SU-E-P-54: Evaluation of the Accuracy and Precision of IGPS-O X-Ray Image-Guided Positioning System by Comparison with On-Board Imager Cone-Beam Computed Tomography

Purpose: The purpose of this study is to assess the positioning accuracy and precision of IGPS-O system which is a novel radiographic kilo-voltage x-ray image-guided positioning system developed for clinical IGRT applications. Methods: IGPS-O x-ray image-guided positioning system consists of two oblique sets of radiographic kilo-voltage x-ray projecting and imaging devices which were equiped on the ground and ceiling of treatment room. This system can determine the positioning error in the form of three translations and three rotations according to the registration of two X-ray images acquired online and the planning CT image. An anthropomorphic head phantom and an anthropomorphic thorax phantom were used for this study. The phantom was set up on the treatment table with correct position and various "planned" setup errors. Both IGPS-O x-ray image-guided positioning system and the commercial On-board Imager Cone-beam Computed Tomography (OBI CBCT) were used to obtain the setup errors of the phantom. Difference of the Result between the two image-guided positioning systems were computed and analyzed. Results: The setup errors measured by IGPS-O x-ray image-guided positioning system and the OBI CBCT system showed a general agreement, the means and standard errors of the discrepancies between the two systems in the left-right, anterior-posterior, superior-inferior directions were −0.13±0.09mm, 0.03±0.25mm, 0.04±0.31mm, respectively. The maximum difference was only 0.51mm in all the directions and the angular discrepancy was 0.3±0.5° between the two systems. Conclusion: The spatial and angular discrepancies between IGPS-O system and OBI CBCT for setup error correction was minimal. There is a general agreement between the two positioning system. IGPS-O x-ray image-guided positioning system can achieve as good accuracy as CBCT and can be used in the clinical IGRT applications