In this study we develop and characterise a six degree-of-freedom (6 DoF) robotic motion system for quality assurance of real-time image-guided radiotherapy techniques. The system consists of a commercially available robotic arm, an acrylic phantom with embedded Calypso markers, a custom base plate to mount the robot to the treatment couch, and control software implementing the appropriate sequence of transformations to reproduce measured tumour motion traces. The robotic motion system was evaluated in terms of the set-up and motion trace repeatability, static localization accuracy and dynamic localization accuracy. Four prostate, two liver and three lung motion traces, representing a range of tumor motion trajectories recorded in real patient treatments, were executed using the robotic motion system and compared with motion measurements from the clinical Calypso motion tracking system. System set-up and motion trace repeatability was better than 0.5 deg and 0.3 mm for rotation and translation, respectively. The static localization accuracy of the robotic motion system in the LR, SI and AP directions was 0.09 mm, 0.08 mm and 0.02 mm for translations, respectively, and 0.2°, 0.06° and 0.06° for rotations, respectively. The dynamic localization accuracy of the robotic motion system was <0.2 mm and <0.6° for translations and rotations, respectively. Thus, we have demonstrated the ability to accurately mimic rigid-body tumor motion using a robotically controlled phantom to provide precise geometric QA for advanced radiotherapy delivery approaches.

HDR BrachyView is a novel in-body dosimetric imaging system for real-time monitoring and verification of the source position in high dose rate (HDR) prostate brachytherapy treatment. It is based on a high-resolution pixelated detector array with a semi-cylindrical multi-pinhole tungsten collimator and is designed to fit inside a compact rectal probe, and is able to resolve the 3D position of the source with a maximum error of 1.5 mm. This paper presents an evaluation of the additional dose that will be delivered to the patient as a result of backscatter radiation from the collimator. Monte Carlo simulations of planar and cylindrical collimators embedded in a tissue-equivalent phantom were performed using Geant4, with an (192)Ir source placed at two different source-collimator distances. The planar configuration was replicated experimentally to validate the simulations, with a MOSkin dosimetry probe used to measure dose at three distances from the collimator. For the cylindrical collimator simulation, backscatter dose enhancement was calculated as a function of axial and azimuthal displacement, and dose distribution maps were generated at three distances from the collimator surface. Although significant backscatter dose enhancement was observed for both geometries immediately adjacent to the collimator, simulations and experiments indicate that backscatter dose is negligible at distances beyond 1 mm from the collimator. Since HDR BrachyView is enclosed within a 1 mm thick tissue-equivalent plastic shell, all backscatter radiation resulting from its use will therefore be absorbed before reaching the rectal wall or other tissues. dosimetry, brachytherapy, HDR.