A robotic C-arm cone beam CT system for image-guided proton therapy: design and performance.

OBJECTIVE: A ceiling-mounted robotic C-arm cone beam CT (CBCT) system was developed for use with a 190° proton gantry system and a 6-degree-of-freedom robotic patient positioner. We report on the mechanical design, system accuracy, image quality, image guidance accuracy, imaging dose, workflow, safety and collision-avoidance. METHODS: The robotic CBCT system couples a rotating C-ring to the C-arm concentrically with a kV X-ray tube and a flat-panel imager mounted to the C-ring. CBCT images are acquired with flex correction and maximally 360° rotation for a 53 cm field of view. The system was designed for clinical use with three imaging locations. Anthropomorphic phantoms were imaged to evaluate the image guidance accuracy. RESULTS: The position accuracy and repeatability of the robotic C-arm was high (<0.5 mm), as measured with a high-accuracy laser tracker. The isocentric accuracy of the C-ring rotation was within 0.7 mm. The coincidence of CBCT imaging and radiation isocentre was better than 1 mm. The average image guidance accuracy was within 1 mm and 1° for the anthropomorphic phantoms tested. Daily volumetric imaging for proton patient positioning was specified for routine clinical practice. CONCLUSION: Our novel gantry-independent robotic CBCT system provides high-accuracy volumetric image guidance for proton therapy. Advances in knowledge: Ceiling-mounted robotic CBCT provides a viable option than CT on-rails for partial gantry and fixed-beam proton systems with the added advantage of acquiring images at the treatment isocentre.

Prevalence of Arcobacter species in retail meats and antimicrobial susceptibility of the isolates in Japan.

A survey was conducted to examine the prevalence of Arcobacter species among meat samples and to investigate the antimicrobial susceptibility of the isolates in Japan. In 1998 and 1999, samples of beef (n=90), pork (n=100) and chicken meat (n=100) were purchased from seven retail shops. Arcobacter species were isolated from 2.2%, 7.0% and 23.0% of beef, pork and chicken meat samples, respectively. The rate of isolations in chicken meats was shown to be significantly higher than those of beef and pork. Species-specific polymerase chain reaction (PCR) demonstrated that the most dominant Arcobacter species was Arcobacter butzleri among the isolates examined. Multiple contaminations with different Arcobacter species were observed in 5% of the chicken samples. Almost all the strains tested showed resistance to vancomycin (100%) and methicillin (97.5%). Strains resistant to cephalothin, sulfamethoxazole-trimethoprim, nalidixic acid and chloramphenicol were detected at the rate of 81.1%, 67.2%, 53.5% and 24.6%, respectively. All Arcobacter strains examined were susceptible to ampicillin, tetracycline, streptomycin and kanamycin.