1
|
Thiyagarajan R, Sharma DS, Kaushik S, Sawant M, Ganapathy K, Nambi Raj NA, Chilukuri S, Sundar SC, Patro KC, Manikandan A, Noufal MP, Sivaraman R, Easow J, Jalali R. Leaf open time sinogram (LOTS): a novel approach for patient specific quality assurance of total marrow irradiation. Radiat Oncol 2020; 15:236. [PMID: 33054792 PMCID: PMC7557063 DOI: 10.1186/s13014-020-01669-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/17/2020] [Indexed: 11/10/2022] Open
Abstract
There is no ideal detector-phantom combination to perform patient specific quality assurance (PSQA) for Total Marrow (TMI) and Lymphoid (TMLI) Irradiation plan. In this study, 3D dose reconstruction using mega voltage computed tomography detectors measured Leaf Open Time Sinogram (LOTS) was investigated for PSQA of TMI/TMLI patients in helical tomotherapy. The feasibility of this method was first validated for ten non-TMI/TMLI patients, by comparing reconstructed dose with (a) ion-chamber (IC) and helical detector array (ArcCheck) measurement and (b) planned dose distribution using 3Dγ analysis for 3%@3mm and dose to 98% (D98%) and 2% (D2%) of PTVs. Same comparison was extended for ten treatment plans from five TMI/TMLI patients. In all non-TMI/TMLI patients, reconstructed absolute dose was within ± 1.80% of planned and IC measurement. The planned dose distribution agreed with reconstructed and ArcCheck measured dose with mean (SD) 3Dγ of 98.70% (1.57%) and 2Dγ of 99.48% (0.81%). The deviation in D98% and D2% were within 1.71% and 4.10% respectively. In all 25 measurement locations from TMI/TMLI patients, planned and IC measured absolute dose agreed within ± 1.20%. Although sectorial fluence verification using ArcCHECK measurement for PTVs chest from the five upper body TMI/TMLI plans showed mean ± SD 2Dγ of 97.82% ± 1.27%, the reconstruction method resulted poor mean (SD) 3Dγ of 92.00% (± 5.83%), 64.80% (± 28.28%), 69.20% (± 30.46%), 60.80% (± 19.37%) and 73.2% (± 20.36%) for PTVs brain, chest, torso, limb and upper body respectively. The corresponding deviation in median D98% and D2% of all PTVs were < 3.80% and 9.50%. Re-optimization of all upper body TMI/TMLI plans with new pitch and modulation factor of 0.3 and 3 leads significant improvement with 3Dγ of 100% for all PTVs and median D98% and D2% < 1.6%. LOTS based PSQA for TMI/TMLI is accurate, robust and efficient. A field width, pitch and modulation factor of 5 cm, 0.3 and 3 for upper body TMI/TMLI plan is suggested for better dosimetric outcome and PSQA results.
Collapse
Affiliation(s)
- Rajesh Thiyagarajan
- Department of Medical Physics, Apollo Proton Cancer Centre, 100 Feet Road Tharamani, Chennai, 600096, Tamil Nadu, India.,School of Advanced Sciences, VIT University, Vellore, 632014, India
| | | | - Suryakant Kaushik
- Department of Medical Physics, Apollo Proton Cancer Centre, 100 Feet Road Tharamani, Chennai, 600096, Tamil Nadu, India
| | - Mayur Sawant
- Department of Medical Physics, Apollo Proton Cancer Centre, 100 Feet Road Tharamani, Chennai, 600096, Tamil Nadu, India
| | - K Ganapathy
- Department of Medical Physics, Apollo Proton Cancer Centre, 100 Feet Road Tharamani, Chennai, 600096, Tamil Nadu, India
| | - N Arunai Nambi Raj
- Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), VIT University, Vellore, 632014, India
| | - Srinivas Chilukuri
- Department of Radiation Oncology, Apollo Proton Cancer Centre, 100 Feet Road Tharamani, Chennai, 600096, Tamil Nadu, India
| | - Sham C Sundar
- Department of Radiation Oncology, Apollo Proton Cancer Centre, 100 Feet Road Tharamani, Chennai, 600096, Tamil Nadu, India
| | - Kartikeswar Ch Patro
- Department of Medical Physics, Apollo Proton Cancer Centre, 100 Feet Road Tharamani, Chennai, 600096, Tamil Nadu, India
| | - Arjunan Manikandan
- Department of Medical Physics, Apollo Proton Cancer Centre, 100 Feet Road Tharamani, Chennai, 600096, Tamil Nadu, India
| | - M P Noufal
- Department of Medical Physics, Apollo Proton Cancer Centre, 100 Feet Road Tharamani, Chennai, 600096, Tamil Nadu, India
| | - Rangasamy Sivaraman
- Department of Medical Physics, Apollo Proton Cancer Centre, 100 Feet Road Tharamani, Chennai, 600096, Tamil Nadu, India
| | - Jose Easow
- Department of Haematology, Blood and Marrow Transplantation, Apollo Speciality Hospital, Teynampet, Chennai, India
| | - Rakesh Jalali
- Department of Radiation Oncology, Apollo Proton Cancer Centre, 100 Feet Road Tharamani, Chennai, 600096, Tamil Nadu, India
| |
Collapse
|
2
|
Kim DS, Kim S, Kang SH, Kim TH, Park SH, Kim KH, Cho MS, Shin DS, Noh YY, Chung JB, Suh TS. To propose adding index of achievement (IOA) to IMRT QA process. Radiat Oncol 2018; 13:112. [PMID: 29903025 PMCID: PMC6003087 DOI: 10.1186/s13014-018-1055-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 05/28/2018] [Indexed: 11/28/2022] Open
Abstract
Background In intensity modulated radiation therapy (IMRT) quality assurance (QA), evaluation of QA result using a pass/non-pass strategy under an acceptance criterion often suffers from lack of information on how good the plan is in absolute manner. In this study, we suggested adding an index system, previously developed for dose painting technique, to current IMRT QA process for better understanding of QA result. Methods The index system consists of three indices, index of achievement (IOA), index of hotness (IOH) and index of coldness (IOC). As indicated by its name, IOA does measure the level of agreement. IOH and IOC, on the other hand, measure the magnitude of overdose and underdose, respectively. A systematic analysis was performed with three 1-dimensional hypothetical dose distributions to investigate the characteristics of the index system. The feasibility of the system was also assessed with clinical volumetric modulated arc therapy (VMAT) QA cases from 8 head & neck and 5 prostate patients. In both simulation studies, certain amount of errors was intentionally induced to each dose distribution. Furthermore, we applied the proposed system to compare calculated with actual measured data for a total of 60 patients (30 head & neck and 30 prostate cases). QA analysis was made using both the index system and gamma method, and results were compared. Results While the gamma evaluation showed limited sensitivity in evaluating QA result depending on the level of tolerance criteria used, the proposed indices tended to better distinguish plans in terms of the amount of errors. Hotness and coldness of prescribed dose in the plan could be evaluated quantitatively by the indices. Conclusions The proposed index system provides information with which IMRT QA result would be better evaluated, especially when gamma pass rates are identical or similar among multiple plans. In addition, the independency of the index system on acceptance criteria would help making clear communications among readers of published articles and researchers in multi-institutional studies.
Collapse
Affiliation(s)
- Dong-Su Kim
- Department of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, 222. Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - Siyong Kim
- Department of Radiation Oncology, Virginia Commonwealth University, 401 College Street, Richmond, VA, 23298-0058, USA.
| | - Seong-Hee Kang
- Department of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, 222. Banpo-daero, Seocho-gu, Seoul, 06591, South Korea.,Department of Radiation Oncology, Seoul National University Bundang Hospital, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea
| | - Tae-Ho Kim
- Department of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, 222. Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - So-Hyun Park
- Department of Radiation Oncology, Jeju National University Hospital, 15, Aran 13-gil, Jeju-si, Jeju-do, 63241, South Korea
| | - Kyeong-Hyeon Kim
- Department of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, 222. Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - Min-Seok Cho
- Department of Radiation Oncology, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Dong-Seok Shin
- Department of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, 222. Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - Yu-Yun Noh
- Department of Radiation Oncology, Eulji University Hospital, 95, Dunsanseo-ro, Seo-gu, Daejeon, 35233, South Korea
| | - Jin-Beom Chung
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea
| | - Tae Suk Suh
- Department of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, 222. Banpo-daero, Seocho-gu, Seoul, 06591, South Korea.
| |
Collapse
|
3
|
O'Connor P, Seshadri V, Charles P. Detecting MLC errors in stereotactic radiotherapy plans with a liquid filled ionization chamber array. Australas Phys Eng Sci Med 2016; 39:247-52. [PMID: 26979835 DOI: 10.1007/s13246-016-0421-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 01/06/2016] [Indexed: 11/30/2022]
Abstract
Quality assurance of stereotactic radiotherapy demands the use of equipment with the highest resolution and sensitivity available. This study examines the sensitivity of a commercially available liquid-filled ionization chamber array--the Octavius 1000 SRS (PTW, Frieburg, Germany) for detecting small (sub-millimetre) multi-leaf collimator (MLC) alignment errors in static square fields (side length 16-40 mm). Furthermore, the effectiveness of detecting small MLC errors in clinical stereotactic radiotherapy patient plans using the device was also evaluated. The commonly used gamma pass rate metric (of the measurements compared with treatment planning system generated results) was used. The gamma pass rates were then evaluated as a function of MLC position error (MLC error size 0.1-2.5 mm). The detector array exhibited a drop in pass rate between plans without error and those which had MLC errors induced. For example a drop in pass rate of 4.5% (gamma criteria 3%, 1 mm) was observed when a 0.8 mm error was introduced into a 16 mm square field. Furthermore the drop in pass rate increased as the MLC position error increased. This study showed that the Octavius 1000 SRS array could be a useful tool for applications requiring the detection of small geometric delivery uncertainties.
Collapse
Affiliation(s)
- Patrick O'Connor
- Princess Alexandra Hospital, Woolloongabba, QLD, Australia. patrick.o'
| | | | - Paul Charles
- Princess Alexandra Hospital, Woolloongabba, QLD, Australia.,Science and Engineering Faculty, Queensland University of Technology, Brisbane, QLD, Australia
| |
Collapse
|