Experimental methods are commonly used for patient‐specific IMRT delivery verification. There are a variety of IMRT QA techniques which have been proposed and clinically used with a common understanding that not one single method can detect all possible errors. The aim of this work was to compare the efficiency and effectiveness of independent dose calculation followed by machine log file analysis to conventional measurement‐based methods in detecting errors in IMRT delivery. Sixteen IMRT treatment plans (5 head‐and‐neck, 3 rectum, 3 breast, and 5 prostate plans) created with a commercial treatment planning system (TPS) were recalculated on a QA phantom. All treatment plans underwent ion chamber (IC) and 2D diode array measurements. The same set of plans was also recomputed with another commercial treatment planning system and the two sets of calculations were compared. The deviations between dosimetric measurements and independent dose calculation were evaluated. The comparisons included evaluations of DVHs and point doses calculated by the two TPS systems. Machine log files were captured during pretreatment composite point dose measurements and analyzed to verify data transfer and performance of the delivery machine. Average deviation between IC measurements and point dose calculations with the two TPSs for head‐and‐neck plans were 1.2±1.3% and 1.4±1.6%, respectively. For 2D diode array measurements, the mean gamma value with 3% dose difference and 3 mm distance‐to‐agreement was within 1.5% for 13 of 16 plans. The mean 3D dose differences calculated from two TPSs were within 3% for head‐and‐neck cases and within 2% for other plans. The machine log file analysis showed that the gantry angle, jaw position, collimator angle, and MUs were consistent as planned, and maximal MLC position error was less than 0.5 mm. The independent dose calculation followed by the machine log analysis takes an average 47±6 minutes, while the experimental approach (using IC and 2D diode array measurements) takes an average about 2 hours in our clinic. Independent dose calculation followed by machine log file analysis can be a reliable tool to verify IMRT treatments. Additionally, independent dose calculations have the potential to identify several problems (heterogeneity calculations, data corruptions, system failures) with the primary TPS, which generally are not identifiable with a measurement‐based approach. Additionally, machine log file analysis can identify many problems (gantry, collimator, jaw setting) which also may not be detected with a measurement‐based approach. Machine log file analysis could also detect performance problems for individual MLC leaves which could be masked in the analysis of a measured fluence.PACS numbers: 87.53.Bn, 87.55.Qr, 87.55.km, 87.57.Uq
The goal of this article is to present the algorithm for DMLC leaf control capable of delivering IMRT to tumors that experience motion in two dimensions in the beams eye view (BEV) plane. The generic, two-dimensional (2D) motion of the projection of the rigid target on BEV plane can be divided into two components. The first component describes the motion of the projection of the target along the x axis (parallel to the MLC leaf motions) and the other describes the motion of the target projection on the y axis (perpendicular to the leaf motion direction). First, time optimal leaf trajectories are calculated independently for each leaf pair of the MLC assembly to compensate the x-axis component of the 2D motion of the target on the BEV. These leaf trajectories are then synchronized following the mid time (MT) synchronization procedure. To compensate for the y-axis component of the motion of the target projection on the BEV plane, the procedure of "switching" leaf pair trajectories in the upward (or downward) direction is executed when the target's BEV projection moves upward (or downward) from its equilibrium position along the y axis. When the intensity function is a 2D histogram, the error between the intended and delivered intensity in 2D DMLC IMRT delivery will depend on the shape of the intensity map and on the MLC physical constraint (leaf width and maximum admissible leaf speed). The MT synchronization of leaf trajectories decreases the impact of above constraints on the error in 2D DMLC IMRT intensity map delivery. The proof is provided, that if hardware constraints in the 2D DMLC IMRT delivery strategy are removed, the errors between planned and delivered 2D intensity maps are entirely eliminated. Examples of 2D DMLC IMRT delivery to rigid targets moving along elliptical orbits on BEV planes are calculated and analyzed for 20 clinical fluence maps. The comparisons between the intensity delivered without motion correction, with motion correction along x axis only, and with motion correction for full 2D motion of the target are calculated and quantitatively evaluated. The fluence maps were normalized to 100 MU and the rms difference between the desired and delivered fluence was 12 MU for no motion compensation, 11.18 MU for 1D compensation, and 4.73 MU for 2D motion compensations. The advantage of correcting for full 2D motion of target projected on the BEV plane is demonstrated.
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