A retrospective analysis for patient-specific quality assurance of volumetric-modulated arc therapy plans

Beam complexity and monitor unit efficiency comparison in two different volumetric modulated arc therapy delivery using automated planning

“…Crowe et al [28] found that the 'small aperture score' provided threshold values which successfully distinguished deliverable treatment plans from plans that did not pass QA using MapCheck2 diode array. Li et al [29] found that the planning parameters such as the average leaf travel and average field indicating a correlation between the plan complexity and the passing rate using ArcCHECK diode array. Dhanabalan et al [20] studied the correlation results between the MCS and gamma analysis results indicate that MCS of a plan has a weak correlation with the planar as well as volumetric gamma analysis passing rates using Octavius4D phantom.…”

Beam complexity and monitor unit efficiency comparison in two different volumetric modulated arc therapy delivery using automated planning

“…Crowe et al [23] found that the 'small aperture score' provided threshold values which successfully distinguished deliverable treatment plans from plans that did not pass QA using MapCheck2 diode array. Li et al [24] found that the planning parameters such as the average leaf travel and average field indicating a correlation between the plan complexity and the passing rate using ArcCHECK diode array. Dhanabalan et al [21] studied the correlation results between the MCS and gamma analysis results indicate that MCS of a plan has a weak correlation with the planar as well as volumetric gamma analysis passing rates using Octavius4D phantom.…”

Quantified VMAT plan complexity in relation to measurement‐based quality assurance results

“…The degree of complexity of VMAT treatment plans was evaluated using previously established complexity metrics 3–6,8–12 . Metrics were selected from those reported to have statistically significant correlations to quality assurance results in previous works, with an emphasis on those describing MLC behavior of the treatment.…”

“…This metric was adapted from McNiven et al’s definition, 7 originally intended for IMRT. Average field width in cm, calculated as the average gap between leaf pairs of a given control point. Average field width per control point is then weighted by the MU to be delivered at each control point 8 Small aperture score (SAS), defined as the proportion of a plan delivered using small apertures, with a fixed range from 0 to 1.…”

“…An increased modulation often leads to increased uncertainty in dose because of the limitations of accurately modeling linac components such as MLC tongue and groove which affects the interleaf leakage, and leaf offset between the calculated rounded leaf tip value and the measured one. Generally, higher degrees of modulation suggest more complex treatments, and consequently increased uncertainty in delivery 3–12 …”