{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:51:48Z","timestamp":1770745908644,"version":"3.49.0"},"reference-count":9,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T00:00:00Z","timestamp":1697241600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Pencil Beam Scanning (PBS) proton therapy has similar requirements on patient alignment to within 1\u00a0mm and 1\u2010degree accuracy as photon radiosurgery. This study describes general workflow, acceptance, and commissioning test procedures and their respective results for an independent robotic arm used for Image Guided Radiotherapy (IGRT) for a Proton Therapy System.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The system is equipped with kV\u2010imaging techniques capable of orthogonal and Cone\u2010Beam Computed Tomography (CBCT) imaging modalities mounted on an independent robotic arm gantry attached to the ceiling. The imaging system is capable of 360\u2010degree rotation around patients to produce CBCT and kilovoltage orthogonal images. The imaging hardware is controlled by Ehmet Health XIS software, and MIM Software handles the image fusion and registration to an acceptable accuracy of \u22641\u2010mm shifts for patients\u2019 alignment. The system was tested according to the requirements outlined in the American Association of Physicists in Medicine (AAPM) Task Group (TG) 142 and TG 179. The system tests included (1) safety, functionality, and connectivity, (2) mechanical testing, (3) image quality, (4) image registration, and (5) imaging dose. Additional tests included imaging gantry isocentricity with a laser tracker and collision\u2010avoiding system checks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The orthogonal and volumetric imaging are comparable in quality to other commercially available On\u2010Board Imagers (OBI) systems. The resulting spatial resolution values were 1.8\u2010, 0.8\u2010, and 0.5\u2010Line Pairs per Millimeter (lp\/mm) for orthogonal, full\u2010fan CBCT, and half\u2010fan CBCT, respectively. The image registration is accurate to within 1\u00a0mm and 1 degree. The data shows consistent imaging\u2010guided system performance with standard deviations in x, y, and z of 0.7, 0.8, and 0.7\u00a0mm, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The system provides excellent image quality and performance, which can be used for IGRT. The proven accuracy of the x\u2010ray imaging and positioning system at McLaren Proton Therapy Center (MPTC) is 1\u00a0mm, making it suitable for proton therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.14181","type":"journal-article","created":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T18:24:20Z","timestamp":1697307860000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The implementation of an image\u2010guided system at a proton therapy center facility"],"prefix":"10.1002","volume":"25","author":[{"given":"Bijan","family":"Arjomandy","sequence":"first","affiliation":[{"name":"Karmanos Cancer Institute at McLaren\u2010Flint McLaren Proton Therapy Center  Flint Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Isabel","family":"Bejarano Buele","sequence":"additional","affiliation":[{"name":"Erlanger Baroness Hospital  Chattanooga Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neal","family":"Clinthorne","sequence":"additional","affiliation":[{"name":"Ehmet Health  Plymouth Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milos","family":"Vujasevic","sequence":"additional","affiliation":[{"name":"Ehmet Health  Plymouth Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basit","family":"Athar","sequence":"additional","affiliation":[{"name":"Karmanos Cancer Institute at McLaren\u2010Flint McLaren Proton Therapy Center  Flint Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Deemer","sequence":"additional","affiliation":[{"name":"Karmanos Cancer Institute at McLaren\u2010Flint McLaren Proton Therapy Center  Flint Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Alkhatib","sequence":"additional","affiliation":[{"name":"Karmanos Cancer Institute at McLaren\u2010Flint McLaren Proton Therapy Center  Flint Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abrar","family":"Hussain","sequence":"additional","affiliation":[{"name":"Karmanos Cancer Institute at McLaren\u2010Flint McLaren Proton Therapy Center  Flint Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,10,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/57\/11\/R99"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2010.07.003"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3190392"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3690466"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1339879"},{"key":"e_1_2_8_7_1","unstructured":"SystemsVM Varian on\u2010Board Imager (obi) Reference Guide. Published online 2008."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20170266"},{"issue":"2","key":"e_1_2_8_9_1","article-title":"Evaluation of imaging performance of major image guidance systems","volume":"7","author":"Chan MF","year":"2011","journal-title":"Biomed Imaging Interv J"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2362872"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.14181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T16:20:23Z","timestamp":1710260423000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.14181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,14]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1002\/acm2.14181"],"URL":"https:\/\/doi.org\/10.1002\/acm2.14181","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,14]]},"assertion":[{"value":"2023-06-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14181"}}