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      Transit and non‐transit 3D EPID dosimetry versus detector arrays for patient specific QA

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          Abstract

          Purpose

          Despite their availability and simplicity of use, Electronic Portal Imaging Devices ( EPIDs) have not yet replaced detector arrays for patient specific QA in 3D. The purpose of this study is to perform a large scale dosimetric evaluation of transit and non‐transit EPID dosimetry against absolute dose measurements in 3D.

          Methods

          After evaluating basic dosimetric characteristics of the EPID and two detector arrays (Octavius 1500 and Octavius 1000 SRS ), 3D dose distributions for 68 VMAT arcs, and 10 IMRT plans were reconstructed within the same phantom geometry using transit EPID dosimetry, non‐transit EPID dosimetry, and the Octavius 4D system. The reconstructed 3D dose distributions were directly compared by γ‐analysis (2L2 = 2% local/2 mm and 3G2 = 3% global/2 mm, 50% isodose) and by the percentage difference in median dose to the high dose volume (%∆ HDV D 50).

          Results

          Regarding dose rate dependency, dose linearity, and field size dependence, the agreement between EPID dosimetry and the two detector arrays was found to be within 1.0%. In the 2L2 γ‐comparison with Octavius 4D dose distributions, the average γ‐pass rate value was 92.2 ± 5.2%(1 SD) and 94.1 ± 4.3%(1 SD) for transit and non‐transit EPID dosimetry, respectively. 3G2 γ‐pass rate values were higher than 95% in 150/156 cases. %∆ HDV D 50 values were within 2% in 134/156 cases and within 3% in 155/156 cases. With regard to the clinical classification of alerts, 97.5% of the treatments were equally classified by EPID dosimetry and Octavius 4D.

          Conclusion

          Transit and non‐transit EPID dosimetry are equivalent in dosimetric terms to conventional detector arrays for patient specific QA. Non‐transit 3D EPID dosimetry can be readily used for pre‐treatment patient specific QA of IMRT and VMAT, eliminating the need of phantom positioning.

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          Most cited references38

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          IMRT commissioning: multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119.

          AAPM Task Group 119 has produced quantitative confidence limits as baseline expectation values for IMRT commissioning. A set of test cases was developed to assess the overall accuracy of planning and delivery of IMRT treatments. Each test uses contours of targets and avoidance structures drawn within rectangular phantoms. These tests were planned, delivered, measured, and analyzed by nine facilities using a variety of IMRT planning and delivery systems. Each facility had passed the Radiological Physics Center credentialing tests for IMRT. The agreement between the planned and measured doses was determined using ion chamber dosimetry in high and low dose regions, film dosimetry on coronal planes in the phantom with all fields delivered, and planar dosimetry for each field measured perpendicular to the central axis. The planar dose distributions were assessed using gamma criteria of 3%/3 mm. The mean values and standard deviations were used to develop confidence limits for the test results using the concept confidence limit = /mean/ + 1.96sigma. Other facilities can use the test protocol and results as a basis for comparison to this group. Locally derived confidence limits that substantially exceed these baseline values may indicate the need for improved IMRT commissioning.
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            Tolerance limits and methodologies for IMRT measurement-based verification QA: Recommendations of AAPM Task Group No. 218.

            Patient-specific IMRT QA measurements are important components of processes designed to identify discrepancies between calculated and delivered radiation doses. Discrepancy tolerance limits are neither well defined nor consistently applied across centers. The AAPM TG-218 report provides a comprehensive review aimed at improving the understanding and consistency of these processes as well as recommendations for methodologies and tolerance limits in patient-specific IMRT QA.
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              Polymer gel dosimetry.

              Polymer gel dosimeters are fabricated from radiation sensitive chemicals which, upon irradiation, polymerize as a function of the absorbed radiation dose. These gel dosimeters, with the capacity to uniquely record the radiation dose distribution in three-dimensions (3D), have specific advantages when compared to one-dimensional dosimeters, such as ion chambers, and two-dimensional dosimeters, such as film. These advantages are particularly significant in dosimetry situations where steep dose gradients exist such as in intensity-modulated radiation therapy (IMRT) and stereotactic radiosurgery. Polymer gel dosimeters also have specific advantages for brachytherapy dosimetry. Potential dosimetry applications include those for low-energy x-rays, high-linear energy transfer (LET) and proton therapy, radionuclide and boron capture neutron therapy dosimetries. These 3D dosimeters are radiologically soft-tissue equivalent with properties that may be modified depending on the application. The 3D radiation dose distribution in polymer gel dosimeters may be imaged using magnetic resonance imaging (MRI), optical-computerized tomography (optical-CT), x-ray CT or ultrasound. The fundamental science underpinning polymer gel dosimetry is reviewed along with the various evaluation techniques. Clinical dosimetry applications of polymer gel dosimetry are also presented.
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                Author and article information

                Contributors
                i.olaciregui@nki.nl
                Journal
                J Appl Clin Med Phys
                J Appl Clin Med Phys
                10.1002/(ISSN)1526-9914
                ACM2
                Journal of Applied Clinical Medical Physics
                John Wiley and Sons Inc. (Hoboken )
                1526-9914
                13 May 2019
                June 2019
                : 20
                : 6 ( doiID: 10.1002/acm2.2019.20.issue-6 )
                : 79-90
                Affiliations
                [ 1 ] Department of Radiation Oncology The Netherlands Cancer Institute – Antoni van Leeuwenhoek Amsterdam The Netherlands
                Author notes
                [*] [* ] Author to whom correspondence should be addressed. Igor Olaciregui‐Ruiz

                E‐mail address: i.olaciregui@ 123456nki.nl

                Telephone: +31205121741; Fax: +31206691101

                Article
                ACM212610
                10.1002/acm2.12610
                6560233
                31083776
                d10da21b-2d33-498b-9087-356ecb0e45e5
                © 2019 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 December 2018
                : 10 April 2019
                : 23 April 2019
                Page count
                Figures: 6, Tables: 1, Pages: 12, Words: 6700
                Categories
                Radiation Oncology Physics
                Radiation Oncology Physics
                Custom metadata
                2.0
                acm212610
                June 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.4 mode:remove_FC converted:12.06.2019

                detector arrays,epid dosimetry,imrt,patient specific qa,vmat

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