Portal Dosimetry as a patient specific Quality Assurance tool for Volumetric Arc Radiotherapy

  • Vikram Rathore Department of Radiotherapy, Pt. J.N.M. Medical College, Raipur
  • Mr. V.K Mishra Assistant Professor, Department of Radiotherapy, Pt. J. N. M. Medical College and Regional Cancer Centre, Jail Road Raipur, Chhattisgarh, India
  • Dr. V Choudhary Director-cum Professor and Dean, Department of Radiotherapy, Pt. J. N. M. Medical College and Regional Cancer Centre, Jail Road Raipur, Chhattisgarh, India
  • Mr. G.S. Gautam Assistant Professor, Department of Radiotherapy, Pt. J. N. M. Medical College and Regional Cancer Centre, Jail Road Raipur, Chhattisgarh, India
  • Ms. P. Kushawaha Registrar, Department of Radiotherapy, Pt. J. N. M. Medical College and Regional Cancer Centre, Jail Road Raipur, Chhattisgarh, India
  • Dr. S.K. Azad Professor, Department of Radiotherapy, Pt. J. N. M. Medical College and Regional Cancer Centre, Jail Road Raipur, Chhattisgarh, India
  • Dr. M. Kerketta Associate Professor, Department of Radiotherapy, Pt. J. N. M. Medical College and Regional Cancer Centre, Jail Road Raipur, Chhattisgarh, India
  • Dr P.K. Chandrakar Associate Professor, Department of Radiotherapy, Pt. J. N. M. Medical College and Regional Cancer Centre, Jail Road Raipur, Chhattisgarh, India
  • Dr R.S. Singh Assistant Professor, Department of Radiotherapy, Pt. J. N. M. Medical College and Regional Cancer Centre, Jail Road Raipur, Chhattisgarh, India
  • Dr. R.R. Jain Assistant Professor, Department of Radiotherapy, Pt. J. N. M. Medical College and Regional Cancer Centre, Jail Road Raipur, Chhattisgarh, India
Keywords: Portal Dosimetry, Gamma Index, VMAT Quality Assurance, Patient-Specific Quality Assurance

Abstract

Introduction: Volumetric Arc Radiotherapy (VMAT) is an advanced technique. Calculations of VMAT plans are not so accurate even with State-of-Art dose calculation algorithms due to their complexity. Hence pre-treatment patient specific Quality Assurance (QA) of each VMAT plan is required. In the present study Electronic Portal Imaging Device (EPID) based portal dosimetry system was used for pre-treatment patient specific QA.

Material and Methods: A total of 50 patients were chosen in this study. Verification plans of each patient were calculated for portal dosimetry then executed on the EPID system to measure the spatial distribution of radiation dose. Calculated and measured dose distribution were compared to evaluate Gamma Index (GI) passing criteria of Dose Difference (DD) of 3% and Distance–to-Agreement (DTA) of 3mm, Area Gamma (γ≤) >95%, Average Gamma (Ave) <0.5% and Maximum Gamma (Max) <3.5%.

Results: The mean values of Area Gamma (γ% ≤1) were observed to be varied from 99.14±0.23% to 99.87±0.18%. The Mean Values of Average Gamma (Ave) are found to vary from 0.19±0.05% to 0.15±0.04% and the mean values of Maximum Gamma (Max) found to be varied from 1.94±0.37% to 1.59±0.41%. All the plans were passed the gamma index criteria with very good agreement. Thus the use of Portal Dosimetry for pre-treatment patient QA is found to be a very useful, quick, precise, efficient and effective pre-treatment patient specific QA tool for VMAT treatment.

Conclusion: Portal Dosimetry can be utilized for routine use for patient specific quality assurance for Volumetric Arc Radiotherapy treatment.

Downloads

Download data is not yet available.

References

Brahme A. Optimisation of stationary and moving beam radiation therapy techniques. Radiother Oncol. 1988;12(2):129-40. DOI: https://doi.org/10.1016/0167-8140(88)90167-3

Otto K. Volumatric modulated arc therapy: IMRT in a single gantry arc. Med. Phys. 2008:35(1):310-7. DOI: https://doi.org/10.1118/1.2818738

Cozzy L,Dinshaw KA, Shrivastava SK et al. A treatment planning study comparing volumetric arc modulation with RapidArc and fixed field IMRT for cervix uteri radiotherapy. Radiotherapy Oncol. 2008; 89(2): 180-91. DOI: https://doi.org/10.1016/j.radonc.2008.06.013

Fogliata A. Clivio A, Nicolini G, Venetti E and Cozzi L. Intensity modulation with photons for benign intracranial tumours: A planning comparision of volumetric single arc, helical arc and fixed gantry techniques. Radiother. Oncol. 2008;89 (3):254-62. DOI: https://doi.org/10.1016/j.radonc.2008.07.021

Verbakel WF,Cuijpers JP, Hoffmans D,; et al. Volumetric intensity-modulated arc therapy vs conventional IMRT in head-and-neck cancer: A comparative planning and dosimetric study. Int. J Radia. Oncol. Biol. Phys.2009;74 (1):252-259. DOI: https://doi.org/10.1016/j.ijrobp.2008.12.033

Nicolini G, Clivio A, Fogliata A,; et al. Simultaneous integrated boost radiotherapy for bilateral breast a treatment planning and dosimetric comparison for volumetric modulated arc and fixed field intensity modulated therapy. Radiol. Oncol. 2009;4:27. DOI: https://doi.org/10.1186/1748-717X-4-27

Rao M, Yang W, Chen F et al. Comparison of Elekta VMAT with helical tomotherapy and fixed field IMRT: Plan quality. Delivery efficiency and accuracy. Med. Phys. 2010;37 (3):1350-9. DOI: https://doi.org/10.1118/1.3326965

Park JM, Park SY, Kim H, Modulation index for VMAT considering both mechanical and dose calculation uncertainties. Phys Med Biol. 2015;60(18):7101-25. DOI: https://doi.org/10.1088/0031-9155/60/18/7101

Fred A, Scherman JB, Fog LS, Munk of Rosenchold P. Patient QA systems for rotational radiation therapy: a comparative experimental study with intentional errors. Med Phys. 2013;40(3): 031716. DOI: https://doi.org/10.1118/1.4788645

Heilmann G, Poppe B, Laub W. On the sentivity of common gamma-index evaluation methods to MLC misalignments in Rapidarc quality assurance. Med Phys. 2013;40(3):031702. DOI: https://doi.org/10.1118/1.4789580

Kim JI, Park SY, Kim HJ, Kim JH, Ye SJ, Park JM. The sensitivity of gamma-index method to the positioning errors of high-definition MLC in patient-specific VMAT QA for SBRT. Radiat Oncol. 2014;9:167. DOI: https://dx.doi.org/10.1186/1748-717X-9-167.

Mehrb C, Chevillard C, Ksouri W, Fawzi M, Bollet M. Comparison between two different algorithms used for pretreatment QA via aSi Portal Images. J. Appl Clin Med Phys. 2015;16: 5202. DOI: https://dx.doi.org/10.1120/jacmp.v16i3.5202

Vieira SC, Dirkx ML, Heijmen BJ, De Boer HC SIFT: A method to verify the IMRT Fluence delivered during patient treatment using an electronic portal imaging device. Int J Radiation Oncology Biol Phys 2004;60:981-248.

DOI: https://doi.org/10.1016/j.ijrobp.2004.06.025.

Sharma DS, Mhatre V, Heigrujam M, Talapatra K, Mallik S. Portal Dosimetry for Pretreatment verification of IMRT Plan: A comparision with 2D ion chamber array. Journal of Applied Clinical Medical Physics, 2010;11:238-248. DOI: https://doi.org/10.1120/jacmp.v11i4.3268

Low DA, Moran JM, Dempsey JF, Dong L, Oldam M. Dosimetry tools and techniques for IMRT, Med. Phys. 2011;38:1313-1326. DOI: https://doi.org/10.1118/1.3514120

Ibrahim AG, Mohammed IE,Zidan HM. Dosimetric comparision of Amorphous Silicon EPID and 2D Array detector for Pre-treatment Verification of Intensity Modulated Radiation Therapy. International journal of Medical Physics, clinical Engineering and Radiation Oncology,2018;7,438-452. DOI: https://doi.org/10.4236/ijmpcero.2018.74037.

Nainggolan A, Pawiro SA, Dosimetric Evaluation of Volumetric Modulated Arc Therapy (VMAT) and intensity Modulated Radiotherapy (IMRT) using AAPM TG 119 Protocol. J.Biomed Phys. Eng. 2019;9(4),395-408. DOI: 10.31661/jbpe.v0i0.839

CITATION
DOI: 10.17511/ijmrr.2021.i01.04
Published: 2021-03-08
How to Cite
1.
Rathore V, Mr. V.K Mishra, Dr. V Choudhary, Mr. G.S. Gautam, Ms. P. Kushawaha, Dr. S.K. Azad, Dr. M. Kerketta, Dr P.K. Chandrakar, Dr R.S. Singh, Dr. R.R. Jain. Portal Dosimetry as a patient specific Quality Assurance tool for Volumetric Arc Radiotherapy. Int J Med Res Rev [Internet]. 2021Mar.8 [cited 2024Apr.25];9(1):29-3. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1238
Section
Original Article