Mobius3D is the first and only 3D dose verification and IMRT/VMAT and treatment delivery QA system. Mobius3D verifies every patient, every plan, and every fraction in 3D to provide six layers of error protection.
THE FIRST 3D PATIENT QA SYSTEM IN THE WORLD
Built from the ground up to segregate errors, Mobius3D is the only system that truly separates machine QA from patient QA—then further subdivides patient QA into planning, data transfer and machine performance errors.
UNSURPASSED ACCURACY MEANS SAFER TREATMENTS FOR YOUR PATIENTS
At the heart of Mobius3D is a proprietary collapsed-cone, convolution-superposition dose calculation engine that has proven more accurate than most commercial treatment planning systems. With a completely automated workflow and intuitive web application, Mobius3D has emerged as the most advanced patient safety system available in radiation therapy.
UNLEASH THE POTENTIAL OF YOUR CBCT IMAGES
Mobius3D is the first system to offer automatic quantitative comparisons between pre-treatment CBCTs and patient planning CTs. With on-line review, gross patient positioning errors are easily diagnosed and corrected. With off-line review, an objective metric is provided for evaluating patient anatomy changes and definitively determining when to replan.
3D PLAN QA: A TRUE SECOND CHECK A simple TPS export triggers automatic 3D dose verification of your plan in the patient CT using independently verified beam models and a proprietary collapsed-cone algorithm.DELIVERABILITY ANALYSIS: CONFIRM BEFORE YOUR PATIENT ARRIVES Mobius3D performs a virtual delivery of the plan and verifies that no gantry collision or violation of your machine’s delivery parameters is predicted.VERIFY EVERY FRACTION AUTOMATICALLY: QA FOR THE ENTIRE TREATMENT Mobius3D will verify plan delivery with each new treatment fraction. Any problems trigger an automatic email alert with a 3D report of that fraction sent to your inbox.ONLINE QUANTITATIVE POSITIONING QA: VERIFY REGISTRATION Mobius3D automatically retrieves every patient CBCT and runs a quantitative comparison to the corresponding planning CT. Within 60 seconds, you have a “go” or “no-go” indication to treat and easy visualization tools, including a3D slice viewer.
DVH LIMIT CHECKS: MEET YOUR OBJECTIVES EVERY TIME Each plan and delivery check in Mobius3D verifies against your clinic’s DVH limit protocols to ensure all objectives are met for every plan. You can easily change, add, or delete Mobius3D’s pre-loaded TG-101 and RTOG limits to customize for your own clinic’s needs.EFFICIENT AND ACCURATE IMRT/VMAT QA: NEVER REMEASURE AGAIN Using the highest resolution measurements available through delivery log files, Mobius3D eliminates phantom setup to more accurately determine the delivered fluence and 3D dose to the patient. Simply deliver the plan and Mobius3D will automatically verify the delivery. Root mean square (RMS) error analysis of each moving machine component allows for in-depth analysis of the delivery.END-TO-END DATA TRANSFER CHECKS: STAY OUT OF THE NEW YORK TIMES For every fraction delivered, Mobius3D compares the actual delivery information found in the log files against the expected plan generated in your TPS. The software immediately alert you if any segment is outside of tolerance and displays in 3D what the difference means for your patient.
MEASUREMENTS IN LOG FILES
- Delivered MU
- Fractional MU
- MLC Positions
- Jaw Positions
- Couch Angles
- Beam Energy
- Collimator Angles
- Gantry Angles
- Wedge Insertion
HOW IT WORKS
Once you export the Plan, Structures, Dose and CT DICOM files from your TPS to Mobius3D, the software does the rest. In minutes, an email alerts you if any issues were found in each of the four verified areas: Target coverage dose, DVH limits, 3D Gamma, and Deliverability. In-depth analysis is available on your computer, tablet or smartphone through the intuitive web application.
IMRT/VMAT QA: Mode up the patient’s plan and deliver the beams to an empty vault—without setting up a measurement device/phantom or deploying an imaging system. Mobius3D automatically captures log files from the treatment machine containing the delivery’s measured data. Using this data, the software then calculates the 3D dose received by the patient positioned in that beam and sends an email alert if any issues occurred during the delivery. The Mobius3D web application (accessed via any browser) includes comprehensive information on exact component breakdown when the delivery fails.
Treatment QA: Each time a patient is treated, Mobius3D automatically acquires log files from the treatment machine and analyzes the target doses, DVH limits, 3D Gamma, RMS errors and data transfer. It automatically sends email alerts if any delivery errors occur throughout treatment. The web application then reveals in full 3D the impact of any delivery errors with a Treatment Summary.
The patient is set up on the treatment couch, a cone-beam CT is acquired, and shifts are determined and applied. The CBCT dataset is automatically acquired by Mobius3D, and within 60 seconds, Mobius3D performs a quantitative gamma evaluation of the registered CBCT to the original planning CT.
The Mobius3D Treatment Dashboard automatically updates with a quantitative percent passing value, allowing clinicians to quickly assess whether it is safe to proceed. A graphical display and an interactive 3D slice viewer can be loaded in seconds for in-depth analysis. Mobius3D can even suggest additional shifts and quantify their provided improvement.
DoseLab: the complete TG-142 solution, is now integrated into Mobius3D to bridge the gap between machine QA and patient QA. View and trend all machine QA results in the Mobius3D interface with the DoseLab Database Viewer.
Run DoseLab’s AutoQA module via Mobius3D by establishing an export of machine QA images to Mobius3D’s built-in DICOM receiver. Machine QA images are automatically processed and saved to the database- zero clicks required. To find out more about AutoQA in DoseLab, visit the DoseLab product page.
The MVP phantom works seamlessly with Mobius3D for easy commissioning, spot checks, investigation into failing plans – or as a simple secondary IMRT QA device. The MVP phantom is fully integrated into Mobius3D, so there is no need to create a separate QA plan or even CT the phantom. The MVP phantom is made of water equivalent material and features seven chamber positions and a film plane for in-depth analysis of dose deliveries.
- Validation of a secondary TPS for IROC-H, Kerns, et al. (Mobius3D) AAPM 2015
- Does classical 2nd monitor unit calculation still have a future, Dejean, et al. (Mobius3D) ESTRO 2015
- 3D dose verification of VMAT lung SBRT using Mobius3D, Van het loo, et al. (Mobius3D) ESTRO 2015
- Independent Verification of VMAT Treatment Plans Using a DICOM-RT Framework, Reynolds, et al. (Mobius3D) AAPM 2013
- Dosimetric impact of implementing kernel hardening and material-specific kernels in the convolution/ superposition method, Huang, et al. (Mobius3D)
- Evaluation of Mobius Dose Calculation Engine Using Out of the Box Preconfigured Beam Data, Cardan, et al. (Mobius3D)
- C. L. Nelson, B. E. Mason, R. C. Robinson, K. D. Kisling and S. M. Kirsner, “Commissioning results of an automated treatment planning verification system,” Journal of Applied Clinical Medical Physics, vol. 15, no. 5, pp. 57 – 65, 2014.
- Centers for Medicare & Medicaid Services, “CMS.gov,” 1 January 2010. Available Online.
- American College of Radiology (ACR), “ACR –ASTRO Practice Guideline For Intensity Modulated Radiation Therapy (IMRT),” American College of Radiology (ACR), Reston, 2011.
- Investigation of various energy deposition kernel refinements for theconvolution/superposition method, Huang, et al. Medical Physics (Mobius3D)
- Evaluation of a novel secondary check tool for intensity-modulated radiotherapy treatment planning, Fontenot, JACMP (Mobius3D)
- Commissioning results of an automated treatment planning verification system, Nelson, et al. JACMP (Mobius3D)
- Dosimetric validation and clinical implementation of two 3D dose verification systems for quality assurance in volumetric-modulated arc therapy techniques, Clemente-Gutiérrez, et al. JACMP (Mobius3D)
FREQUENTLY ASKED QUESTIONS
HOW ACCURATE IS THE MOBIUS3D DOSE CALCULATION ALGORITHM?
The accuracy of the Mobius3D CCCS algorithm has merited several published papers and multiple posters presented at scientific meetings. Nelson, et al., reported that in homogeneous phantom geometry, the greatest difference observed between the Mobius3D calculated and the measured doses was 0.58% for the 3 x 3 cm jaw defined fields; all other measurements were under 0.35% differences. In delivering IMRT and VMAT plans to a homogeneous phantom, Mobius3D’s calculated doses were found to be more accurate than the fully commissioned TPS when compared to measured data. Additional resources are available from your Mobius Medical Systems representative.
WHAT TYPE OF PLANNING ERRORS CAN MOBIUS3D DETECT?
Dose grid placement, dose grid size, failed DVH objectives, structure contouring, undeliverable beams, and gantry collisions.
IS LOG FILE-BASED IMRT QA COMPLIANT WITH BILLING AND REGULATORY CODES?
Yes. The Centers for Medicare & Medicaid Services (CMS) state that in order to receive payment for the IMRT Treatment Planning billing code (CPT 77301), the “computer plan distribution must be verified for positional accuracy based on dosimetry verification of the intensity map.” Mobius3D obtains the intensity map via machine log file measurements and converts to dose using a full 3D dose calculation algorithm.
The American College of Radiology (ACR) states that “the accuracy of dose delivery should be documented by irradiating a phantom containing a calibrated dosimetry system to verify that the dose delivered is the dose planned” and that “acceptable alternative tests provide equivalent or even more detailed verification. It is the responsibility of the medical physicist to assure the equivalence or superiority of an alternative testing procedure.”
Mobius Medical Systems has published the Mobius3D Accreditation and Billing Justification, which provides the information necessary to assure log file-based QA’s compliance with the CPT 77301 billing requirements. Contact your local Mobius Medical Systems representative to receive a copy.
WHAT TYPE OF TPS ERRORS CAN MOBIUS3D DETECT?
Dose calculation errors, commissioning measurement errors, beam modeling errors, IMRT optimization errors (i.e., segments delivered outside of target), undeliverable beams, and DVH calculation errors.
WILL YOU ADD EPID ANALYSIS TO MOBIUS3D?
No. EPID panels were not designed to capture radiation from every treatment fraction. Receiving 25 to 100 times more radiation reduces their lifetime. Patient-specific QA with EPID panels is also impossible in many circumstances due to field size, collimator rotation, or clearance issues. Log file analysis eliminates all these problems and has demonstrated superiority for patient-specific QA.