Design and implementation of an anthropomorphic quality assurance phantom for intensity-modulated radiation therapy for the Radiation Therapy Oncology Group

Molineu, A.; Followill, David S; Balter, Peter A; Hanson, W. F.; Gillin, Michael; Huq, M. Saiful; Eisbruch, Avraham; Ibbott, Geoffrey S.

doi:10.1016/j.ijrobp.2005.05.021

Cited by 131 publications

(122 citation statements)

References 9 publications

Supporting

Mentioning

109

Contrasting

Order By: Relevance

“…Overall, 66% of the phantom irradiations analyzed by the RPC passed all credentialing criteria on their first attempt (16). One of the main reasons for this moderate pass rate is that the spine phantom was assigned more stringent dosimetric and targeting accuracy (±5%/3mm) than the RPC's other IMRT phantoms (±7%/4mm for head and neck and prostate, ±5%/5mm for lung), (14). Ultimately, the strict criteria of the credentialing phantom study provided institutions with an opportunity to become familiar with the protocol prescription, image-guidance and planning procedures, likely contributing to the success of the primary feasibility endpoint, despite the complexity of spine SRS.…”

Section: Discussionmentioning

confidence: 99%

“…The institution submitted their treatment planning data and dose distribution electronically to the RPC, where the measured dose distributions and the institution's calculated doses were compared. TLDs were read using the RPC's standard phantom reading method (14). The film was read with a densitometer.…”

Section: Quality Assurance and Protocol Compliance Criteriamentioning

confidence: 99%

See 1 more Smart Citation

RTOG 0631 Phase II/III Study of Image-guided Stereotactic Radiosurgery for Localized Spine Metastases: Phase II Results

Sungpil

James

Gerszten

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Purpose-The phase II component of RTOG 0631 assessed the feasibility and safety of spine radiosurgery (SRS) for localized spine metastases in a cooperative group setting.Materials and Methods-Patients with 1-3 spine metastasis with a Numerical Rating Pain Scale (NRPS) score ≥ 5 received 16 Gy single fraction SRS. The primary endpoint was SRS feasibility: image-guidance RT (IGRT) targeting accuracy ≤ 2mm, target volume coverage > 90% of prescription dose, maintaining spinal cord dose constraints (10 Gy to ≤ 10% of the cord volume from 5-6mm above to 5-6mm below the target or absolute spinal cord volume < 0.35cc) and other normal tissue dose constraints. A feasibility success rate < 70% was considered unacceptable for continuation of the phase III component. Based on the one-sample exact binomial test with α=0.10 Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (1-sided), 41 patients were required. Acute toxicity was assessed using the National Cancer Institute Common Toxicity Criteria for Adverse Events, version 3.0. NIH Public AccessResults-Sixty-five institutions were credentialed with spine phantom dosimetry and IGRT compliance. Forty-six patients were accrued, and 44 were eligible. There were 4 cervical, 21 thoracic and 19 lumbar sites. Median NRPS was 7 at presentation. Final pre-treatment rapid review was approved in 100%. Accuracy of image-guided SRS targeting was in compliance with the protocol in 95%. The target coverage and spinal cord dose constraint were in accordance with the protocol requirements in 100% and 97%. Overall compliance for other normal tissue constraints was per protocol in 74%. There were no cases of grade 4-5 acute treatment-related toxicity. Conclusion-The phase II results demonstrate the feasibility and accurate use of SRS to treat spinal metastases, with rigorous quality control, in a cooperative group setting. The planned RTOG 0631 phase III component will proceed to compare pain relief and quality of life between SRS and external beam radiotherapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Quality Assurance and Protocol Compliance Criteriamentioning

confidence: 99%

RTOG 0631 Phase II/III Study of Image-guided Stereotactic Radiosurgery for Localized Spine Metastases: Phase II Results

Sungpil

James

Gerszten

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

show abstract

“…This verification is traditionally based on manual monitor unit (MU) calculation methods for 3D conformal radiotherapy (3D CRT) treatments 3 , 4 , 5 , 6 , 7 . The complexity present in the modulated treatments requires an introduction of a comprehensive quality assurance program aimed at its implementation (8) . Such QA routines must take into account two approaches.…”

Section: Introductionmentioning

confidence: 99%

Dosimetric validation and clinical implementation of two 3D dose verification systems for quality assurance in volumetric‐modulated arc therapy techniques

Clemente-Gutiérrez

Perez-Vara

2015

J Applied Clin Med Phys

View full text Add to dashboard Cite

A pretreatment quality assurance program for volumetric techniques should include redundant calculations and measurement‐based verifications. The patient‐specific quality assurance process must be based in clinically relevant metrics. The aim of this study was to show the commission, clinical implementation, and comparison of two systems that allow performing a 3D redundant dose calculation. In addition, one of them is capable of reconstructing the dose on patient anatomy from measurements taken with a 2D ion chamber array. Both systems were compared in terms of reference calibration data (absolute dose, output factors, percentage depth‐dose curves, and profiles). Results were in good agreement for absolute dose values (discrepancies were below 0.5%) and output factors (mean differences were below 1%). Maximum mean discrepancies were located between 10 and 20 cm of depth for PDDs (‐2.7%) and in the penumbra region for profiles (mean DTA of 1.5 mm). Validation of the systems was performed by comparing point‐dose measurements with values obtained by the two systems for static, dynamic fields from AAPM TG‐119 report, and 12 real VMAT plans for different anatomical sites (differences better than 1.2%). Comparisons between measurements taken with a 2D ion chamber array and results obtained by both systems for real VMAT plans were also performed (mean global gamma passing rates better than 87.0% and 97.9% for the 2%/2 mm and 3%/3 mm criteria). Clinical implementation of the systems was evaluated by comparing dose‐volume parameters for all TG‐119 tests and real VMAT plans with TPS values (mean differences were below 1%). In addition, comparisons between dose distributions calculated by TPS and those extracted by the two systems for real VMAT plans were also performed (mean global gamma passing rates better than 86.0% and 93.0% for the 2%/2 mm and 3%/3 mm criteria). The clinical use of both systems was successfully evaluated.PACS numbers: 87.56.Fc, 87.56.‐v, 87.55.dk, 87.55.Qr, 87.55.‐x, 07.57.Kp, 85.25.Pb

show abstract

“…AAPM TG 119 recommend the DD/DTA passing criteria of 90% for 3%/3 mm and ESTRO study proposed criteria of 4%/3 mm with 95% passing criteria [11][12]. Many pilot studies suggested different criteria for DD/DTA parameter [17][18], however recommendations and reports for interpretation of gamma passing rate are scarce until now and these criteria remain empirically determined [17]. International Commission of Radiation Units and Measurements ICRU recommend less stringent γ score of 5%/5 mm criteria [19], however there is no general consensus.…”

Section: Methodsmentioning

confidence: 99%

Interpretation of Gamma Index for Quality Assurance of Simultaneously Integrated Boost (SIB) IMRT Plans for Head and Neck Carcinoma

Atiq

Iqbal

et al. 2017

Polish Journal of Medical Physics and Engineering

View full text Add to dashboard Cite

Objective: The Gamma Index is prerequisite to estimate point-by-point difference between measured and calculated dose distribution in terms of both Distance to Agreement (DTA) and Dose Difference (DD). This study aims to inquire what percentage of pixels passing a certain criteria assure a good quality plan and suggest gamma index as efficient mechanism for dose verification of Simultaneous Integrated Boost Intensity Modulated Radiotherapy plans. Method: In this study, dose was calculated for 14 head and neck patients and IMRT Quality Assurance was performed with portal dosimetry using the Eclipse treatment planning system. Eclipse software has a Gamma analysis function to compare measured and calculated dose distribution. Plans of this study were deemed acceptable when passing rate was 95% using tolerance for Distance to agreement (DTA) as 3mm and Dose Difference (DD) as 5%. Result and Conclusion: Thirteen cases pass tolerance criteria of 95% set by our institution. Confidence Limit for DD is 9.3% and for gamma criteria our local CL came out to be 2.0% (i.e., 98.0% passing). Lack of correlation was found between DD and γ passing rate with R 2 of 0.0509. Our findings underline the importance of gamma analysis method to predict the quality of dose calculation. Passing rate of 95% is achieved in 93% of cases which is adequate level of accuracy for analyzed plans thus assuring the robustness of SIB IMRT treatment technique. This study can be extended to investigate gamma criteria of 5%/3mm for different tumor localities and to explore confidence limit on target volumes of small extent and simple geometry.

show abstract

Design and implementation of an anthropomorphic quality assurance phantom for intensity-modulated radiation therapy for the Radiation Therapy Oncology Group

Cited by 131 publications

References 9 publications

RTOG 0631 Phase II/III Study of Image-guided Stereotactic Radiosurgery for Localized Spine Metastases: Phase II Results

RTOG 0631 Phase II/III Study of Image-guided Stereotactic Radiosurgery for Localized Spine Metastases: Phase II Results

Dosimetric validation and clinical implementation of two 3D dose verification systems for quality assurance in volumetric‐modulated arc therapy techniques

Interpretation of Gamma Index for Quality Assurance of Simultaneously Integrated Boost (SIB) IMRT Plans for Head and Neck Carcinoma

Contact Info

Product

Resources

About