Implementation and Application of the IORT INTRABEAM 600 System – Commissioning Measurements and Independent Treatment Verification
Abstract
Introduction
Intraoperative radiotherapy (IORT) delivers a single high-dose radiation fraction directly to the tumor or tumor bed during surgery, minimizing exposure to healthy tissue. The INTRABEAM 600 system, with its compact design and low-energy X-rays, requires thorough commissioning and quality assurance. This study performs dosimetric measurements, establishes an independent verification method, and compares Calibration v4.0 and TARGIT approaches to ensure accurate, safe, and reliable IORT delivery, supporting improved clinical outcomes.
Materials and Methods
The INTRABEAM 600 system delivers low-energy X-rays via a XRS generator for precise intraoperative radiotherapy. Commissioning involved depth dose rate measurements in a water phantom using ionization chambers, with probe tip positioned along X, Y, and Z axes. Dose rates were determined using Calibration v4.0 and TARGIT methods, correlated via a conversion function. QA checks included PAICH output, IRM baseline, and isotropy verification, ensuring accurate, reproducible treatment delivery.
Results
Dynamic offset analysis showed minimal deviations, confirming accurate beam targeting. The Output Check confirmed stable system performance. Depth dose rate curve measurements revealed a mean difference of -1.3 ± 1% from certification data. Treatment time calculations using spherical applicators showed minor differences between INTRABEAM600 and radiance, with the largest at -1.9 ± 1.1% for the 20 mm applicator. TARGIT results were similar, with the largest differences at -1.8 ± 0.6% for the 15 mm and 20 mm applicators.
Conclusion
Comprehensive commissioning and QA confirmed that the INTRABEAM 600 system is stable, precise, and clinically reliable. Dynamic offsets showed minimal deviations, verifying correct beam alignment, while Output Check tests confirmed XRS generator stability. Depth dose rate measurements agreed closely with certification data −1.3 ± 1.0%. Treatment time comparisons using Calibration v4.0 and TARGIT showed minor discrepancies, largest for small applicators (15–20 mm). Independent verification and radiance simulations support accurate dose delivery.
© 2026 Michal Poltorak, Klaudia Benisz, Katarzyna Ziemba, Irena Walecka, Artur Zaczynski, published by Polish Society of Medical Physics
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.