MO‐SAMS‐AUD‐01: Daily Localization — I: Kilovolt Imaging

As high‐precision 3‐D conformal radiation therapy and intensity‐modulated radiation therapy have become standard practice, radiographic imaging using kilovoltage (kV) x‐ray sources has been rapidly implemented for in‐room target localization and patient positioning to ensure conformal dose delivery. Various types of imaging devices are commercially available for clinical applications and their typical imaging functionalities include 2‐D radiographic and fluoroscopic imaging as well as 3‐D cone beam CT. There are substantial demands for fundamental understanding of what kind of systems can be used for clinical practice, when and what imaging systems should be used, how they can be properly used for daily target localization for different anatomical sites, and what kind of quality assurance programs are needed. In this session, we will briefly introduce the latest commercially available imaging systems using kV imaging for in‐room target localization and their imaging principles. Clinical applications and imaging protocols using these systems for accurate target localization and patient positioning will then be discussed. Finally, systematic quality assurance procedures will be presented. Objectives: 1. Understand the latest commercially available technologies for in‐room kV radiography, fluoroscopy, and cone‐beam CT and their basic imaging principles. 2. Understand the basic clinical imaging applications for daily localization. 3. Understand the basic system limitations and QA components of a comprehensive QA program.