Evaluation of Dosimetry Check software for IMRT patient-specific quality assurance.
Ontology highlight
ABSTRACT:
SUBMITTER: Narayanasamy G
PROVIDER: S-EPMC5690116 | biostudies-other | 2015 May
REPOSITORIES: biostudies-other
Similar Datasets
Project description:PurposeTo evaluate the performance of Delta4DVH Anatomy in patient-specific intensity-modulated radiotherapy quality assurance.Materials and methodsDose comparisons were performed between Anatomy doses calculated with treatment plan dose measured modification and pencil beam algorithms, treatment planning system doses, film doses, and ion chamber measured doses in homogeneous and inhomogeneous geometries. The sensitivity of Anatomy doses to machine errors and output calibration errors was also investigated.ResultsFor a Volumetric Modulated Arc Therapy (VMAT) plan evaluated on the Delta4 geometry, the conventional gamma passing rate was 99.6%. For a water-equivalent slab geometry, good agreements were found between dose profiles in film, treatment planning system, and Anatomy treatment plan dose measured modification and pencil beam calculations. Gamma passing rate for Anatomy treatment plan dose measured modification and pencil beam doses versus treatment planning system doses was 100%. However, gamma passing rate dropped to 97.2% and 96% for treatment plan dose measured modification and pencil beam calculations in inhomogeneous head & neck phantom, respectively. For the 10 patients' quality assurance plans, good agreements were found between ion chamber measured doses and the planned ones (deviation: 0.09% ± 1.17%). The averaged gamma passing rate for conventional and Anatomy treatment plan dose measured modification and pencil beam gamma analyses in Delta4 geometry was 99.6% ± 0.89%, 98.54% ± 1.60%, and 98.95% ± 1.27%, respectively, higher than averaged gamma passing rate of 97.75% ± 1.23% and 93.04% ± 2.69% for treatment plan dose measured modification and pencil beam in patients' geometries, respectively. Anatomy treatment plan dose measured modification dose profiles agreed well with those in treatment planning system for both Delta4 and patients' geometries, while pencil beam doses demonstrated substantial disagreement in patients' geometries when compared to treatment planning system doses. Both treatment planning system doses are sensitive to multileaf collimator and monitor unit (MU) errors for high and medium dose metrics but not sensitive to the gantry and collimator rotation error smaller than 3°.ConclusionsThe new Delta4DVH Anatomy with treatment plan dose measured modification algorithm is a useful tool for the anatomy-based patient-specific quality assurance. Cautions should be taken when using pencil beam algorithm due to its limitations in handling heterogeneity and in high-dose gradient regions.
| S-EPMC7388137 | biostudies-literature
Project description:A first-time survey across 15 cancer centers in Ontario, Canada, on the current practice of patient-specific quality assurance (PSQA) for intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) delivery was conducted. The objectives were to assess the current state of PSQA practice, identify areas for potential improvement, and facilitate the continued improvement in standardization, consistency, efficacy, and efficiency of PSQA regionally. The survey asked 40 questions related to PSQA practice for IMRT/VMAT delivery. The questions addressed PSQA policy and procedure, delivery log evaluation, instrumentation, measurement setup and methodology, data analysis and interpretation, documentation, process, failure modes, and feedback. The focus of this survey was on PSQA activities related to routine IMRT/VMAT treatments on conventional linacs, including stereotactic body radiation therapy but excluding stereotactic radiosurgery. The participating centers were instructed to submit answers that reflected the collective view or opinion of their department and represented the most typical process practiced. The results of the survey provided a snapshot of the current state of PSQA practice in Ontario and demonstrated considerable variations in the practice. A large majority (80%) of centers performed PSQA measurements on all VMAT plans. Most employed pseudo-3D array detectors with a true composite (TC) geometry. No standard approach was found for stopping or reducing frequency of measurements. The sole use of delivery log evaluation was not widely implemented, though most centers expressed interest in adopting this technology. All used the Gamma evaluation method for analyzing PSQA measurements; however, no universal approach was reported on how Gamma evaluation and pass determination criteria were determined. All or some PSQA results were reviewed regularly in two-thirds of the centers. Planning related issues were considered the most frequent source for PSQA failures (40%), whereas the most frequent course of action for a failed PSQA was to review the result and decide whether to proceed to treatment.
| S-EPMC8292698 | biostudies-literature
Project description:A practical method was designed to verify the accuracy of dose distributions calculated using Compass, which can reconstruct the dose distribution inside a patient's body during intensity-modulated radiation therapy (IMRT). Twelve virtual IMRT treatment plans were developed using an ArcCHECK diode detector array, and then the recalculated and reconstructed doses in Compass were compared with the actual measurements to assess the dosimetric accuracy. Based on the results of gamma evaluation for the 12 plans, Compass achieved average pass rates higher than 98%, which confirmed proper dosimetric accuracy in the IMRT quality assurance process. The validity of Compass for clinical applications was also confirmed through an additional comparison with the results calculated using 3DVH, another dose reconstruction program. It is necessary to verify the accuracy of the dose calculated using the program in advance before the commercialized dose reconstruction program is applied in clinical practice. This study has limitations in that it did not provide a real scientific contribution such as an introduction of new algorithm for dose calculation and the development of new measurement tools. However, the method based on the comparative analysis with the actual measured dose values as devised in this study seems to be useful in that it can be applied effectively to verify the dosimetric accuracy of the dose reconstruction program before first using it in the clinical cases.
| S-EPMC6301628 | biostudies-literature
Project description:The Delta(4DVH) Anatomy 3D quality assurance (QA) system (ScandiDos), which converts the measured detector dose into the dose distribution in the patient geometry was evaluated. It allows a direct comparison of the calculated 3D dose with the measured back-projected dose. In total, 16 static and 16 volumetric-modulated arc therapy (VMAT) fields were planned using four different energies. Isocenter dose was measured with a pinpoint chamber in homogeneous phantoms to investigate the dose prediction by the Delta(4DVH) Anatomy algorithm for static fields. Dose distributions of VMAT fields were measured using GAFCHROMIC film. Gravitational gantry errors up to 10° were introduced into all VMAT plans to study the potential of detecting errors. Additionally, 20 clinical treatment plans were verified. For static fields, the Delta(4DVH) Anatomy predicted the isocenter dose accurately, with a deviation to the measured phantom dose of 1.1% ± 0.6%. For VMAT fields the predicted Delta(4DVH) Anatomy dose in the isocenter plane corresponded to the measured dose in the phantom, with an average gamma agreement index (GAI) (3 mm/3%) of 96.9± 0.4%. The Delta(4DVH) Anatomy detected the induced systematic gantry error of 10° with a relative GAI (3 mm/3%) change of 5.8% ± 1.6%. The conventional Delta(4PT) QA system detected a GAI change of 4.2%± 2.0%. The conventional Delta(4PT) GAI (3 mm/3%) was 99.8% ± 0.4% for the clinical treatment plans. The mean body and PTV-GAI (3 mm/5%) for the Delta(4DVH) Anatomy were 96.4% ± 2.0% and 97.7%± 1.8%; however, this dropped to 90.8%± 3.4% and 87.1% ± 4.1% for passing criteria of 3 mm/3%. The anatomy-based patient specific quality assurance system predicts the dose distribution correctly for a homogeneous case. The limiting factor for the error detection is the large variability in the error-free plans. The dose calculation algorithm is inferior to that used in the TPS (Eclipse).
| S-EPMC5875461 | biostudies-literature
Project description:In this work, overshoot and undershoot effects associated with step-and-shoot IMRT (SSIMRT) delivery on a Varian Clinac 21iX are investigated, and their impact on patient-specific QA point dose measurements and treatment plan delivery are evaluated. Pinnacle3 SSIMRT plans consisting of 5, 10, and 15 identical 5 × 5 cm2 MLC defined segments and MU/segment values of 5 MU, 10 MU, and 20 MU were utilized and delivered at 600/300 MU/min. Independent of the number of segments the overshoot and undershoot at 600 MU/min were approximately ± 10%, ± 5%, and ± 2.5% for 5 MU/segment, 10 MU/segment, and 20 MU/segment, respectively. At 300 MU/min, each of these values is approximately halved. Interfractional variation of these effects (10 fractions), as well as dosimetric variations for intermediate segments, are reduced at the lower dose rate. QA point-dose measurements for a sample (n = 29) of head and neck SSIMRT beams were on average 2.9% (600 MU/min) and 1.7% (300 MU/min) higher than Pinnacle3 planned doses. In comparison for prostate beams (n = 46), measured point doses were 0.8% (600 MU/min) and 0.4% (300 MU/min) higher. The reduction in planned-measured point-dose discrepancies at 300 MU/min can be attributed in part to the inclusion of the first segment (overshoot) in the admixture of segments that deliver measured dose. Pinnacle3 plans for 10/9 head and neck/prostate treatments were adjusted by ± 0.5 MU to include the effects of overshoot and undershoot at 600 MU/min. Comparing original and adjusted plans for each site indicated that the original plan was preferred in 70% and 89% of head and neck and prostate cases, respectively. The disparity between planned and delivered treatment that this suggests can potentially be mitigated by treating SSIMRT at a dose rate below 600 MU/min.
| S-EPMC5690035 | biostudies-literature
Project description:PurposeTo evaluate a two-dimensional diode array for patient-specific quality assurance of VMAT stereotactic radiosurgery (SRS) plans.MethodsThe diode array, an SRS MapCHECK (SRSMC), was composed of a 77 mm ×77 mm face-centered array having a spacing of 2.47 mm. Sixty SRS plans were selected from our clinical database, 30 for treatment of a single target and 30 for multiple targets. The target sizes ranged from 2.4 mm to 44.7 mm equivalent diameter (median 8.7 mm). The plans were delivered to the diode array. For multiple target plans, two measurements were obtained at two locations, one corresponding to the largest target and the other to the smallest target. Gamma using a 3%/1 mm criteria and the dose to the center diode were compared with radiochromic film (RCF). Dose to selected regions of the detector electronics was calculated.ResultsThe mean difference between the center diode and RCF was -1.2%. For a threshold of at least 95% of detectors/pixels having gamma < 1 for a 3%/1 mm criteria, SRSMC and RCF gave consistent results for 79 of the 90 measurements. For plans with an arc having a patient support angle of 90° or 270°, the median dose to the electronics was 0.65% of the prescription dose.ConclusionsSRSMC is an efficient tool for accurate patient-specific quality assurance of VMAT single and multiple target radiosurgery, yielding similar clinical decisions as radiochromic film.
| S-EPMC8664143 | biostudies-literature
Project description:PURPOSE:To create a snapshot of common practices for 3D-CRT and intensity-modulated radiation therapy (IMRT) QA through a large-scale survey and compare to TG-218 recommendations. METHODS:A survey of 3D-CRT and IMRT QA was constructed at and distributed by the IROC-Houston QA center to all institutions monitored by IROC (n = 2,861). The first part of the survey asked about methods to check dose delivery for 3D-CRT. The bulk of the survey focused on IMRT QA, inquiring about treatment modalities, standard tools used to verify planned dose, how assessment of agreement is calculated and the comparison criteria used, and the strategies taken if QA fails. RESULTS:The most common tools for dose verification were a 2D diode array (52.8%), point(s) measurement (39.0%), EPID (27.4%), and 2D ion chamber array (23.9%). When IMRT QA failed, the highest average rank strategy utilized was to remeasure with the same setup, which had an average position ranking of 1.1 with 90.4% of facilities employing this strategy. The second highest average ranked strategy was to move to a new calculation point and remeasure (54.9%); this had an average ranking of 2.1. CONCLUSION:The survey provided a snapshot of the current state of dose verification for IMRT radiotherapy. The results showed variability in approaches and that work is still needed to unify and tighten criteria in the medical physics community, especially in reference to TG-218's recommendations.
| S-EPMC7386182 | biostudies-literature
Project description:The gamma analysis used for quality assurance of a complex radiotherapy plan examines the dosimetric equivalence between planned and measured dose distributions within some tolerance. This study explores whether the dosimetric difference is correlated with any radiobiological difference between delivered and planned dose.VMAT or IMRT plans optimized for 14 cancer patients were calculated and delivered to a QA device. Measured dose was compared against planned dose using 2-D gamma analysis. Dose volume histograms (for various patient structures) obtained by interpolating measured data were compared against the planned ones using a 3-D gamma analysis. Dose volume histograms were used in the Poisson model to calculate tumor control probability for the treatment targets and in the Sigmoid dose-response model to calculate normal tissue complication probability for the organs at risk.Differences in measured and planned dosimetric data for the patient plans passing at ?94.9% rate at 3%/3 mm criteria are not statistically significant. Average ± standard deviation tumor control probabilities based on measured and planned data are 65.8±4.0% and 67.8±4.1% for head and neck, and 71.9±2.7% and 73.3±3.1% for lung plans, respectively. The differences in tumor control probabilities obtained from measured and planned dose are statistically insignificant. However, the differences in normal tissue complication probabilities for larynx, lungs-GTV, heart, and cord are statistically significant for the patient plans meeting ?94.9% passing criterion at 3%/3 mm.A ?90% gamma passing criterion at 3%/3 mm cannot assure the radiobiological equivalence between planned and delivered dose. These results agree with the published literature demonstrating the inadequacy of the criterion for dosimetric QA and suggest for a tighter tolerance.
| S-EPMC5874955 | biostudies-literature
Project description:BackgroundThe responsible use of 3D-printing in medicine includes a context-based quality assurance. Considerable literature has been published in this field, yet the quality of assessment varies widely. The limited discriminatory power of some assessment methods challenges the comparison of results. The total error for patient specific anatomical models comprises relevant partial errors of the production process: segmentation error (SegE), digital editing error (DEE), printing error (PrE). The present review provides an overview to improve the general understanding of the process specific errors, quantitative analysis, and standardized terminology.MethodsThis review focuses on literature on quality assurance of patient-specific anatomical models in terms of geometric accuracy published before December 4th, 2022 (n = 139). In an attempt to organize the literature, the publications are assigned to comparable categories and the absolute values of the maximum mean deviation (AMMD) per publication are determined therein.ResultsThe three major examined types of original structures are teeth or jaw (n = 52), skull bones without jaw (n = 17) and heart with coronary arteries (n = 16). VPP (vat photopolymerization) is the most frequently employed basic 3D-printing technology (n = 112 experiments). The median values of AMMD (AMMD: The metric AMMD is defined as the largest linear deviation, based on an average value from at least two individual measurements.) are 0.8 mm for the SegE, 0.26 mm for the PrE and 0.825 mm for the total error. No average values are found for the DEE.ConclusionThe total error is not significantly higher than the partial errors which may compensate each other. Consequently SegE, DEE and PrE should be analyzed individually to describe the result quality as their sum according to rules of error propagation. Current methods for quality assurance of the segmentation are often either realistic and accurate or resource efficient. Future research should focus on implementing models for cost effective evaluations with high accuracy and realism. Our system of categorization may be enhancing the understanding of the overall process and a valuable contribution to the structural design and reporting of future experiments. It can be used to educate specialists for risk assessment and process validation within the additive manufacturing industry.
| S-EPMC10967057 | biostudies-literature
Project description:We have automated the determination of the placement location of the dosimetry ion chamber within intensity-modulated radiotherapy (IMRT) fields, as part of streamlining the entire IMRT quality assurance process. This paper describes the mathematical image-processing techniques to arrive at the appropriate measurement locations within the planar dose maps of the IMRT fields. A specific spot within the found region is identified based on its flatness, radiation magnitude, location, area, and the avoidance of the interleaf spaces. The techniques used include applying a Laplacian, dilation, erosion, region identification, and measurement point selection based on three parameters: the size of the erosion operator, the gradient, and the importance of the area of a region versus its magnitude. These three parameters are adjustable by the user. However, the first one requires tweaking in extremely rare occasions, the gradient requires rare adjustments, and the last parameter needs occasional fine-tuning. This algorithm has been tested in over 50 cases. In about 5% of cases, the algorithm does not find a measurement point due to the extremely steep and narrow regions within the fluence maps. In such cases, manual selection of a point is allowed by our code, which is also difficult to ascertain, since the fluence map does not yield itself to an appropriate measurement point selection.
| S-EPMC5723455 | biostudies-literature