PTW Presentation

HEALTH PHYSICS NUCLEAR MEDICINE DIAGNOSTIC RADIOLOGY RADIATION THERAPY
Dosimetry Pioneers since 1922

Mohsen Shahrabi – International Sales Manager
ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

OCTAVIUS® 4D - New features and future outlook RADIATION THERAPY
Table of Contents
1 Company Introduction
2 OCTAVIUS®4D - New Features
3 OCTAVIUS®4D - Future Outlook

Company Facts COMPANY
From Humble Beginnings

It started with a groundbreaking invention.
1919: Professor Wilhelm Hammer 1927: Dr. Herbert Pychlau resumes

invents electrostatic relay. ownership. PTW had six employees. More
than 1,000 Hammer dosemeters produced
1922: PTW is founded. First Hammer by late 1920s.
dosemeters produced in backyard of
Hammer residence. 1958: PTW moves into current head-
quarters building in Lörracher Str. 9,
Freiburg.

PTW Today -
A Global Leader in Dosimetry
Full range supplier of radiation dosimetry products –
in family hands for almost a century
Industry-leading product portfolio (> 350 products)
328 employees worldwide
9 international subsidiaries, 2 manufacturing sites,
worldwide sales and service network
Strong commitment to quality and safety:
PTW Calibration Lab / PTW Dosimetry School

PTW Calibration Laboratory
Calibrations traceable to
national and international standards
One of the oldest and largest calibration
laboratories for ionizing radiation worldwide
Secondary Standard Dosimetry Laboratory
(SSDL)
Accredited by PTB since 1979
Member of DAkkS and IAEA / WHO SSDL
Network
11 calibration benches
12,000 chamber calibrations per year

The Dosimetry School
Sharing Knowledge
Inspiring Practice
Founded in 2014
Nationwide education initiative to enhance
understanding and practice of clinical
dosimetry
Great variety of training opportunities -
scientific and practical trainings
Worldwide cooperation network with
clinical partners
Expert platform to meet and share
knowledge

OCTAVIUS® 4D
New Features and Future Outlook

OCTAVIUS
Patient QA® 4D - New features and future outlook RADIATION THERAPY
OCTAVIUS® 4D – Principal Workflow
Only Input:
SSD 85 cm
Set up Measurement PDDs
measured
in water
Evaluation Calculation
OCTAVIUS
OCTAVIUS® 4D – System components

1 OCTAVIUS® Detector Family 4 Wireless Inclinometer
(Bluetooth)
2 Detector Interface 5 Control Unit with integrated
Bluetooth receiver, TCP/IP
3 Rotation Unit connection to PC
4
1 3

OCTAVIUS
OCTAVIUS® 4D – System components

OCTAVIUS
Application-dependent patient QA…
…with suitable OCTAVIUS® detectors.
OCTAVIUS® OCTAVIUS® OCTAVIUS®

Detector Detector Detector
729 1500 1000SRS

The modular OCTAVIUS® 4D phantom

Motorized base unit with
Standard phantom top (1), 1
Ø 32 cm
SRS QA top (2): Ø 17 cm,

for small field sizes/volumes
2 3
More accurate:
TPS-calculation is often less accurate in larger depths
Closer to the patient‘s geometry in SRS applications in H&N regions
Faster TPS-calculation at typically (very) high calculation resolution
Small-sized Export-files

The modular OCTAVIUS® 4D phantom

LINAC QA top (3): flat,
5 cm build-up material 1
Classical LINAC QA from

different angles
2 3
Unlock top, pull out top, push in top you want to use, relock – done!

OCTAVIUS
Application-dependent patient QA…
…with appropriate phantom setups.
Rotation unit top

Standard Rotation unit top
SRS Rotation unit top
Linac QA

VeriSoft® – A flexible verification platform
Data window A Results window
Data window B Compare Window

OCTAVIUS
Verisoft – Dose Reconstruction principle

Measurement Data Processing (Example)
(time & angle dependent) Interval 1:
Time 0 – 200 ms // angle 0.0°
Interval 2:
Time 200 – 400 ms // angle 0.5°
Interval 3:
Time 400 – 600 ms // angle 1.2°
….
...
Interval n:
Time xxx-xxx ms // angle xx.x°
Determination of an equivalent
field size for each interval
OCTAVIUS
Verisoft – Dose Reconstruction principle

Dose reconstruction based on measured PDDs (0x0 cm² to 26x26 cm²) in
water phantom
Example: Reconstruction of an interval with equivalent field size 8x8 cm²
PDD field size 8x8 cm²
Measured dose at
detector (16 cm)
Summation of all dose points, measured and extrapolated at a given

interval, over all intervals leads to the 3D phantom dose distribution

OCTAVIUS® 4D– DVH Analysis

Patient dose calculation based on measurement & patient‘s CT DICOM
Algorithm takes changes in SSD and different densities into account
TPS DVHs are recalculated (not every TPS stores DVHs in DICOM-RT)
Comparison of measured and planned DVHs of structures in RT_Struct
Example:

OCTAVIUS® 4D – DVH Analysis

OCTAVIUS
VeriSoft 7 – New special dosimetry apps

Standard Diff. Energies Non-coplanar Off-axis Large fields
Classical IMRT / VMAT IMRT / VMAT IMRT / VMAT IMRT / VMAT

IMRT / VMAT application application application application
application + + + +
Beams with Non-coplanar Off-axis PTVs Large PTVs
multiple energies beams (outside FOV) (larger than FOV)
Standard algorithm New algorithms!

OCTAVIUS
Verification of off-axis target volumes

In a few treatment scenarios the isocenter is far away from the PTV
(i.e. Lung SABR patients)
=> PTV not/ not completely covered by OCTAVIUS® detector
Example:
OCTAVIUS®
detector SRS
with Rotation
Unit SRS

OCTAVIUS

A new algorithm allows dose reconstruction of measurement data aquired at
arbitrary poitions of the OCTAVIUS® 4D phantom
Simply type in the x,y,z coordinates of the new phantom center position
Isocenter related position Target related position

Example:
OCTAVIUS® Isocenter
detector
SRS
Phantom shift
PTV (vector)

OCTAVIUS
Off-Axis – Evaluation workflow

For off-axis dose reconstruction in VeriSoft “Off-axis 4D dosimetry” has to
be activated in the options menu…
Off-Axis dosimetry
must be activated !!

OCTAVIUS
Off-Axis – Evaluation workflow

Simply load the measurement file(s) & assign the phantom shift before
dose reconstruction…
Reconstruction

OCTAVIUS

Dose reconstruction principle comparable to non-coplanar dosimetry
Additionaly, the new phantom center position is taken into account
Dose measured by the OCTAVIUS

detector
Relative dose at SSD

depth zp (normalized), correction
PDD curve for detected
fieldsize A
Classical setup Off-axis setup

Phantom center = isocenter Phantom center ≠ isocenter
OCTAVIUS

Further information concerning details on the dose reconstruction principle
in off-axis setups can be taken from the following document …
(see homepage)

OCTAVIUS
Compose – When do I need it?

Large fields that extend the FOV (= field of view) Case 1:
of the OCTAVIUS Detector on both sides
(case 1)
Large fields that extend the FOV (= field of view)

of the OCTAVIUS Detector on a single side
(case 2)
Typical clinical examples:

Case 2:
Craniospinal treatments
More-field breast irradiations with

isocenter positioned far away from
field center

OCTAVIUS
Compose – Measurement Workflow

Step 7:
1: Align
2:
4:
3:
5:
6: Leave
Insertphantom
Shift
Enter the
the
room
roomPhantom
OCTAVIUS
& deliver
again, at
aturn
for the Detector
the
the
treatment
isocenter
certain
same treatment
inplan
offset
phantom
offsetthe
in
180°using
asplan
OCTAVIUS
abefore,
second
(TARGET
target
and the laser
time
itRotation
direction
align
now inmeasurement)…
atsystem
(GUN
the
GUN Unit
measurement)…
(using the couch)
isocenter
direction
again
Offset Offset
TARGET GUN
TARGET
GUN
OCTAVIUS
Compose – Workflow at the TPS

Plan on the extended artificial CT dataset of OCTAVIUS provided by PTW:
http://www.ptw.de/index.php?id=2469
Artificial CT:
OCTAVIUS_4D_CT_structure_sets_
RU_Standard_increased_length
Phantom Length: 500 mm
Treatment plan should include the total dose

Export of RT Dose + RT Plan (total dose is recommended)

OCTAVIUS
Compose – Evaluation with VeriSoft

Simply load in the measurement files & type in the TG shift of the
OCTAVIUS 4D phantom
Classical treatment plan verification…
Compose dialogue
Reconstruction

OCTAVIUS
Compose – Dose Reconstruction

The TARGET
GUN in measurement
dosemeasurement
If thealgorithm checks
the contains
contains
whether
overlap region isthe
the the
dose
identicalleft
leftinpart
thepart
of of the
the
overlap
TARGET irradiation
irradiation field
GUNisfield
region
and identical
in TARGET andare
measurement GUN measurement
composed to a big matrix
Offset Offset
TARGET GUN
TARGET
GUN
Overlap
ICTP School of Medical Physics forRegion
Radiation Therapy – 03.04.2019
OCTAVIUS
Compose – Hardware Combinations

OCTAVIUS 4D Phantom types:
Rotation Unit Top „Standard“ Rotation Unit Top „SRS“
OCTAVIUS Detectors:
Each Phantom type is compatible with all OCTAVIUS Detectors

Compose – Specifications
Compose Rotation Unit Top „SRS“
relevant
specs OCTAVIUS® 1500 OCTAVIUS® 1000 RS OCTAVIUS® 729
Detector size 4.4 x 4.4 x 3 mm³ 2.3 x 2.3 x 0.5 mm³ 5 x 5 x 5 mm³
Detector spacing 10 mm center-to-center in 2.5 mm center-to-center* 10 mm center-to-center in
TG direction in TG direction TG direction
Shift increments 10 mm 5 mm 10 mm
Maximum shift in TG 110 mm 45 mm 110 mm
Maximum Field (27 x 27) cm² (11 x 11) cm² (27 x 27) cm²
enlargement
(48 x 27) cm² (22 x 11) cm² (48 x 27) cm²
Minimum Overlap 3 Detector Rows (= 3cm) 4 Detector Rows (=2 cm) 3 Detector Rows (=3cm)
region
Compatibility • Rot. Unit Top Standard • Rot. Unit Top Standard • Rot. Unit Top Standard
• Rotation
ICTP School ofUnit
Medical SRS for•Radiation
TopPhysics Rotation Unit– Top
Therapy SRS
03.04.2019 • Rotation Unit Top SRS
OCTAVIUS
Compose – Further information…

New Product information sheet available on our homepage…

OCTAVIUS
Non-Coplanar – Where do I need it?

In general non-coplanar fields are applied to increase the conformity of
the treatment plan (=> more dose to PTV & less dose to OARs)
Mostly, treatment plans contain only coplanar fields. In special situations
non-coplanar fields are beneficial (see below).
Clinical Examples:
Breast treatments, where conventional
techniques failed to achieve high conformal
avoidance => Minimization of the lung dose
Lung treatments, e.g. certain lung tumors lying
close to the heart in order to minimize
Stereotactic head treatments, e.g. at brain
treatments in order to minimize the dose to
the surrounding brain parenchyma

OCTAVIUS
Non-Coplanar – Data Acquisition

Workflow during the measurement with OCTAVIUS 4D:
Setup the OCTAVIUS 4D system as usual
Stepwise measurement of the treatment plan:
Deliver all fields that belong to a certain couch angle
Always collapse the couch angle to 0° at non-coplanar fields
(=> Phantom may not be deflected!)
Start/Stop/Save each measurement

OCTAVIUS
Non-Coplanar – Measurement workflow

Exemplary measurement workflow for a 6-Field Prostate IMRT plan:
Simultaneous
Measurement of
Save XCC file for
Field 1
6-Field Prostate IMRT couch angle 0°
Field 3
Field Gantry Couch Field 4
No. Angle Angle
Field 1 0° 0°
Simultaneous
Field 2 60° 340° Save XCC file for
Measurement of
couch angle 340°
Field 3 120° 0° Field 2
Measure with
Field 4 180° 0°
couch angle 0°!!
Field 5 240° 20°
Field 6 300° 20°
Simultaneous
Measurement of Save XCC file for
Field 5 couch angle 20°
Field 6
Measure with
couch angle 0° !!
OCTAVIUS
Non-Coplanar – Evaluation workflow

For non-coplanar dose reconstruction in veriSoft “Non-coplanar Dosimetry”
has to be activated in the options menu…
Non-coplanar 4D dosimetry
must be activated !!

OCTAVIUS
Non-Coplanar – Evaluation workflow

Simply load the measurement file(s) & assign PDD file and couch angle to
each measurement file…
Reconstruction

OCTAVIUS
Non-Coplanar – Dose reconstruction

Dose reconstruction principle:
Dose measured by the
OCTAVIUS detector
SSD new
Depth zp Source
Dp
Percentage depth dose at SSD
depth zp (normalized) correction
A Dq for fieldsize A parameterized
SSD 85 cm at the surface
Depth zq
Brown Phantom: OCTAVIUS 4D phantom as used for dose reconstruction of
measurements at couch angle 0°
Green Phantom: Virtual, rotated OCTAVIUS 4D phantom, used for dose
reconstruction of an arbitrary couch angle x°

OCTAVIUS
OCTAVIUS® 4D – Now available for HalcyonTM

2 rpm
Max. 4 rpm
taken from www.varian.com 4 rpm
Key Challenge: Rotation speed

Adaption of OCTAVIUS 4D rotation
speed necessary to ensure fast and
smooth rotation at 4rpm.

OCTAVIUS
OCTAVIUS® 4D – Integration into VERIQA
VERIQA
Client-based Server-based
DICOM and Pre-treatment Treatment

DICOM RT QA delivery QA
Viewing Monte Carlo dose Log file analysis
calculation
Evaluation OCTAVIUS® Evaluation for

measurement adaptive RT
Track-it
OCTAVIUS
OCTAVIUS® 4D – Integration into VERIQA

Web-Server OCTAVIUS® client
Treatment DICOM
Planning RT
System OCTAVIUS®
Patient worklist generation

Automated dose calculation
Patient worklist processing
Automated dose comparison (OCTAVIUS measurement)
VERIQA web client VERIQA Windows client

@ Email
XML + PDF
Track-it
Evaluation/Configuration Detailed evaluation
Auto reporting
OCTAVIUS
Thank you for

your attention!

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What are some of the new features of OCTAVIUS 4D?

What are some of the new features of OCTAVIUS 4D?

How does OCTAVIUS 4D reconstruct dose for non-coplanar beams?

How does OCTAVIUS 4D reconstruct dose for non-coplanar beams?

HEALTH PHYSICS NUCLEAR MEDICINE DIAGNOSTIC RADIOLOGY RADIATION THERAPY

Dosimetry Pioneers since 1922

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

2 OCTAVIUS®4D - New Features

3 OCTAVIUS®4D - Future Outlook

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

From Humble Beginnings

1919: Professor Wilhelm Hammer 1927: Dr. Herbert Pychlau resumes

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

PTW Calibration Laboratory

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

The Dosimetry School

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

OCTAVIUS® 4D – Principal Workflow

OCTAVIUS® 4D – System components

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

OCTAVIUS® 4D – System components

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

Application-dependent patient QA…

…with suitable OCTAVIUS® detectors.

OCTAVIUS® OCTAVIUS® OCTAVIUS®

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

The modular OCTAVIUS® 4D phantom

SRS QA top (2): Ø 17 cm,

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

The modular OCTAVIUS® 4D phantom

Classical LINAC QA from

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

Application-dependent patient QA…

…with appropriate phantom setups.

Rotation unit top

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

VeriSoft® – A flexible verification platform

Data window A Results window

Data window B Compare Window

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

Verisoft – Dose Reconstruction principle

Verisoft – Dose Reconstruction principle

PDD field size 8x8 cm²

Summation of all dose points, measured and extrapolated at a given

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

OCTAVIUS® 4D– DVH Analysis

Algorithm takes changes in SSD and different densities into account

Comparison of measured and planned DVHs of structures in RT_Struct

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

OCTAVIUS® 4D – DVH Analysis

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

VeriSoft 7 – New special dosimetry apps

Classical IMRT / VMAT IMRT / VMAT IMRT / VMAT IMRT / VMAT

Standard algorithm New algorithms!

ICTP School of Medical Physics for Radiation Therapy – 03.04.2019

Verification of off-axis target volumes

=> PTV not/ not completely covered by OCTAVIUS® detector