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Abstract
Noncoplanar radiation therapy techniques such as 4π have potential dosimetric advantages
but introduce complexities in treatment delivery that increase the risk for collision.
Direct or remote visual confirmation of clearance is a safeguard against collisions
of the gantry, couch, and patient. With our institution's Varian TrueBeam system,
we identified configurations that cannot be visualized with the included closed-circuit
television cameras. At our practice, electronic, portal imaging device (EPID) collision
risk also exists because of the routine deployment to capture exit-dose images for
treatment quality assurance. We propose a simple, cost-effective solution using network
cameras to help eliminate blind spots that permits safe, noncoplanar arrangements
with an EPID-acquired exit dose.