The Vero linear accelerator delivers dynamic tumor tracking (DTT) treatment using a gimbal motion. However, the availability of treatment planning systems (TPS) to simulate DTT is limited. This study aims to implement and verify the gimbal tracking beam geometry in the dose calculation. Gimbal tracking was implemented by rotating the reference CT outside the TPS according to the ring, gantry, and gimbal tracking position obtained from the tracking log file. The dose was calculated using these rotated CTs. The geometric accuracy was verified by comparing calculated and measured film response using a ball bearing phantom. The dose was verified by comparing calculated 2D dose distributions and film measurements in a ball bearing and a homogeneous phantom using a gamma criterion of 2%/2 mm. The effect of implementing the gimbal tracking beam geometry in a 3D patient data dose calculation was evaluated using dose volume histograms (DVH). Geometrically, the gimbal tracking implementation accuracy was <0.94 mm. The isodose lines agreed with the film measurement. The largest dose difference of 9.4% was observed at maximum tilt positions with an isocenter and target separation of 17.51 mm. Dosimetrically, gamma passing rates were >98.4%. The introduction of the gimbal tracking beam geometry in the dose calculation shifted the DVH curves by 0.05%-1.26% for the phantom geometry and by 5.59% for the patient CT dataset. This study successfully demonstrates a method to incorporate the gimbal tracking beam geometry into dose calculations. By combining CT rotation and MU distribution according to the log file, the TPS was able to simulate the Vero tracking treatment dose delivery. The DVH analysis from the gimbal tracking dose calculation revealed changes in the dose distribution during gimbal DTT that are not visible with static dose calculations.
We report an investigation on the accuracy of dose calculation based on the cone‐beam computed tomography (CBCT) images of the nonbowtie filter kV imaging system of the Vero linear accelerator. Different sets of materials and tube voltages were employed to generate the Hounsfield unit lookup tables (HLUTs) for both CBCT and fan‐beam CT (FBCT) systems. The HLUTs were then implemented for the dose calculation in a treatment planning system (TPS). Dosimetric evaluation was carried out on an in‐house‐developed cube phantom that consists of water‐equivalent slabs and inhomogeneity inserts. Two independent dosimeters positioned in the cube phantom were used in this study for point‐dose and two‐dimensional (2D) dose distribution measurements. The differences of HLUTs from various materials and tube voltages in both CT systems resulted in differences in dose calculation accuracy. We found that the higher the tube voltage used to obtain CT images, the better the point‐dose calculation and the gamma passing rate of the 2D dose distribution agree to the values determined in the TPS. Moreover, the insert materials that are not tissue‐equivalent led to higher dose‐calculation inaccuracy. There were negligible differences in dosimetric evaluation between the CBCT‐ and FBCT‐based treatment planning if the HLUTs were generated using the tissue‐equivalent materials. In this study, the CBCT images of the Vero system from a complex inhomogeneity phantom can be applied for the TPS dose calculation if the system is calibrated using tissue‐equivalent materials scanned at high tube voltage (i.e., 120 kV).PACS number(s): 87.55.de, 87.56.Fc, 87.57.qp
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