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Electronic Portal Imaging Device in Pre-Treatment Patient-Specific Quality Assurance of volumetric-modulated arc therapy delivery. JOURNAL OF RADIOTHERAPY IN PRACTICE 2023. [DOI: 10.1017/s1460396922000334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Abstract
Background:
Radiotherapy treatment delivery is evaluated by a pre-treatment patient-specific quality assurance (PSQA) procedure to ensure the patient receives an accurate radiation dose. The current PSQA practice by using conventional phantoms requires more set-up time and cost of purchasing the tools. Therefore, this study aimed to investigate the efficiency of an electronic portal imaging device (EPID) of linear accelerator (LINAC) as a PSQA tool for volumetric-modulated arc therapy (VMAT) planning technique for nasopharyngeal carcinoma (NPC) treatment delivery.
Methods:
A NPC VMAT plan on a Rando phantom was performed by following the Radiation Therapy Oncology Group (RTOG) 0615 protocol. The gamma passing rate of the EPID and PSQA phantom (ArcCHECK) were compared among the gamma criteria of 3%/3 mm, 2%/2 mm and 1%/1 mm, respectively.
Results:
Both EPID and ArcCHECK phantom had distinguishable gamma passing rates in 3%/3 mm and 2%/2 mm with a difference of 0·87% and 0·30%, respectively. Meanwhile, the EPID system had a lower gamma passing rate than the ArcCHECK phantom in 1%/1 mm (21·23% difference). Furthermore, the sensitivity of the EPID system was evaluated and had the largest deviation in gamma passing rate from the reference position in gamma criteria of 2%/2 mm (41·14%) compared to the 3%/3 mm (25·45%) and 1%/1 mm (31·78%), discretely. The best fit line of the linear regression model for EPID was steeper than the ArcCHECK phantom in 3%/3 mm and 2%/2 mm, and vice versa in gamma criteria of 1%/1 mm. This indicates that the EPID had a higher sensitivity than the ArcCHECK phantom in 3%/3 mm and 2%/2 mm but less sensitivity in 1%/1 mm.
Conclusions:
The EPID system was efficient in performing the PSQA test of VMAT treatment in HUSM with the gamma criteria of 3%/3 mm and 2%/2 mm.
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Sadowski B, Milewska K, Ginter J. Machine Learning Based Prediction of Gamma Passing Rate for VMAT Radiotherapy Plans. J Pers Med 2022; 12:jpm12122071. [PMID: 36556291 PMCID: PMC9781864 DOI: 10.3390/jpm12122071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The use of machine learning algorithms (ML) in radiotherapy is becoming increasingly popular. More and more groups are trying to apply ML in predicting the so-called gamma passing rate (GPR). Our team has developed a customized approach of using ML algorithms to predict global GPR for electronic portal imaging device (EPID) verification for dose different 2% and distance to agreement 2 mm criteria for VMAT dynamic plans. Plans will pass if the GPR is greater than 98%. The algorithm was learned and tested on anonymized clinical data from 13 months which resulted in more than 3000 treatment plans. The obtained results of GPR prediction are very interesting. Average specificity of the algorithm based on an ensemble of 50 decision tree regressors is 91.6% for our criteria. As a result, we can reduce the verification process by 50%. The novel approach described by our team can offer a new insight into the application of ML and neural networks in GPR prediction and dosimetry.
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Affiliation(s)
- Bartłomiej Sadowski
- Medical Physics Department, The Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Karolina Milewska
- Biomedical Physics Division, Institute of Experimental Physics, Faculty of Physics, University of Warsaw, 02-093 Warsaw, Poland
| | - Józef Ginter
- Biomedical Physics Division, Institute of Experimental Physics, Faculty of Physics, University of Warsaw, 02-093 Warsaw, Poland
- Correspondence:
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Katayama H, Takahashi Y, Kobata T, Kawasaki H, Kitaoka M, Oishi A, Shibata T. Evaluating the effect of high-density measurement mode on patient-specific quality assurance for head and neck cancer with ArcCHECK. Phys Eng Sci Med 2022; 45:1153-1161. [PMID: 36318385 DOI: 10.1007/s13246-022-01180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 09/14/2022] [Indexed: 11/07/2022]
Abstract
The high-density measurement (HDm) mode of the ArcCHECK device can achieve a twofold resolution enhancement compared to the standard measurement (Sm) mode. The aim of this study was to evaluate the effect of HDm on the gamma passing rate (GPR) for the patient-specific quality assurance (PSQA) in head and neck cancer. We retrospectively evaluated 30 patients who underwent volumetric modulated arc therapy (VMAT) for head and neck cancer. Absolute gamma analysis was performed on Sm and HDm data. We also investigated correlations between the modulation complexity score for VMAT (MCSv) and differences in the GPR between the two measurement modes. The global GPR of Sm and HDm was 81.0% ± 8.4% and 82.6% ± 7.6% for the 2%/2 mm criterion, 94.0% ± 4.1% and 94.9% ± 3.6% for the 3%/2 mm criterion, and 96.6% ± 2.4% and 97.0% ± 2.4% for the 3%/3 mm criterion, respectively. HDm slightly improved GPR (p < 0.01) for the 2%/2 mm criterion. Differences in GPR between Sm and HDm for the 2%/2 mm, 3%/2 mm, and 3%/3 mm criteria were 1.6% ± 3.0%, 0.8% ± 2.0%, and 0.4% ± 1.2%, respectively. No correlation was identified between the MCSv and the difference in GPR between Sm and HDm. Despite an improvement in GPR with HDm, the difference in GPR between Sm and HDm was approximately 2% even when the tighter criteria were used. Moreover, the change in the GPR between Sm and HDm did not depend on plan complexity. Thus, the effect of HDm on GPR is limited for the PSQA in VMAT for head and neck cancer.
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Affiliation(s)
- Hiroki Katayama
- Department of Clinical Radiology, Kagawa University Hospital, 1750-1 Ikenobe, Miki- cho, Kita-gun, 761-0793, Kagawa, Japan.
| | - Yosuke Takahashi
- Department of Clinical Radiology, Kagawa University Hospital, 1750-1 Ikenobe, Miki- cho, Kita-gun, 761-0793, Kagawa, Japan
| | - Takuya Kobata
- Department of Clinical Radiology, Kagawa University Hospital, 1750-1 Ikenobe, Miki- cho, Kita-gun, 761-0793, Kagawa, Japan
| | - Hiroki Kawasaki
- Department of Clinical Radiology, Kagawa University Hospital, 1750-1 Ikenobe, Miki- cho, Kita-gun, 761-0793, Kagawa, Japan
| | - Motonori Kitaoka
- Department of Clinical Radiology, Kagawa University Hospital, 1750-1 Ikenobe, Miki- cho, Kita-gun, 761-0793, Kagawa, Japan
| | - Akihiro Oishi
- Department of Clinical Radiology, Kagawa University Hospital, 1750-1 Ikenobe, Miki- cho, Kita-gun, 761-0793, Kagawa, Japan
| | - Toru Shibata
- Department of Radiation Oncology, Kagawa University Hospital, Kagawa, Japan
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Frigo SP, Ohrt J, Suh Y, Balter P. Interinstitutional beam model portability study in a mixed vendor environment. J Appl Clin Med Phys 2021; 22:37-50. [PMID: 34643323 PMCID: PMC8664150 DOI: 10.1002/acm2.13445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/19/2021] [Accepted: 09/14/2021] [Indexed: 11/17/2022] Open
Abstract
A 6 MV flattened beam model for a Varian TrueBeamSTx c‐arm treatment delivery system in RayStation, developed and validated at one institution, was implemented and validated at another institution. The only parameter value adjustments were to accommodate machine output at the second institution. Validation followed MPPG 5.a. recommendations, with particular attention paid to IMRT and VMAT deliveries. With this minimal adjustment, the model passed validation across a broad spectrum of treatment plans, measurement devices, and staff who created the test plans and executed the measurements. This work demonstrates the possibility of using a single template model in the same treatment planning system with matched machines in a mixed vendor environment.
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Affiliation(s)
- Sean P Frigo
- Department of Human Oncology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jared Ohrt
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yelin Suh
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Peter Balter
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Hadsell CS, Lenards N, Hunzeker A, Tallhamer MJ, Hadsell MJ. The effect of measurement geometry on patient specific QA pass/fail rates for stereotactic body radiation therapy (SBRT) Plans. Med Dosim 2021; 46:389-397. [PMID: 34176732 DOI: 10.1016/j.meddos.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/30/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Abstract
Patient quality assurance (QA) is a required part of the treatment care path, and plan failure can lead to increased personnel hours or delay of treatment. The recommendation by the American Association of Physicists in Medicine is that gamma analysis be used to evaluate measured volumetric modulated arc therapy plans. Vendors have developed many different measurement geometries for patient QA devices which could yield varying pass rates when used with the recommended tolerances, normalization, and criterion. For this study, clinically treated stereotactic body radiation therapy plans were used to evaluate differences in gamma dose tolerances and sampled dose distribution complexity for centralized or peripheral measurement geometries on a cylindrical phantom. Random errors were then introduced into a subset of these plans, and the differences in pass rates between the geometries were correlated with differences in the observed mathematical differences. Finally, a single clinically relevant target coverage deviation was introduced to another subset of plans to evaluate whether a particular geometry is measurably better at identifying clinically relevant errors. It was found that centralized geometries resulted in more lenient dose tolerances and less complex sampled dose distributions compared to peripheral geometries. Pass rates were uniformly lower in the peripheral measurement geometry, and the difference in pass rates between the geometries correlated strongly with the difference in dose tolerance and weakly with the difference in the chosen complexity metrics. However, neither of the geometries were sufficiently sensitive enough to detect clinically relevant changes to target coverage when using recommended tolerances and criteria, and no statistically significant difference was found between their pass rates. Given these findings, the authors concluded that stereotactic body radiation therapy plans could fail patient QA when measured in the peripheral geometry but pass in the centralized geometry, with possibly neither having correlation to true clinical deviation.
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Affiliation(s)
- Courtney S Hadsell
- Medical Dosimetry Program at the University of Wisconsin, La Crosse, WI, USA.
| | - Nishele Lenards
- Medical Dosimetry Program at the University of Wisconsin, La Crosse, WI, USA
| | - Ashley Hunzeker
- Medical Dosimetry Program at the University of Wisconsin, La Crosse, WI, USA
| | | | - Michael J Hadsell
- Departments of Radiation Oncology, Centura Health, Centennial, CO, USA
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Chang KH, Lee YH, Park BH, Han MC, Kim J, Kim H, Cho MS, Kang H, Lee H, Kim DW, Park K, Cho J, Kim YB, Kim JS, Hong CS. Statistical Analysis of Treatment Planning Parameters for Prediction of Delivery Quality Assurance Failure for Helical Tomotherapy. Technol Cancer Res Treat 2020; 19:1533033820979692. [PMID: 33302821 PMCID: PMC7734483 DOI: 10.1177/1533033820979692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: This study aimed to investigate the parameters with a significant impact on delivery quality assurance (DQA) failure and analyze the planning parameters as possible predictors of DQA failure for helical tomotherapy. Methods: In total, 212 patients who passed or failed DQA measurements were retrospectively included in this study. Brain (n = 43), head and neck (n = 37), spinal (n = 12), prostate (n = 36), rectal (n = 36), pelvis (n = 13), cranial spinal irradiation and a treatment field including lymph nodes (n = 24), and other types of cancer (n = 11) were selected. The correlation between DQA results and treatment planning parameters were analyzed using logistic regression analysis. Receiver operating characteristic (ROC) curves, areas under the curves (AUCs), and the Classification and Regression Tree (CART) algorithm were used to analyze treatment planning parameters as possible predictors for DQA failure. Results: The AUC for leaf open time (LOT) was 0.70, and its cut-off point was approximately 30%. The ROC curve for the predicted probability calculated when the multivariate variable model was applied showed an AUC of 0.815. We confirmed that total monitor units, total dose, and LOT were significant predictors for DQA failure using the CART. Conclusions: The probability of DQA failure was higher when the percentage of LOT below 100 ms was higher than 30%. The percentage of LOT below 100 ms should be considered in the treatment planning process. The findings from this study may assist in the prediction of DQA failure in the future.
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Affiliation(s)
- Kyung Hwan Chang
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Hyun Lee
- Eretec Inc. 401, Simin-daero, Dongan-gu, Anyang-si, Gyeonggi-do, South Korea
| | - Byung Hun Park
- Eretec Inc. 401, Simin-daero, Dongan-gu, Anyang-si, Gyeonggi-do, South Korea
| | - Min Cheol Han
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Jihun Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Hojin Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Min-Seok Cho
- Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Hyokyeong Kang
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Ho Lee
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong Wook Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Kwangwoo Park
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Jaeho Cho
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Bae Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Sung Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Chae-Seon Hong
- Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
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Jiménez-Melguizo M, Espinosa M, Montes J, Guirado D, Lallena AM. Response of the ArcCHECK® device at 6 MV and 15 MV for VMAT and IMRT quality control. Phys Med 2020; 80:373-382. [PMID: 33310373 DOI: 10.1016/j.ejmp.2020.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/10/2020] [Accepted: 11/14/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To study the response of the ArcCHECK® device as VMAT and IMRT verification system. METHODS Various tests analyzing the linearity, the repeatability and the angular dependence of the device response, its dependence with the pulse repetition rate and the leakage losses were performed. The long-term response in dose measurements and the uniformity of the detectors conforming the system were controlled using a statistical process control program. The Elekta Infinity™ 6 and 15MV photon beams were used. RESULTS The device showed excellent repeatability and linearity. The differences between the responses obtained for any pair of angular incidences were less than 2%. The absorbed dose increased by 3% when the pulse repetition rate varied from 50 to 600MU/min. Results are in overall agreement with those found in previous works for the ArcCHECK®, in which a reduced number of the device diodes were analyzed, and for the MapCheck®, an older 2D device that used the same diodes. Charge losses were found to be negligible except for some of the diodes of the device. The statistical process control program is a very useful tool to control the correct functioning of the device in the long term. CONCLUSIONS The results of the analysis carried out indicate that the working and stability conditions of the ArcCHECK® device are adequate for its purpose. The dependence with the pulse repetition rate should be considered when VMAT or similar treatments are evaluated. A control program for the statistical monitoring of the device would be desirable and useful.
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Affiliation(s)
- Miguel Jiménez-Melguizo
- Servicio de Radiofísica y Protección Radiológica, Hospital Universitario "Virgen de las Nieves", E-18014 Granada, Spain; Unidad de Radiofísica, Hospital Universitario Clínico "San Cecilio", E-18016 Granada, Spain
| | - Miguel Espinosa
- Unidad de Radiofísica, Hospital Universitario Clínico "San Cecilio", E-18016 Granada, Spain
| | - Joaquín Montes
- Unidad de Radiofísica, Hospital Universitario Clínico "San Cecilio", E-18016 Granada, Spain
| | - Damián Guirado
- Unidad de Radiofísica, Hospital Universitario Clínico "San Cecilio", E-18016 Granada, Spain; Instituto de Investigación Biosanitaria (ibs.GRANADA), Complejo Hospitalario Universitario de Granada/Universidad de Granada, E-18016 Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Granada, Spain
| | - Antonio M Lallena
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Complejo Hospitalario Universitario de Granada/Universidad de Granada, E-18016 Granada, Spain; Departamento de Física Atómica, Molecular y Nuclear, Universidad de Granada, E-18071 Granada, Spain
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Simplification of head and neck volumetric modulated arc therapy patient-specific quality assurance, using a Delta4 PT. Rep Pract Oncol Radiother 2020; 25:793-800. [PMID: 32879621 DOI: 10.1016/j.rpor.2020.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 06/19/2020] [Accepted: 07/27/2020] [Indexed: 11/23/2022] Open
Abstract
Background/Aim In many facilities, intensity-modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT) use intensity-modulated beams, formed by a multi-leaf collimator (MLC). In IMRT and VMAT, MLC and linear accelerator errors (both geometric and dose), can significantly affect the doses administered to patients. Therefore, IMRT and VMAT treatment plans must include the use of patient-specific quality assurance (QA) before treatment to confirm dose accuracy. Materials and methods In this study, we compared and analyzed the results of dose verification using a multi-dimensional dose verification system Delta4 PT, an ionization chamber dosimeter, and gafchromic film, using data from 52 patients undergoing head and neck VMAT as the test material. Result Based on the results of the absolute dose verification for the ionization chamber dosimeter and Delta4 PT, taking an axial view, the upper limit of the 95% confidence interval was 3.13%, and the lower limit was -3.67%, indicating good agreement. These results mean that as long as absolute dose verification for the axial view does not deviate from this range, Delta4 PT can be used as an alternative to an ionization chamber dosimeter for absolute dose verification. When we then reviewed dose distribution verification, the pass rate for Delta4 PT was acceptable, and was less varied than that of gafchromic film. Conclusion This results in that provided the pass rate result for Delta4 PT does not fall below 96%, it can be used as a substitute for gafchromic film in dose distribution verification. These results indicate that patient-specific QA could be simplified.
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Suitability of a set compost of 2D and a 3D array detectors for the commissioning of dynamic wedge filters. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2019.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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10
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Kumar L, Yadav G, Kishore V, Bhushan M, Gairola M, Tripathi D. Validation of the RapidArc Delivery System Using a Volumetric Phantom as Per Task Group Report 119 of the American Association of Physicists in Medicine. J Med Phys 2019; 44:126-134. [PMID: 31359931 PMCID: PMC6580814 DOI: 10.4103/jmp.jmp_118_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim This study validated the RapidArc (RA) delivery using a volumetric ArcCHECK phantom as per the guidelines proposed in Task Group Report 119 from the American Association of Physicists in Medicine Task group 119 (AAPM TG 119). This study also investigated the impact of the Acuros XB (AXB) algorithm in comparison to analytical anisotropic algorithm (AAA) on the RA dose calculations in the homogeneous medium of the ArcCHECK phantom. Materials and Methods A volumetric ArcCHECK phantom along with AAPM TG 119 tests was used to evaluate the RA plans and verify the dose delivery for photon beam of 6 MV energy. Results The RA planning results were comparable and satisfied the planning criteria stated in the TG 119 report for all test cases. The average percentage gamma passing rates for the AAA-calculated plans were 98.5 (standard deviation [SD]: 0.6), 98.5 (SD: 1.3), and 98.1 (SD: 2.0) and for the AXB-calculated plans were 95.1 (SD: 1.8), 96.1 (SD: 1.3), and 94.0 (SD: 0.9) for the Clinac-iX (6 MV) and TrueBeam (TB)-STx (6 MV_filtered beam [FB] and 6 MV_flattening filter-free beam [FFFB]), respectively. For ion chamber measurements, the average percentage dose differences for the AAA-calculated plans were 1.5 (SD: 2.5), 2.7 (SD: 1.4), and 1.4(SD: 2.7) and for AXB-calculated plans were 2.3 (SD: 1.6), 3.2 (SD: 1.5), and 2.3 (SD: 2.0) for Clinac-iX (6 MV) and TB-STx (6 MV_FB and 6 MV_FFFB), respectively. Conclusion Thus, the ArcCHECK can successfully be utilized for the validation of the RA delivery. The AXB has potential to perform dose calculations comparable to those of the AAA for RA plans in the homogeneous medium of the ArcCHECK phantom.
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Affiliation(s)
- Lalit Kumar
- Department of Radiation Oncology, Division of Medical Physics, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.,Department of Applied Science and Humanities, Dr. A.P.J Abdul Kalam Technical University, Lucknow, Uttar Pradesh, India
| | - Girigesh Yadav
- Department of Radiation Oncology, Division of Medical Physics, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Vimal Kishore
- Department of Applied Science and Humanities, Bundelkhand Institute of Engineering and Technology, Jhansi, Uttar Pradesh, India
| | - Manindra Bhushan
- Department of Radiation Oncology, Division of Medical Physics, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.,Department of Applied Science, Amity School of Applied Sciences, Amity University, Noida, Uttar Pradesh, India
| | - Munish Gairola
- Department of Radiation Oncology, Division of Medical Physics, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Deepak Tripathi
- Department of Applied Science, Amity School of Applied Sciences, Amity University, Noida, Uttar Pradesh, India
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Murtaza G, Mehmood S, Rasul S, Murtaza I, Khan EU. Dosimetric effect of limited aperture multileaf collimator on VMAT plan quality: A study of prostate and head-and-neck cancers. Rep Pract Oncol Radiother 2018; 23:189-198. [PMID: 29760593 DOI: 10.1016/j.rpor.2018.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/29/2017] [Accepted: 02/16/2018] [Indexed: 12/25/2022] Open
Abstract
AIM The aim of study was to evaluate the dosimetric effect of collimator-rotation on VMAT plan quality, when using limited aperture multileaf collimator of Elekta Beam Modulator™ providing a maximum aperture of 21 cm × 16 cm. BACKGROUND The increased use of VMAT technique to deliver IMRT from conventional to very specialized treatments present a challenge in plan optimization. In this study VMAT plans were optimized for prostate and head and neck cancers using Elekta Beam-ModulatorTM, whereas previous studies were reported for conventional Linac aperture. MATERIALS AND METHODS VMAT plans for nine of each prostate and head-and-neck cancer patients were produced using the 6 MV photon beam for Elekta-SynergyS® Linac using Pinnacle3 treatment planning system. Single arc, dual arc and two combined independent-single arcs were optimized for collimator angles (C) 0°, 90° and 0°-90° (0°-90°; i.e. the first-arc was assigned C0° and second-arc was assigned C90°). A treatment plan comparison was performed among C0°, C90° and C(0°-90°) for single-arc dual-arc and two independent-single-arcs VMAT techniques to evaluate the influence of extreme collimator rotations (C0° and 90°) on VMAT plan quality. Plan evaluation criteria included the target coverage, conformity index, homogeneity index and doses to organs at risk. A 'two-sided student t-test' (p ≤ 0.05) was used to determine if there was a significant difference in dose volume indices of plans. RESULTS For both prostate and head-and-neck, plan quality at collimator angles C0° and C(0°-90°) was clinically acceptable for all VMAT-techniques, except SA for head-and-neck. Poorer target coverage, higher normal tissue doses and significant p-values were observed for collimator angle 90° when compared with C0° and C(0°-90°). CONCLUSIONS A collimator rotation of 0° provided significantly better target coverage and sparing of organs-at-risk than a collimator rotation of 90° for all VMAT techniques.
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Affiliation(s)
- Ghulam Murtaza
- School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Shahid Mehmood
- Medical Physics, Combined Military Hospital, Rawalpindi, Pakistan
| | - Shahid Rasul
- Oncology Department, Combined Military Hospital, Rawalpindi, Pakistan
| | - Imran Murtaza
- Physics Department, International Islamic University, Islamabad, Pakistan
| | - Ehsan Ullah Khan
- Physics Department, International Islamic University, Islamabad, Pakistan
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Sun WZ, Zhang DD, Peng YL, Chen L, Kang DH, Wang B, Deng XW. Retrospective dosimetry study of intensity-modulated radiation therapy for nasopharyngeal carcinoma: measurement-guided dose reconstruction and analysis. Radiat Oncol 2018; 13:42. [PMID: 29544512 PMCID: PMC5856312 DOI: 10.1186/s13014-018-0993-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Conventional phantom-based planar dosimetry (2D-PBD) quality assurance (QA) using gamma pass rate (GP (%)) is inadequate to reflect clinically relevant dose error in intensity-modulated radiation therapy (IMRT), owing to a lack of information regarding patient anatomy and volumetric dose distribution. This study aimed to evaluate the dose distribution accuracy of IMRT delivery for nasopharyngeal carcinoma (NPC), which passed the 2D-PBD verification, using a measurement-guided 3D dose reconstruction (3D-MGR) method. METHODS Radiation treatment plans of 30 NPC cases and their pre-treatment 2D-PBD data were analyzed. 3D dose distribution was reconstructed on patient computed tomography (CT) images using the 3DVH software and compared to the treatment plans. Global and organ-specific dose GP (%), and dose-volume histogram (DVH) deviation of each structure was evaluated. Interdependency between GP (%) and the deviation of the volumetric dose was studied through correlation analysis. RESULTS The 3D-MGR achieved global GP (%) similar to conventional 2D-PBD in the same criteria. However, structure-specific GP (%) significantly decreased under stricter criteria, including the planning target volume (PTV). The average deviation of all inspected dose volumes (DV) and volumetric dose (VD) parameters ranged from - 2.93% to 1.17%, with the largest negative deviation in V100% of the PTVnx of - 15.66% and positive deviation in D1cc of the spinal cord of 6.66%. There was no significant correlation between global GP (%) of 2D-PBD or 3D-MGR and the deviation of the most volumetric dosimetry parameters (DV or VD), when the Pearson's coefficient value of 0.8 was used for correlation evaluation. CONCLUSION Even upon passing the pre-treatment phantom based dosimetric QA, there could still be risk of dose error like under-dose in PTVnx and overdose in critical structures. Measurement-guided 3D volumetric dosimetry QA is recommended as the more clinically efficient verification for the complicated NPC IMRT.
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Affiliation(s)
| | | | - Ying-Lin Peng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Li Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - De-Hua Kang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Bin Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Xiao-Wu Deng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
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Young MR, Craft DL, Colbert CM, Remillard K, Vanbenthuysen L, Wang Y. Volumetric-modulated arc therapy using multicriteria optimization for body and extremity sarcoma. J Appl Clin Med Phys 2016; 17:283-291. [PMID: 27929501 PMCID: PMC5690529 DOI: 10.1120/jacmp.v17i6.6547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 08/29/2016] [Accepted: 08/26/2016] [Indexed: 11/23/2022] Open
Abstract
This study evaluates the implementation of volumetric‐modulated arc therapy (VMAT) using multicriteria optimization (MCO) in the RayStation treatment planning system (TPS) for complex sites, namely extremity and body sarcoma. The VMAT‐MCO algorithm implemented in RayStation is newly developed and requires an integrated, comprehensive analysis of plan generation, delivery, and treatment efficiency. Ten patients previously treated by intensity‐modulated radiation therapy (IMRT) with MCO were randomly selected and replanned using VMAT‐MCO. The plan quality was compared using homogeneity index (HI) and conformity index (CI) of the planning target volume (PTV) and dose sparing of organs at risk (OARs). Given the diversity of the tumor location, the 10 plans did not have a common OAR except for skin. The skin D50 and Dmean was directly compared between VMAT‐MCO and IMRT‐MCO. Additional OAR dose points were compared on a plan‐by‐plan basis. The treatment efficiency was compared using plan monitor units (MU) and net beam‐on time. Plan quality assurance was performed using the Sun Nuclear ArcCHECK phantom and a gamma criteria of 3%/3 mm. No statistically significant differences were found between VMAT‐ and IMRT‐MCO for HI and CI of the PTV or D50 and Dmean to the skin. The VMAT‐MCO plans showed general improvements in sparing to OARs. The VMAT‐MCO plan set showed statistically significant improvements over the IMRT‐MCO set in treatment efficiency per plan MU (p<0.05) and net beam‐on time (p<0.01). The VMAT‐MCO plan deliverability was validated. Similar gamma passing rates were observed for the two modalities. This study verifies the suitability of VMAT‐MCO for sarcoma cancer and highlighted the comparability in plan quality and improvement in treatment efficiency offered by VMAT‐MCO as compared to IMRT‐MCO. PACS number(s): separated by commas 87.55.D, 87.55.de, 87.55.Qr
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Affiliation(s)
- Michael R Young
- Massachusetts General Hospital and Harvard Medical School; University of Massachusetts.
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