DOSE CONTROL SYSTEM (DCS) TEcHNOLOGY

ANOTHER TREaTMENT REVOLUTION

Feedback: Electron Gun Current Dose Control

Helical TomoTherapy treatments are widely System Electron Electrons accepted as the gold standard in radiation Gun treatment delivery. With the new Dose Control Control Software System, Accuray Incorporated continues RF Power to improve treatment quality and system performance. The Dose Control System Inputs virtually eliminates dose rate variations during Feedback: Measured Dose Dose each gantry rotation, treatment session, and Monitor over the entire course of treatment. In particular, X-Rays dose rates during longer treatments such as total marrow irradiation and stereotactic procedures will now remain within even more tightly-controlled limits. Further, safety interlocks that interrupt a treatment because of dose rate instabilities are dramatically reduced with DCS. A more consistent dose rate means fewer system adjustments by staff and service personnel.
Linear Accelerator (LINAC) Outputs

DCS KEY BENEFITs

DCS MAINTAINS DOSE RATE CONSISTENCY Throughout daily treatment delivery Throughout a course of treatment Between service visits DCS MINIMIZES SYSTEM INTERRUPTIONS Due to rotational dose rate variation Due to dose rate drift

DCS OpERaTIONaL DIFFERENcE

Without DCS
System tuning is accomplished during a service visit and remains constant between visits Output variations naturally occur due to mechanical, thermal and component variations Once dose levels are observed approaching tolerable limits, service intervention re-tunes the machine

With DCS
An initial service procedure prepares the machine for servo operation A feedback system monitors gun current and dose rate Near real-time control of RF power and gun current is based on feedback signals Greater mechanical, thermal, and component variations can be tolerated without intervention

DCS EXaMpLEs
Dose rate variation In this example, the dose output without DCS installed exhibits both a gradual average drop over several minutes and a rotational variation per gantry revolution. The DCS system is able to stabilize both the periodic and gradual dose variations
36000 35000

Output (Raw) After Dose Control System

Count

34000

Before Dose Control System

33000

32000

1000

2000

3000

4000

5000

6000

Pulse

Average dose rate errors per week before DCS with DCS
0 0.2 0.4 0.6 0.8 1 1.2 dose rate errors per week 1.4 1.6

Interrupts Examination of system log les can reveal the rate of interrupts of various types. These include interlocks due to deviations in actual dose rate from the expected dose rate. Data analysis for the 18 systems in a DCS pilot program shows that the weekly rate of these interlocks decreased onaverage by approximately 90% between the before DCS and with DCS data, or going from one dose rate-related interrupt every few days to one every few weeks or months of clinical use.

DCS TEcHNIcaL EssENTIaLs

DCS is a servo mechanism based on feedback from the monitor ionization chambers (dose output measurement) and injector cabling (electron gun current measurement) DCS controls magnetron power output and injector current to maintain constant dose output EUROPE UNITEDand STATES gun current ASIA DCS isHeadquarters designed to stabilize bothAccuray dose rate power) (via Europe gun current)Tomotherapy Belgium BVBA TomoTherapy Accuray Asia Ltd. - Hong Kong and Accuraybeam Chengdu energyAccuray Accuray Corporate Japan K.K. - (via Tokyo magnetron
1310 Chesapeake Terrace Sunnyvale, CA 94089 USA Tel: +1.408.716.4600 Toll Free: 1.888.522.3740 Fax: +1.408.716.4601 Email: sales@accuray.com

At the heart of the Dose Control System is a closed loop feedback process. The concept is simple: the system continuously monitors key output signals in order to make small, rapid adjustments to the parameters that control the beam. The result is consistent dose rate maintained by an intelligent feedback loop that constantly compensates for factors such as mechanical motion due to gantry rotation, along with temperature shifts and component wear. 2012 Accuray Incorporated. All Rights Reserved. Accuray, the stylized logo, CyberKnife, Synchrony, Xsight, Xchange, RoboCouch, TomoTherapy, HiArt, and TomoHD are among the trademarks and/or registered trademarks of Accuray Incorporated
in the United States and other countries. TomoTherapy is a wholly owned subsidiary of Accuray. 500846.B

1240 Deming Way Madison, WI 53717 USA Tel: +1 608 824 2800 Fax: +1 608 824 2996

Shin Otemachi Building 7F 2-2-1 Otemachi, Chiyoda-ku Tokyo 100-0004 Japan Tel: +81.3.6265.1526 Fax: +81.3.3272.6166

Suites 1702 - 1704, Tower 6 The Gateway, Harbour City 9 Canton Road, T.S.T. Hong Kong Tel: +852.2247.8688 Fax: +852.2175.5799

#39 Huatai Road, Longtan Industrial Zone, Section 2 East, 3rd Ring Road, Chengdu, Sichuan 610051 China

Tour Atlantique 25e 1 Place de la Pyramide 92911 Paris La Dfense Cedex France Tel: +33.1.5523.2021 Fax: +33.1.5523.2039

Pegasuslaan 5 1831 Diegem Belgium Tel: +32 (0)2 400 4400 Fax: +32 (0)2 400 4401/02

DCS CONTROL LOOps

Dose Servo Control Monitored: Dose ionization chamber signal Controlled: Magnetron power output
Gun l

Radiation Generating System

Gun Servo
Toroid

UNITED STATES Accuray Corporate Headquarters 1310 Chesapeake Terrace Sunnyvale, CA 94089 USA Tel: +1.408.716.4600 Toll Free: 1.888.522.3740 Fax: +1.408.716.4601 Email: sales@accuray.com TomoTherapy 1240 Deming Way Madison, WI 53717 USA Tel: +1 608 824 2800 Fax: +1 608 824 2996

ASIA

X-RAY

EUROPE

Ion Chamber

X-RAY
Tomotherapy Belgium BVBA
Pegasuslaan 5 1831 Diegem Belgium Tel: +32 (0)2 400 4400 Fax: +32 (0)2 400 4401/02

Accuray Accuray Japan K.K. - Tokyo Inj_IAsia Ltd. - Hong Kong Suites 1702 - 1704, Tower 6 Shin Otemachi Building 7F The Gateway, Harbour City 2-2-1 Otemachi, Chiyoda-ku Gun Servo Control 9 Canton Road, T.S.T. Tokyo 100-0004 Monitored: Gun current Hong Kong Japan Controlled: Injector current setting Tel: +852.2247.8688 Tel: +81.3.6265.1526 Fax: +852.2175.5799 Fax: +81.3.3272.6166

Accuray Europe Accuray Chengdu Tour Atlantique 25e #39 Huatai Road, Longtan 1 Place de la Pyramide Industrial Zone, 92911 Paris La Dfense Cedex Section 2 East, 3rd Ring Road, PAC Dose Servo France Chengdu, Sichuan 610051 Dose 1 Tel: +33.1.5523.2021 China Fax: +33.1.5523.2039

2012 Accuray Incorporated. All Rights Reserved. Accuray, the stylized logo, CyberKnife, Synchrony, Xsight, Xchange, RoboCouch, TomoTherapy, HiArt, and TomoHD are among the trademarks and/or registered trademarks of Accuray Incorporated in the United States and other countries. TomoTherapy is a wholly owned subsidiary of Accuray. 500857.A