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IGRT in Prostate Cancer: The Calypso 4D Localization System


T Djemil


T Djemil1*, (1) Cleveland Clinic Foundation,

TH-C-218-3 Thursday 10:30:00 AM - 12:30:00 PM Room: 218

There is mounting evidence that for prostate cancer patients treated with EBRT, dose escalation to the prostate increases local control. This benefit comes at the cost of toxicities and complications. Therefore, restricting the dose to normal tissue becomes of utmost importance. Image guidance for accurate treatment delivery and intra-fraction motion monitoring is critical in this environment of dose escalation and hypo fractionation.

A variety of systems could be utilized for this purpose, such as transabdominal ultrasound, KV X-rays, and KV/MV CBCT. However, these systems have several disadvantages: they only provide snapshots of the prostate position; they are not available during radiation delivery; they cause an additional ionizing radiation exposure; and they may be subjective and operator dependant in acquisition and interpretation. A newer technology using non ionizing electromagnetic field and implanted fiducial markers (transponders) to locate and track patient tumors is available by Calypso Medical.

In this presentation, our experience with IMRT and SBRT prostate treatments at the Cleveland Clinic will be presented. The treatment plans are generated with the Pinnacle treatment planning system, the localization and tracking is performed by the 4D Calypso system, and the treatment delivery is done on an Elekta Synergy S linac.

Learning Objectives:

1. Understand the clinical rationale for localization and tracking
2. Understand the necessity of hybrid technologies and systems
3. Understand the physics behind the Calypso localization mechanism and its principles of operation
4. Understand operational and quality assurance aspects of Calypso combined with Synergy-S and Pinnacle TPS
5. Understand the technical limitations of the hybrid system
6. Describe clinical implementation of the system and typical cases treated


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