculation when we have time." E-mail: [email protected] RT-CA-E-COMPASS_CT_Cheonan_Rev.1-0312 | © IBA 2012 / All rights reserved IBA Dosimetry GmbH Bahnhofstraße 5 | 90592 Schwarzenbruck | Deutschland | Tel.: + 49 9128 607 0 | Fax: + 49 9128 607 10 Register-Ger. Nürnberg, HR B 4262 | WEEE-Reg.-Nr. DE 65960409 | Geschäftsführer: Pierre Mottet, Rob Plompen [email protected] | www.iba-dosimetry.com COMPASS Clinical Proof December 2011 Medanta – the Medicity, Haryana, India, replaced 2D patient plan verification by COMPASS 3D dosimetry for IMRT and VMAT Medanta – the Medicity was set up as a health care establishment in November, 2009. The Division of Radiation Oncology became clinical in February 2010 and has established cutting edge technology with two Linear accelerators, an Integrated Brachytherapy unit, CT, MR and PET-CT simulation. The advanced techniques of radiation delivery, Volumetric Modulated Arc therapy, 6-D correction with HEXA-POD, Monte Carlo calculation dose engine in Monaco, COMPASS as a QA tool are a few of the highlights that have been applied to daily clinical practice. "We have commissioned COMPASS 3D dosimetry for Elekta INFINITY and Synergy S Beam Modulator Linac. We have replaced 2D verification with COMPASS 3D dosimetry using combination of MatriXX ion chamber array detector. Our observations on clinical commissioning and use are as follows. Dr. Tejinder Kataria, MD, DNB, CCST, FIMSA Chairperson Radiation Oncology Medanta Cancer Institute Sector 38, Gurgaon, – We have used COMPASS for various sites such as head & neck, prostate, esophagus, and breast for IMRT and volumetric modulated arc therapy. We found that the results are well within limit and good agreement between TPS & measured. – COMPASS is a robust and precise tool for pre-treatment and plan verification of IMRT and volumetric modulated arc therapy. – COMPASS allows Radiation Oncologist and Physicist to do the IMRT and VMAT plan verification on real patient's anatomy with tissue inhomogeneity correction and dose volume statistics. – COMPASS reduced our medical physicist and treatment planning system time in generating QA plans (as it does not need any QA plans on phantom), increased flexibility to verify accurately and decreased time for more complex treatment modalities of IMRT and VMAT. – There is no tool to check the accuracy of TPS calculated dose and its algorithm so far. Only COMPASS verification software allows to cross check whether the TPS calculated dose is correct or not before delivery to patient. – COMPASS has an advanced dose calculation engine "collapsed cone convolution" that enabled us to independently verify the beam model commissioning of different treatment planning systems. – COMPASS is a fast and reliable 3D dosimetry verification system using with ion chamber array detector." Haryana 122 001, India Phone: +91 124-4141 414 Fax: +91 124-4834 111 [email protected] www.medanta.org Dr. Tejinder Kataria Chairperson - Radiation Oncology IBA Dosimetry GmbH Bahnhofstraße 5 | 90592 Schwarzenbruck | Deutschland | Tel.: + 49 9128 607 0 | Fax: + 49 9128 607 10 Register-Ger. Nürnberg, HR B 4262 | WEEE-Reg.-Nr. DE 65960409 | Geschäftsführer: Pierre Mottet, Rob Plompen [email protected] | www.iba-dosimetry.com COMPASS Clinical Proof September 2010 COMPASS: 3D personalized plan verification. Treatment safety, patient based, anatomically detailed: Radiation Oncologists can now verify the actual delivered patient-in-dividual dose using the new COMPASS 2.0 platform. The new IBA solution closes the missing link between personalized treatment planning and delivery by giving Radiation Oncologists the power to verify treatment delivery not only generically as in the past but individually for each patient. With its unique approach, COMPASS is the only solution that veriies and displays dose independently in each patient´s anatomy, bringing treatment verification to an entirely new oncologist-driven level. Based on measurements of all irradiated fields and arcs, COMPASS calculates the delivered 3D dose distribution utilizing the patient-individual anatomy and tissue inhomogeneity. Compared to conventional cubic or cylindrical phantom based solutions which do not allow a patient-specific verification, this approach provides far more accurate treatment verification. The COMPASS 3D dose distribution can be compared to the TPS predicted dose with an intuitive and easy to use graphical user interface: patient 3D dose overlay in sagittal, coronal and transversal views as well as Dose-Volume-Histograms are available for an analysis on ROI level. The COMPASS Viewing Station makes treatment verification and decision taking easy by bringing all relavant information onto the oncologists´s desktop. Klinik & Poliklinik für Strahlentherapie und Radioonkologie Göttingen Germany Dr. med. Dipl.-Phys. Hilke Vorwerk Senior Physician "The COMPASS system enables me as a Radiation Oncologist to verify the actual applied radiation therapy doses prior to treatment in a patient-based 3D approach. The clinical relevance of underdose and overdose areas can now be evaluated in relation to the patient individual organs at risk and target volume based on clinical criteria, allowing me to ensure safer treatment delivery. Additional advantages of COMPASS are the 3 dimensional verification of the real machine parameters that are integrated in the measured doses as well as an independent check of the treatment planning system that provides us with a higher confidence level for our patient treatments." IBA Dosimetry GmbH Bahnhofstraße 5 | 90592 Schwarzenbruck | Deutschland | Tel.: + 49 9128 607 0 | Fax: + 49 9128 607 10 Register-Ger. Nürnberg, HR B 4262 | WEEE-Reg.-Nr. DE 65960409 | Geschäftsführer: Pierre Mottet, Rob Plompen [email protected] | www.iba-dosimetry.com COMPASS Clinical Proof University Medical Center Groningen The Netherlands Erik Korevaar, PhD Medical Physicist Department of Radiation December 2011 "At the Radiotherapy Department of the University Medical Center Groningen we replaced film dosimetry by COMPASS software with MatriXX detector for pre-treatment verification in February 2009. We used the unique COMPASS solution for verification of over 900 patient plans in the 36 months after introduction. COMPASS was used for QA of IMRT treatment plans for H&N, lung and prostate but also in cases like sarcomas and cervix cancer. COMPASS is our standard QA tool for VMAT prostate plans as well. Oncology Tel.: +31 50 36 11 230 Fax: +31 50 36 11 692 [email protected]. All QA results were within clinical criteria which shows that we have a stable linear accelerator, a reliable and well configured TPS and a stable QA system. With COMPASS it was possible to avoid false non passing verifications which appeared in some cases using film and which caused time consuming final verification. By irradiating QA plans on a regular basis and analyzing them with COMPASS we were able to improve the control of critical IMRT parameters, mainly the MLC calibration. This enables us to apply COMPASS as a pure calculational verification for some routine cases, thus again reducing the time needed for a single patient. An important reason to introduce the calculational verification is to shorten the time until the start of treatment. Moreover, the application of COMPASS measurement based verification for sample patients at various moments in time allows us to further control stability of delivery. With the increased flexibility in allocation of our physicist´s time, we are now in the process of commissioning the new rotational modality VMAT which will enable us to increase the number of patients treated with modulated modality. We expect COMPASS to play a decisive role in the optimization and verification of VMAT as well.” IBA Dosimetry GmbH Bahnhofstraße 5 | 90592 Schwarzenbruck | Deutschland | Tel.: + 49 9128 607 0 | Fax: + 49 9128 607 10 Register-Ger. Nürnberg, HR B 4262 | WEEE-Reg.-Nr. DE 65960409 | Geschäftsführer: Pierre Mottet, Rob Plompen [email protected] | www.iba-dosimetry.com COMPASS Clinical Proof January 2012 The Clinical Center Bayreuth, Germany, has been using COMPASS clinically for all VMAT pre-treatment patient plan verifications since mid 2010 The Clinical Center Bayreuth GmbH is the only hospital with maximum medical care in the Upper Franconian region. The clinic of radiation therapy is one of the most effective and modern radiation therapy centers in Germany. Radiation therapy treatments with modern high precision treatment machines allow for a maximum of patient safety. The team of seven physicians, five experts in medical physics, nine medical technical assistants as well as nursing staff, medical secretaries and secretaries ensure highest level patient-centered care. “After initial installation of COMPASS in our department, we have been using the system in a research phase for verification against our 2D plan verification solution. Since mid 2010 we have been using COMPASS clinically for all our VMAT pre-treatment patient plan verifications. We especially appreciate that COMPASS allows us to analyze the accuracy of the plan delivery based on patient specific anatomy in 3D. Knowing dose errors related to the patient anatomy is the basis to determine the clinical relevance of any discrepancies in the plan verification. Clinical Center Bayreuth Germany Dipl. Phys. Univ. Mathias Dierl COMPASS’ sophisticated dose calculation routine follows the proven approach implemented in all treatment planning systems: Collapsed Cone calculations utilizing the patient specific CT guarantee a very precise calculation of the delivered dose in 3D which is then verified against the imported 3D dose from the TPS. Beyond the routine plan verification COMPASS allows detection of spontaneous malfunction of radiation delivery equipment as documented in a separate case study.” Head of Medical Physics Radiation Therapy mathias.dierl@ klinikum-bayreuth.de RT-CA-E-Compass_CT_Bayreuth-Rev.1-0212 | © IBA 2012 / All rights reserved IBA Dosimetry GmbH Bahnhofstraße 5 | 90592 Schwarzenbruck | Deutschland | Tel.: + 49 9128 607 0 | Fax: + 49 9128 607 10 Register-Ger. Nürnberg, HR B 4262 | WEEE-Reg.-Nr. DE 65960409 | Geschäftsführer: Pierre Mottet, Rob Plompen [email protected] | www.iba-dosimetry.com COMPASS Clinical Proof January 2011 "Yashoda Hospitals being a leader in introducing high end technology is really proud to be the first COMPASS user in India. Since March 2010 we have been using the COMPASS to check all our IMRT & RapidArc plans. With 100 RapidArc patients being treated every day we found COMPASS as a comprehensive 3D QA tool because of the following reasons: – Ability to independently check the accuracy of treatment plans from TPS – Verification of individual arc segments precisely per rotation in timely sequence Sai Subramanian, Chief Medical Physicist, Yashoda Hospitals, Hyderabad, India – Accurate insight information about the treatment delivery, with delivered dose distribution on planning CT to determine the clinical relevance of dose discrepancies witah enhanced visuals – Analysis of 3D gamma & dose difference on patient anatomy Above all we could easily discuss our QA results with the Radiation Oncologists as the results directly address the clinical consequences of delivery." RT-CA-E-Compass_CT_Yashoda-Rev.1-0212 | © IBA 2012 / All rights reserved IBA Dosimetry GmbH Bahnhofstraße 5 | 90592 Schwarzenbruck | Deutschland | Tel.: + 49 9128 607 0 | Fax: + 49 9128 607 10 Register-Ger. Nürnberg, HR B 4262 | WEEE-Reg.-Nr. DE 65960409 | Geschäftsführer: Pierre Mottet, Rob Plompen [email protected] | www.iba-dosimetry.com
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