Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities

Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the presen...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Clivio, Alessandro [verfasserIn] Nicolini, Giorgia Vanetti, Eugenio Fogliata, Antonella Cozzi, Luca

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2011

Schlagwörter:	UNIQUE linear accelerator RapidArc Beam Commissioning

Anmerkung:	© Clivio et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (

Übergeordnetes Werk:	Enthalten in: Radiation oncology - London : BioMed Central, 2006, 6(2011), 1 vom: 30. Sept.
Übergeordnetes Werk:	volume:6 ; year:2011 ; number:1 ; day:30 ; month:09

Links:	Volltext

DOI / URN:	10.1186/1748-717X-6-129

Katalog-ID:	SPR029602165

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520			\|a Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning and first year results from clinical operation. Methods Commissioning data, beam characteristics and the modeling into the treatment planning system were summarized. Imaging system of UNIQUE included a 2D-2D matching capability and tests were performed to identify system repositioning capability. Finally, since the system is capable of delivering volumetric modulated arc therapy with RapidArc, a summary of the tests performed for such modality to assess its performance in preclinical settings and during clinical usage was included. Results Isocenter virtual diameter was measured as less than 0.2 mm. Observed accuracy of isocenter determination and repositioning for 2D-2D matching procedures in image guidance was <1.2 mm. Concerning reproducibility and stability over a period of 1 year, deviations from reference were found <0.3 ± 0.2% for linac output, <0.1% for homogeneity, similarly to symmetry. Rotational accuracy of the entire gantry-portal imager system showed a maximum deviation from nominal 0.0 of <1.2 mm. Pre treatment quality assurance of RapidArc plans resulted with a Gamma Agreement Index (fraction of points passing the gamma criteria) of 97.0 ± 1.6% on the first 182 arcs verified. Conclusions The results of the commissioning tests and of the first period of clinical operation, resulted meeting specifications and having good margins respect to tolerances. UNIQUE was put into operation for all delivery techniques; in particular, as shown by the pre-treatment quality assurance results, it enabled accurate and safe delivery of RapidArc plans.
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allfields	10.1186/1748-717X-6-129 doi (DE-627)SPR029602165 (SPR)1748-717X-6-129-e DE-627 ger DE-627 rakwb eng Clivio, Alessandro verfasserin aut Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Clivio et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning and first year results from clinical operation. Methods Commissioning data, beam characteristics and the modeling into the treatment planning system were summarized. Imaging system of UNIQUE included a 2D-2D matching capability and tests were performed to identify system repositioning capability. Finally, since the system is capable of delivering volumetric modulated arc therapy with RapidArc, a summary of the tests performed for such modality to assess its performance in preclinical settings and during clinical usage was included. Results Isocenter virtual diameter was measured as less than 0.2 mm. Observed accuracy of isocenter determination and repositioning for 2D-2D matching procedures in image guidance was <1.2 mm. Concerning reproducibility and stability over a period of 1 year, deviations from reference were found <0.3 ± 0.2% for linac output, <0.1% for homogeneity, similarly to symmetry. Rotational accuracy of the entire gantry-portal imager system showed a maximum deviation from nominal 0.0 of <1.2 mm. Pre treatment quality assurance of RapidArc plans resulted with a Gamma Agreement Index (fraction of points passing the gamma criteria) of 97.0 ± 1.6% on the first 182 arcs verified. Conclusions The results of the commissioning tests and of the first period of clinical operation, resulted meeting specifications and having good margins respect to tolerances. UNIQUE was put into operation for all delivery techniques; in particular, as shown by the pre-treatment quality assurance results, it enabled accurate and safe delivery of RapidArc plans. UNIQUE linear accelerator (dpeaa)DE-He213 RapidArc (dpeaa)DE-He213 Beam Commissioning (dpeaa)DE-He213 Nicolini, Giorgia aut Vanetti, Eugenio aut Fogliata, Antonella aut Cozzi, Luca aut Enthalten in Radiation oncology London : BioMed Central, 2006 6(2011), 1 vom: 30. Sept. (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:6 year:2011 number:1 day:30 month:09 https://dx.doi.org/10.1186/1748-717X-6-129 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2011 1 30 09
spelling	10.1186/1748-717X-6-129 doi (DE-627)SPR029602165 (SPR)1748-717X-6-129-e DE-627 ger DE-627 rakwb eng Clivio, Alessandro verfasserin aut Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Clivio et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning and first year results from clinical operation. Methods Commissioning data, beam characteristics and the modeling into the treatment planning system were summarized. Imaging system of UNIQUE included a 2D-2D matching capability and tests were performed to identify system repositioning capability. Finally, since the system is capable of delivering volumetric modulated arc therapy with RapidArc, a summary of the tests performed for such modality to assess its performance in preclinical settings and during clinical usage was included. Results Isocenter virtual diameter was measured as less than 0.2 mm. Observed accuracy of isocenter determination and repositioning for 2D-2D matching procedures in image guidance was <1.2 mm. Concerning reproducibility and stability over a period of 1 year, deviations from reference were found <0.3 ± 0.2% for linac output, <0.1% for homogeneity, similarly to symmetry. Rotational accuracy of the entire gantry-portal imager system showed a maximum deviation from nominal 0.0 of <1.2 mm. Pre treatment quality assurance of RapidArc plans resulted with a Gamma Agreement Index (fraction of points passing the gamma criteria) of 97.0 ± 1.6% on the first 182 arcs verified. Conclusions The results of the commissioning tests and of the first period of clinical operation, resulted meeting specifications and having good margins respect to tolerances. UNIQUE was put into operation for all delivery techniques; in particular, as shown by the pre-treatment quality assurance results, it enabled accurate and safe delivery of RapidArc plans. UNIQUE linear accelerator (dpeaa)DE-He213 RapidArc (dpeaa)DE-He213 Beam Commissioning (dpeaa)DE-He213 Nicolini, Giorgia aut Vanetti, Eugenio aut Fogliata, Antonella aut Cozzi, Luca aut Enthalten in Radiation oncology London : BioMed Central, 2006 6(2011), 1 vom: 30. Sept. (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:6 year:2011 number:1 day:30 month:09 https://dx.doi.org/10.1186/1748-717X-6-129 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2011 1 30 09
allfields_unstemmed	10.1186/1748-717X-6-129 doi (DE-627)SPR029602165 (SPR)1748-717X-6-129-e DE-627 ger DE-627 rakwb eng Clivio, Alessandro verfasserin aut Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Clivio et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning and first year results from clinical operation. Methods Commissioning data, beam characteristics and the modeling into the treatment planning system were summarized. Imaging system of UNIQUE included a 2D-2D matching capability and tests were performed to identify system repositioning capability. Finally, since the system is capable of delivering volumetric modulated arc therapy with RapidArc, a summary of the tests performed for such modality to assess its performance in preclinical settings and during clinical usage was included. Results Isocenter virtual diameter was measured as less than 0.2 mm. Observed accuracy of isocenter determination and repositioning for 2D-2D matching procedures in image guidance was <1.2 mm. Concerning reproducibility and stability over a period of 1 year, deviations from reference were found <0.3 ± 0.2% for linac output, <0.1% for homogeneity, similarly to symmetry. Rotational accuracy of the entire gantry-portal imager system showed a maximum deviation from nominal 0.0 of <1.2 mm. Pre treatment quality assurance of RapidArc plans resulted with a Gamma Agreement Index (fraction of points passing the gamma criteria) of 97.0 ± 1.6% on the first 182 arcs verified. Conclusions The results of the commissioning tests and of the first period of clinical operation, resulted meeting specifications and having good margins respect to tolerances. UNIQUE was put into operation for all delivery techniques; in particular, as shown by the pre-treatment quality assurance results, it enabled accurate and safe delivery of RapidArc plans. UNIQUE linear accelerator (dpeaa)DE-He213 RapidArc (dpeaa)DE-He213 Beam Commissioning (dpeaa)DE-He213 Nicolini, Giorgia aut Vanetti, Eugenio aut Fogliata, Antonella aut Cozzi, Luca aut Enthalten in Radiation oncology London : BioMed Central, 2006 6(2011), 1 vom: 30. Sept. (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:6 year:2011 number:1 day:30 month:09 https://dx.doi.org/10.1186/1748-717X-6-129 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2011 1 30 09
allfieldsGer	10.1186/1748-717X-6-129 doi (DE-627)SPR029602165 (SPR)1748-717X-6-129-e DE-627 ger DE-627 rakwb eng Clivio, Alessandro verfasserin aut Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Clivio et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning and first year results from clinical operation. Methods Commissioning data, beam characteristics and the modeling into the treatment planning system were summarized. Imaging system of UNIQUE included a 2D-2D matching capability and tests were performed to identify system repositioning capability. Finally, since the system is capable of delivering volumetric modulated arc therapy with RapidArc, a summary of the tests performed for such modality to assess its performance in preclinical settings and during clinical usage was included. Results Isocenter virtual diameter was measured as less than 0.2 mm. Observed accuracy of isocenter determination and repositioning for 2D-2D matching procedures in image guidance was <1.2 mm. Concerning reproducibility and stability over a period of 1 year, deviations from reference were found <0.3 ± 0.2% for linac output, <0.1% for homogeneity, similarly to symmetry. Rotational accuracy of the entire gantry-portal imager system showed a maximum deviation from nominal 0.0 of <1.2 mm. Pre treatment quality assurance of RapidArc plans resulted with a Gamma Agreement Index (fraction of points passing the gamma criteria) of 97.0 ± 1.6% on the first 182 arcs verified. Conclusions The results of the commissioning tests and of the first period of clinical operation, resulted meeting specifications and having good margins respect to tolerances. UNIQUE was put into operation for all delivery techniques; in particular, as shown by the pre-treatment quality assurance results, it enabled accurate and safe delivery of RapidArc plans. UNIQUE linear accelerator (dpeaa)DE-He213 RapidArc (dpeaa)DE-He213 Beam Commissioning (dpeaa)DE-He213 Nicolini, Giorgia aut Vanetti, Eugenio aut Fogliata, Antonella aut Cozzi, Luca aut Enthalten in Radiation oncology London : BioMed Central, 2006 6(2011), 1 vom: 30. Sept. (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:6 year:2011 number:1 day:30 month:09 https://dx.doi.org/10.1186/1748-717X-6-129 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2011 1 30 09
allfieldsSound	10.1186/1748-717X-6-129 doi (DE-627)SPR029602165 (SPR)1748-717X-6-129-e DE-627 ger DE-627 rakwb eng Clivio, Alessandro verfasserin aut Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Clivio et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning and first year results from clinical operation. Methods Commissioning data, beam characteristics and the modeling into the treatment planning system were summarized. Imaging system of UNIQUE included a 2D-2D matching capability and tests were performed to identify system repositioning capability. Finally, since the system is capable of delivering volumetric modulated arc therapy with RapidArc, a summary of the tests performed for such modality to assess its performance in preclinical settings and during clinical usage was included. Results Isocenter virtual diameter was measured as less than 0.2 mm. Observed accuracy of isocenter determination and repositioning for 2D-2D matching procedures in image guidance was <1.2 mm. Concerning reproducibility and stability over a period of 1 year, deviations from reference were found <0.3 ± 0.2% for linac output, <0.1% for homogeneity, similarly to symmetry. Rotational accuracy of the entire gantry-portal imager system showed a maximum deviation from nominal 0.0 of <1.2 mm. Pre treatment quality assurance of RapidArc plans resulted with a Gamma Agreement Index (fraction of points passing the gamma criteria) of 97.0 ± 1.6% on the first 182 arcs verified. Conclusions The results of the commissioning tests and of the first period of clinical operation, resulted meeting specifications and having good margins respect to tolerances. UNIQUE was put into operation for all delivery techniques; in particular, as shown by the pre-treatment quality assurance results, it enabled accurate and safe delivery of RapidArc plans. UNIQUE linear accelerator (dpeaa)DE-He213 RapidArc (dpeaa)DE-He213 Beam Commissioning (dpeaa)DE-He213 Nicolini, Giorgia aut Vanetti, Eugenio aut Fogliata, Antonella aut Cozzi, Luca aut Enthalten in Radiation oncology London : BioMed Central, 2006 6(2011), 1 vom: 30. Sept. (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:6 year:2011 number:1 day:30 month:09 https://dx.doi.org/10.1186/1748-717X-6-129 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2011 1 30 09
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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning and first year results from clinical operation. Methods Commissioning data, beam characteristics and the modeling into the treatment planning system were summarized. Imaging system of UNIQUE included a 2D-2D matching capability and tests were performed to identify system repositioning capability. 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title	Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities
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title_full	Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities
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title_sort	commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities
title_auth	Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities
abstract	Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning and first year results from clinical operation. Methods Commissioning data, beam characteristics and the modeling into the treatment planning system were summarized. Imaging system of UNIQUE included a 2D-2D matching capability and tests were performed to identify system repositioning capability. Finally, since the system is capable of delivering volumetric modulated arc therapy with RapidArc, a summary of the tests performed for such modality to assess its performance in preclinical settings and during clinical usage was included. Results Isocenter virtual diameter was measured as less than 0.2 mm. Observed accuracy of isocenter determination and repositioning for 2D-2D matching procedures in image guidance was <1.2 mm. Concerning reproducibility and stability over a period of 1 year, deviations from reference were found <0.3 ± 0.2% for linac output, <0.1% for homogeneity, similarly to symmetry. Rotational accuracy of the entire gantry-portal imager system showed a maximum deviation from nominal 0.0 of <1.2 mm. Pre treatment quality assurance of RapidArc plans resulted with a Gamma Agreement Index (fraction of points passing the gamma criteria) of 97.0 ± 1.6% on the first 182 arcs verified. Conclusions The results of the commissioning tests and of the first period of clinical operation, resulted meeting specifications and having good margins respect to tolerances. UNIQUE was put into operation for all delivery techniques; in particular, as shown by the pre-treatment quality assurance results, it enabled accurate and safe delivery of RapidArc plans. © Clivio et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (
abstractGer	Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning and first year results from clinical operation. Methods Commissioning data, beam characteristics and the modeling into the treatment planning system were summarized. Imaging system of UNIQUE included a 2D-2D matching capability and tests were performed to identify system repositioning capability. Finally, since the system is capable of delivering volumetric modulated arc therapy with RapidArc, a summary of the tests performed for such modality to assess its performance in preclinical settings and during clinical usage was included. Results Isocenter virtual diameter was measured as less than 0.2 mm. Observed accuracy of isocenter determination and repositioning for 2D-2D matching procedures in image guidance was <1.2 mm. Concerning reproducibility and stability over a period of 1 year, deviations from reference were found <0.3 ± 0.2% for linac output, <0.1% for homogeneity, similarly to symmetry. Rotational accuracy of the entire gantry-portal imager system showed a maximum deviation from nominal 0.0 of <1.2 mm. Pre treatment quality assurance of RapidArc plans resulted with a Gamma Agreement Index (fraction of points passing the gamma criteria) of 97.0 ± 1.6% on the first 182 arcs verified. Conclusions The results of the commissioning tests and of the first period of clinical operation, resulted meeting specifications and having good margins respect to tolerances. UNIQUE was put into operation for all delivery techniques; in particular, as shown by the pre-treatment quality assurance results, it enabled accurate and safe delivery of RapidArc plans. © Clivio et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (
abstract_unstemmed	Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning and first year results from clinical operation. Methods Commissioning data, beam characteristics and the modeling into the treatment planning system were summarized. Imaging system of UNIQUE included a 2D-2D matching capability and tests were performed to identify system repositioning capability. Finally, since the system is capable of delivering volumetric modulated arc therapy with RapidArc, a summary of the tests performed for such modality to assess its performance in preclinical settings and during clinical usage was included. Results Isocenter virtual diameter was measured as less than 0.2 mm. Observed accuracy of isocenter determination and repositioning for 2D-2D matching procedures in image guidance was <1.2 mm. Concerning reproducibility and stability over a period of 1 year, deviations from reference were found <0.3 ± 0.2% for linac output, <0.1% for homogeneity, similarly to symmetry. Rotational accuracy of the entire gantry-portal imager system showed a maximum deviation from nominal 0.0 of <1.2 mm. Pre treatment quality assurance of RapidArc plans resulted with a Gamma Agreement Index (fraction of points passing the gamma criteria) of 97.0 ± 1.6% on the first 182 arcs verified. Conclusions The results of the commissioning tests and of the first period of clinical operation, resulted meeting specifications and having good margins respect to tolerances. UNIQUE was put into operation for all delivery techniques; in particular, as shown by the pre-treatment quality assurance results, it enabled accurate and safe delivery of RapidArc plans. © Clivio et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (
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title_short	Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities
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author2	Nicolini, Giorgia Vanetti, Eugenio Fogliata, Antonella Cozzi, Luca
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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background A new-generation low-energy linear accelerator (UNIQUE) was introduced in the clinical arena during 2009 by Varian Medical Systems. The world's first UNIQUE was installed at Oncology Institute of Southern Switzerland and put into clinical operation in June 2010. The aim of the present contribution was to report experience about its commissioning and first year results from clinical operation. Methods Commissioning data, beam characteristics and the modeling into the treatment planning system were summarized. Imaging system of UNIQUE included a 2D-2D matching capability and tests were performed to identify system repositioning capability. Finally, since the system is capable of delivering volumetric modulated arc therapy with RapidArc, a summary of the tests performed for such modality to assess its performance in preclinical settings and during clinical usage was included. Results Isocenter virtual diameter was measured as less than 0.2 mm. Observed accuracy of isocenter determination and repositioning for 2D-2D matching procedures in image guidance was <1.2 mm. Concerning reproducibility and stability over a period of 1 year, deviations from reference were found <0.3 ± 0.2% for linac output, <0.1% for homogeneity, similarly to symmetry. Rotational accuracy of the entire gantry-portal imager system showed a maximum deviation from nominal 0.0 of <1.2 mm. Pre treatment quality assurance of RapidArc plans resulted with a Gamma Agreement Index (fraction of points passing the gamma criteria) of 97.0 ± 1.6% on the first 182 arcs verified. Conclusions The results of the commissioning tests and of the first period of clinical operation, resulted meeting specifications and having good margins respect to tolerances. 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Commissioning and early experience with a new-generation low-energy linear accelerator with advanced delivery and imaging functionalities

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