{"doi":"10.1002/acm2.13240","title":"Commissioning of optical surface imaging systems for cranial frameless stereotactic radiosurgery","abstract":"PURPOSE: This study aimed to evaluate and compare different system calibration methods from a large cohort of systems to establish a commissioning procedure for surface-guided frameless cranial stereotactic radiosurgery (SRS) with intrafractional motion monitoring and gating. Using optical surface imaging (OSI) to guide non-coplanar SRS treatments, the determination of OSI couch-angle dependency, baseline drift, and gated-delivered-dose equivalency are essential. METHODS: Eleven trained physicists evaluated 17 OSI systems at nine clinical centers within our institution. Three calibration methods were examined, including 1-level (2D), 2-level plate (3D) calibration for both surface image reconstruction and isocenter determination, and cube phantom calibration to assess OSI-megavoltage (MV) isocenter concordance. After each calibration, a couch-angle dependency error was measured as the maximum registration error within the couch rotation range. A head phantom was immobilized on the treatment couch and the isocenter was set in the middle of the brain, marked with the room lasers. An on-site reference image was acquired at couch zero, the facial region of interest (ROI) was defined, and static verification images were captured every 10° for 0°-90° and 360°-270°. The baseline drift was assessed with real-time monitoring of the motionless phantom over 20 min. The gated-delivered-dose equivalency was assessed using the electron portal imaging device and gamma test (1%/1mm) in reference to non-gated delivery. RESULTS: The maximum couch-angle dependency error occurs in longitudinal and lateral directions and is reduced significantly (P < 0.05) from 1-level (1.3 ± 0.4 mm) to 2-level (0.8 ± 0.3 mm) calibration. The MV cube calibration does not further reduce the couch-angle dependency error (0.8 ± 0.2 mm) on average. The baseline drift error plateaus at 0.3 ± 0.1 mm after 10 min. The gated-delivered-dose equivalency has a >98% gamma-test passing rate. CONCLUSION: A commissioning method is recommended using the 3D plate calibration, which is verified by radiation isocenter and validated with couch-angle dependency, baseline drift, and gated-delivered-dose equivalency tests. This method characterizes OSI uncertainties, ensuring motion-monitoring accuracy for SRS treatments.","journal":"Journal of Applied Clinical Medical Physics","year":2021,"id":191787,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9579,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":757593,"name":"Sarath Vijayan","orcid":"0000-0001-9550-9333","position":1,"is_corresponding":false},{"id":757594,"name":"Sheng Huang","orcid":"0000-0002-4090-3859","position":2,"is_corresponding":false},{"id":757595,"name":"Yulin Song","orcid":"0000-0002-2391-7466","position":3,"is_corresponding":false},{"id":377935,"name":"Tianfang Li","orcid":null,"position":4,"is_corresponding":false},{"id":377110,"name":"Xiang Li","orcid":"0000-0001-8338-4123","position":5,"is_corresponding":false},{"id":746563,"name":"E Hipp","orcid":null,"position":6,"is_corresponding":false},{"id":273556,"name":"Maria F. Chan","orcid":"0000-0002-9140-8604","position":7,"is_corresponding":false},{"id":757596,"name":"Hsiang‐Chi Kuo","orcid":"0000-0003-0063-2473","position":8,"is_corresponding":false},{"id":757597,"name":"Xiaoli Tang","orcid":"0000-0003-4428-0895","position":9,"is_corresponding":false},{"id":757598,"name":"Grace Tang","orcid":"0000-0001-6179-5343","position":10,"is_corresponding":false},{"id":757599,"name":"Seng Boh Lim","orcid":"0000-0002-4054-8789","position":11,"is_corresponding":false},{"id":660149,"name":"D. Michael Lovelock","orcid":"0000-0002-9371-3573","position":12,"is_corresponding":false},{"id":686991,"name":"Åse Ballangrud","orcid":"0000-0001-8269-8921","position":13,"is_corresponding":false},{"id":757600,"name":"Guang Li","orcid":"0000-0002-9022-2883","position":14,"is_corresponding":false},{"id":757592,"name":"Lei Zhang","orcid":"0000-0001-5369-5756","position":0,"is_corresponding":true}],"reference_count":25,"raw_metadata":null,"created_at":"2026-07-18T23:49:35.285023Z","pmid":"33779052","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}