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Share thoughts on frameless, maskless stereotactic radiosurgery with SGRT.
By soddiraju United States flag
#520
Can anyone tell how to monitor patients during CBCT for SRS cones. Since ROI is blocked by the imaging arms and cones, AlignRT is giving us a message saying that patient movement outside tolerance for more than 0 seconds even though we know that our patient hasn't moved.
By paul_jursinic
#521
We have been using AlignRT with cones for over two years.  Blockage of the ROI by the accelerator gantry can be a problem.  Make sure your ROI includes the side of the face going back as far as possible to the hair line near the temples.

We do not use AlignRT gating of the accelerator but we closely observe the patient and the accelerator gantry position.  We can predict at what gantry angles we will have a camera eclipsed by the gantry and for those angles we tolerate AlignRT being outside our tolerance of 1 mm.  Usually this only lasts for 5 to 10 s.  If the patient is out of tolerance when we know the gantry is not blocking a camera, then we will stop the accelerator by hand and go into the room to adjust the patient setup so that they are back within AlighRT tolerance.  Treatment is then resumed.

I hope this helps.

Paul Jursinic