Clinically relevant quality assurance (QA) for prostate RapidArc plans: Gamma maps and DVH-based evaluation |
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| Affiliation: | 1. School of Physics (A28), The University of Sydney, NSW 2006, Australia;2. West German Proton Therapy Centre Essen, Hufeland Straße 55, D-45147 Essen, Germany;1. Université Paris Est, Ecole Doctorale Sciences de la Vie et de la Santé – ED402, Créteil, F-94010, France;2. AP-HP, Groupe Henri Mondor Albert Chenevier, Imagerie Médicale, Créteil, F-94010, France;3. AP-HP, Hôpital Tenon, Imagerie Médicale, Paris, F-75020, France;4. DoseWatch, GE Healthcare, Buc, F-78530, France;5. Université Paris Est Créteil, Créteil, Faculté de Médecine, F-94010, France;6. INSERM Unité U955 IMRB, Equipe 18, Créteil, F-94010, France;1. H.H. Wills Physics Laboratory, University of Bristol, Tyndall Avenue, Bristol BS8 1TL, UK;2. Swansea University, Singleton Park, Swansea SA2 8PP, UK;3. Bristol Haematology and Oncology Centre, University Hospitals Bristol, NHS Foundation Trust, UK;1. Medical Physics Dept, San Raffaele Scientific Institute, Milano, Italy;2. Università Statale di Milano, Milano, Italy;3. Medical Physics Dept, University Hospital of Parma AOUP, Italy;4. Medical Physics Unit, Department of Advanced Technology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy;5. Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;6. Medical Physics Department, Veneto Institute of Oncology IOV–IRCCS, Padua, Italy;7. Department of Medical Physics, University Hospital, Udine, Italy;8. IRCCS Istituto Nazionale dei Tumori Regina Elena, Rome, Italy;9. University Hospital, “Federico II”, Naples, Italy;10. Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy;11. Amethyst Radioterapia Italia, Medical Physics Department, San Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy |
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| Abstract: | The aim of this paper is to evaluate clinically relevant quality assurance (QA) tests for RapidArc prostate patients. 26 plans were verified by the COMPASS system that provides an independent angle response and a reconstruction of dose distribution in patient CT model. Plan data were imported from treatment planning system via DICOM. The fluencies, measured by a 2D detector, were used by COMPASS to forward calculate dose in CT patients and reconstruct dose-volume-histogram (DVH). The gamma analysis was performed, using both the criteria 3%-3-mm and 2%-2 mm, for the whole grid patient and the per-structure volume. A DVH-based analysis was accomplished for target and organs-at-risk (OAR). The correlation between gamma passing rates and DVH discrepancies was performed using Pearson's test. Sensitivity, specificity and accuracy of whole and per-structure gamma method were calculated.No significant DVH deviation was observed for target and OAR. Weak correlation between gamma passing rates and dosimetric deviations was observed, all significant r-values were negative. The whole gamma method shows lack of sensitivity to detect dosimetric deviations >5%. Instead, a better balance between sensitivity and specificity was obtained employing per structure gamma both with 3%-3 mm and 2%-2 mm criteria.Because of the poor correlation between DVH goals and gamma passing rates, we encourage the DVH-based gamma passing rates, when it is possible. At least, a gamma method specific for structure was strongly suggested. |
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| Keywords: | 3D quality assurance COMPASS system 3D gamma RapidArc prostate |
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