Purpose: To compare the sensitivity of ArcCHECK (AC), portal dosimetry (PD), and an in-house logfile-based system (LF) to multileaf collimators (MLC) aperture errors and the ability to identify these errors. Methods and Materials: For 12 retrospective original head and neck volumetric modulated arc therapy (VMAT) plans, MLC aperture errors of ± 0.4mm, ± 1.2mm, ± 2mm, and ± 3mm were introduced for each plan, resulting in 96 plans with errors. AC, PD, and LF were used for the gamma evaluation at 3%/3mm, 3%/2mm, and 2%/2mm criteria. Gradient analysis was used to evaluate the sensitivity to MLC aperture errors. The area under the curve (AUC) obtained from the receiver operating characteristic (ROC) curve was used to evaluate the ability to identify MLC aperture errors and dose errors, and the optimal cut-off value to identify the error was obtained. Results: The gamma pass rate (%GP) of LF had the smallest descent gradient as the MLC error increases in any case. The descent gradient of PD was larger than AC, except for the case at the 2%/2mm criteria. For the 3%/3mm criteria, the MLC aperture errors that can be perfectly identified by AC, PD, and LF were ± 3mm, ± 2mm, and ± 1.2mm, respectively, and the average percent dose error (%DEs) of dose metrics in targets that can be perfectly identified were 4% to 5%, 3% to 4%, and 2% to 3%, respectively. For the 3%/2mm criteria, the errors that AC, PD, and LF can perfectly identify were the same as the 3%/3mm criteria. For the 2%/2mm criteria, AC can perfectly identify the MLC error of ± 2mm and the %DE of 3% to 4%. PD and LF can identify the MLC error of ± 1.2mm and the %DE of 2% to 3%. Conclusion: Different patient-specific quality assurance (PSQA) systems have different sensitivity and recognition abilities to MLC aperture errors. Institutions should formulate their own customized %GP limits based on their PSQA process through ROC or other methods.
Purpose The aim of this study is to investigate an implementation method and the results of a voxel-based self-adaptive prescription dose optimization algorithm for intensity-modulated radiotherapy. Materials and methods The self-adaptive prescription dose optimization algorithm used a quadratic objective function, and the optimization engine was implemented using the molecular dynamics. In the iterative optimization process, the optimization prescription dose changed with the relationship between the initial prescription dose and the calculated dose. If the calculated dose satisfied the initial prescription dose, the optimization prescription dose was equal to the calculated dose; otherwise, the optimization prescription dose was equal to the initial prescription dose. We assessed the performance of the self-adaptive prescription dose optimization algorithm with two cases: a mock head and neck case and a breast case. Isodose lines, dose–volume histogram, and dosimetric parameters were compared between the conventional molecular dynamics optimization algorithm and the self-adaptive prescription dose optimization algorithm. Results The self-adaptive prescription dose optimization algorithm produces the different optimization results compared with the conventional molecular dynamics optimization algorithm. For the mock head and neck case, the planning target volume (PTV) dose uniformity improves, and the dose to organs at risk is reduced, ranging from 1 to 4%. For the breast case, the use of self-adaptive prescription dose optimization algorithm also leads to improvements in the dose distribution, with the dose to organs at risk almost unchanged. Conclusion The self-adaptive prescription dose optimization algorithm can generate an ideal clinical plan more effectively, and it could be integrated into a treatment planning system after more cases are studied.
By investigating the influence of initial electrons on dosimetric characteristics, reasonable incident electron parameters for the nominal 6 MV photon beam of the XHA600D accelerator are finally established, i.e., a 6 MeV monoenergetic electron beam with a radial intensity FWHM of 2.5 mm and an angular divergency of 0.15°. Based on reasonable initial parameters, Percentage Depth Doses (PDDs), Off-Axis Ratios (OARs), total scatter factors, beam qualities, and penumbra widths of both flatteningfilter (FF) and flattening-filter-free (FFF) beams for fields ranging from 4 × 4 to 30 × 30 cm2 are simulated systematically with EGSnrc codes. Not only the simulated dosimetric properties are in excellent agreement with the measurements, but also the dosimetric discrepancies between FF and FFF beams are consistent with the laws of previous studies on other accelerators. Therefore, reasonable incident electron parameters are able to accurately verify the performance of the XHA600D accelerator and can be used for further dosimetry research.
Hybrid pencil beam model (HPBM) based on photon characteristic line algorithm has been presented to get accurate three-dimensional (3D) dose distribution for lung radiotherapy in small fields. In the model, we introduced a scattering factor to accurately describe the transport behavior of scattered photons and secondary electrons, combined with the equivalent depth correction and the weighted density correction. The pencil beam kernels of heterogeneous lung phantoms were redefined by the scattering factor and depth dose for a reference field by photon characteristic line algorithm. Subsequently, the 3D dose distribution in lung phantoms with density of 0.1, 0.26, and 0.4 g/cm3, was calculated by the Finite-size pencil beam algorithm in five regular fields and an irregular field for 6 MV photon beam. The dose distributions obtained by the HPBM are in agreement with those obtained by the MC simulations, with a relative error of less than 3% in most of the cases. However, there are apparent discrepancies at media interfaces and lung anterior portion. Moreover, at media interfaces, relative dose errors of the two methods decrease with the increase in field size and lung density. The depth range in which relative errors is greater than 3% increases with the increase in field size at lung anterior portion. In these examples, maximum relative errors are between 5 and 29%. Nevertheless, it is shown that the HPBM based on photon characteristic line algorithm has potential research values in lung dose calculation under conditions of small fields.
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