Hi all! I am a Clinapp for Vision RT in the Southeast. I wanted to give provide you with what Vision RT expects given this known situation with the surface not looking optimal with the use of the Monaco TPS. I also wanted to provide some tips that may help you feel better about daily workflows.
With our previous version (Dollis Hill or v5) and now with AlignRT Advance (v6), we are seeing this same DICOM surface/CT sim surface situation with Monaco. We continue to investigate how/why this may be happening, however we are confident in the setups and tracking we get with using these surfaces.
A few tips:
I find drawing an ROI that gives some forgiveness in how you need to cover the patient (to avoid the jagged edges of the ROI) can be helpful.
On the first day, if you get a great setup and have an SGRT surface (reference capture) taken, I recommend fine tuning the ROI to your liking on that surface, and use this surface to setup daily. Like always, it’s important to keep an eye on the ROI daily to ensure what you are setting up with and tracking is stable and only on patient surface.
Once you have an SGRT surface that you feel is reliable for daily setup, you can go into the preparation screen and deselect the CT Sim surface (unapproving it essentially), and it will not be available to use in the treatment screen. This can streamline the workflow/clean things up.
All this being said, the CT Sim surface that comes from Monaco is reliable enough to use daily for setup. But I wanted to give another perspective/option for a workflow to go by if any feel less confident in the surface they are getting from the Monaco TPS.
We do recognize this situation and we do look out for reasons as to why this is occurring.
Any more feedback is always appreciated and will be taken back to the team for review!