EPID-based 3D dosimetry for pre-treatment FFF VMAT stereotactic body radiotherapy plan verification using dosimetry CheckTM. (January 2021)

• Record Type: Journal Article
• Authors: Chendi, Agnese; Botti, Andrea; Orlandi, Matteo; Sghedoni, Roberto; Iori, Mauro; Cagni, Elisabetta
• Is Part Of: Physica medica. Volume 81(2021)
• Page Start: 227
• Page End: 236
• Publication Date: 2021-01
• Subjects: Stereotactic radiotherapy -- Unflattened photon beams -- EPID -- Treatment dosimetric quality assurance; Medical physics -- Periodicals; Biophysics -- Periodicals; Biophysics -- Periodicals; Imagerie médicale -- Périodiques; Radiothérapie -- Périodiques; Rayons X -- Sécurité -- Mesures -- Périodiques; Physique -- Périodiques; Médecine -- Périodiques; 610.153
• DOI: 10.1016/j.ejmp.2020.12.014
• Languages: English
• ISSNs: 1120-1797

Abstract

Highlights: DC was configured for FFF VMAT using an appropriate correction procedure. Good agreement between DC and TPS in pre-treatment modality. Difference between DC and Octavius in high dose area in pre-treatment modality. Customized tolerance level for DC FFF VMAT verification is required. Abstract: Purpose: The software Dosimetry Check (DC) reconstructs the 3D dose distribution on CT images data set by using EPID measured signal. This study aimed to evaluate DC for stereotactic body radiotherapy (SBRT) with unflattened photon beams (FFF) for dosimetric independent plan verification in pre-treatment modality. Methods: DC v.4.1 was configured for Varian TrueBeam STx FFF beams equipped with EPID aS-1200. The DC FFF models were tested using arc open fields (from 1×1 cm 2 to 15×15 cm 2 ) and VMAT (Volumetric Modulated Arc Therapy) SBRT plans on phantom and patient CTs. DC dose distributions ( D DC ) were compared with that calculated by Eclipse with Acuros XB algorithm ( D AXB ) and one measured by Octavius 1000 SRS detector ( D OCT ). All differences were quantified in terms of the local 3D gamma passing rate (%GP), DVH and point dose differences. Results: DC was configured for FFF VMAT using an appropriate correction procedure. %GP2%2mm (mean±standard deviation) of D OCT - D DC was 96.3±2.7% for open fields whereas it was 90.1±5.9% for plans on homogeneous phantom CT. However, average %GP3%3mm of D AXB - D DC was 95.0±4.1 for treatments on patient CT. The fraction of plans passing the %GP3%3mm DQA tolerance level [10% (50%) of maximum dose threshold] were 20/20 (14/20) and 18/20 (16/20) for OCT on phantom CT and DC on patient CT, respectively. Conclusions: DC characterization for FFF beams was performed. For stereotactic VMAT plan verifications DC showed good agreement with TPS whereas underlined discrepancies with Octavius in the high dose regions. A customized tolerance level is required for EPID-based VMAT FFF pre-treatment verification when DC system is applied.