Sci‐Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques ‐ 09: Impact of the distance of reflective markers from linac isocenter on the positional accuracy of an infrared tracking system

Purpose: The HexaPOD™ six degree of freedom couchtop is equipped with an optical tracking system, consisting of a stereoscopic camera and a reference frame (RF) carrying infrared reflective markers. The manufacturer recommends placing the RF within 50 cm from linac isocenter (ISO), which is a serious limitation since the RF does not fit around the shoulders of most brain patients. This study quantifies the impact of extended RF distances from ISO on positional accuracy. Methods: An in‐house tool with an estimated resolution of 0.3 mm and 0.1° was used. It is a large cube and a mathematical model of HexaPOD motion to determine the intersection of room lasers with the ruled cube edges. Combinations of translations (±1 and ±3 cm) and rotations (±2.5°) were executed on two HexaPOD couchtops for multiple RF distances from ISO (35 to 77 cm). For each combination, ten laser readings were fed into a least squares algorithm to determine the executed translations and rotations while minimizing operator reading errors. Results: The usable tracking volume is up to an RF distance of 82 cm from ISO. Positional accuracy of the HexaPOD/iGuide system is 0.6 mm and 0.1° (95% confidence). Positional accuracy variations versus RF distance from ISO are statistically insignificant (p = 0.05). Our results generally confirm recent internal estimates by the manufacturer (for future release). Conclusions: RF distances up to 77 cm from ISO are clinically acceptable, provided performing a patient safety study with a verification scan.