Estimating dose delivery accuracy in stereotactic body radiation therapy: A review of in-vivo measurement methods

Esposito, Marco; Villaggi, E.; Bresciani, S.; Cilla, Savino; Falco, M.D.; Garibaldi, Cristina; Russo, S.; Talamonti, Cinzia; Stasi, M.; Mancosu, P.

doi:10.1016/j.radonc.2020.05.014

Cited by 41 publications

(37 citation statements)

References 112 publications

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“…In order to prevent future misinterpretations, a concise definition of IVD in the scope of EBRT is provided in the Methods section. According to this definition, point detectors placed on the patient's skin in the treatment field such as thermoluminescent detectors, silicon diodes, metal-oxide semiconductor field-effect transistors, optically stimulated luminescence dosimeters, and electronic portal imaging devices (EPIDs) [4,5] are the main commercially available IVD methods. Due to the limitations of point detectors for large-scale implementation of IVD in modern EBRT, the emphasis of this report lies on EPID-based IVD (EIVD) systems.…”

Section: Introductionmentioning

confidence: 99%

In vivo dosimetry in external beam photon radiotherapy: Requirements and future directions for research, development, and clinical practice

Olaciregui-Ruiz

Beddar

Greer

et al. 2020

Physics and Imaging in Radiation Oncology

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External beam radiotherapy with photon beams is a highly accurate treatment modality, but requires extensive quality assurance programs to confirm that radiation therapy will be or was administered appropriately. In vivo dosimetry (IVD) is an essential element of modern radiation therapy because it provides the ability to catch treatment delivery errors, assist in treatment adaptation, and record the actual dose delivered to the patient. However, for various reasons, its clinical implementation has been slow and limited. The purpose of this report is to stimulate the wider use of IVD for external beam radiotherapy, and in particular of systems using electronic portal imaging devices (EPIDs). After documenting the current IVD methods, this report provides detailed software, hardware and system requirements for in vivo EPID dosimetry systems in order to help in bridging the current vendor-user gap. The report also outlines directions for further development and research. In vivo EPID dosimetry vendors, in collaboration with users across multiple institutions, are requested to improve the understanding and reduce the uncertainties of the system and to help in the determination of optimal action limits for error detection. Finally, the report recommends that automation of all aspects of IVD is needed to help facilitate clinical adoption, including automation of image acquisition, analysis, result interpretation, and reporting/documentation. With the guidance of this report, it is hoped that widespread clinical use of IVD will be significantly accelerated.

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Section: Introductionmentioning

confidence: 99%

In vivo dosimetry in external beam photon radiotherapy: Requirements and future directions for research, development, and clinical practice

Olaciregui-Ruiz

Beddar

Greer

et al. 2020

Physics and Imaging in Radiation Oncology

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“…Esposito et al 20 performed the IQM that is a useful in vivo dosimetry tool with the strengths of real-time monitoring of linac status and can monitor all fractions. The differences in surface and build-up dose, PDD 20,10 , PDD curves, and crossline/inline profiles, and attenuation of the IQM for 6-and 10-MV X-ray beams with and without the IQM were relatively similar to the findings published in previous papers.…”

Section: C | the Effect Of Iqm On The Crossline And Inline Profilesmentioning

confidence: 99%

“…[9][10][11][12][13][14][15][16][17][18][19] The point dosimeters and EPID are sensitive to linac and patient errors. 20 Transmission detectors monitor linac performance with high sensitivity in real time. 20 Linac log file analysis is sensitive to plan corruption errors.…”

Section: Introductionmentioning

confidence: 99%

“…20 Linac log file analysis is sensitive to plan corruption errors. 20 Dose accumulation methods are used to evaluate intrafraction movements and the multileaf collimator (MLC) tracking systems. 20 A type of new transmission detector called an integral quality monitor (IQM) has been commercialized by iRT Systems GmbH, Koblenz, Germany.…”

Section: Introductionmentioning

confidence: 99%

“…20 Dose accumulation methods are used to evaluate intrafraction movements and the multileaf collimator (MLC) tracking systems. 20 A type of new transmission detector called an integral quality monitor (IQM) has been commercialized by iRT Systems GmbH, Koblenz, Germany. The IQM is mounted on a linear accelerator (linac) gantry head and uses an independent system monitor to provide on-line beam monitoring that can detect treatment delivery errors that exceed an acceptance level.…”

Section: Introductionmentioning

confidence: 99%

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Effect of an integral quality monitor on 4‐, 6‐, 10‐MV, and 6‐MV flattening filter‐free photon beams

Nguyen

Yokoyama

Kojima

et al. 2020

J Applied Clin Med Phys

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PurposeTo investigate the effect of an integral quality monitor (IQM; iRT Systems GmbH, Koblenz, Germany) on 4, 6, 10, and 6‐MV flattening filter‐free (FFF) photon beams.MethodsWe assessed surface dose, PDD20,10, TPR20,10, PDD curves, inline and crossline profiles, transmission factor, and output factor with and without the IQM. PDD, transmission factor, and output factor were measured for square fields of 3, 5, 10, 15, 20, 25, and 30 cm and profiles were performed for square fields of 3, 5, 10, 20, and 30 cm at 5‐, 10‐, and 30‐cm depth.ResultsThe differences in surface dose of all energies for square fields of 3, 5, 10, 15, 20, and 25 cm were within 3.7% whereas for a square field of 30 cm, they were 4.6%, 6.8%, 6.7%, and 8.7% for 4‐MV, 6‐MV, 6‐MV‐FFF, and 10‐MV, respectively. Differences in PDD20,10, TPR20,10, PDD, profiles, and output factors were within ±1%. Local and global gamma values (2%/2 mm) were below 1 for PDD beyond dmax and inline/crossline profiles in the central beam region, respectively. The gamma passing rates (10% threshold) for PDD curves and profiles were above 95% at 2%/2 mm. The transmission factors for 4‐MV, 6‐MV, 6‐MV‐FFF, and 10‐MV for field sizes from 3 × 3 to 30 × 30 cm2 were 0.926–0.933, 0.937–0.941, 0.937–0.939, and 0.949–0.953, respectively.ConclusionsThe influence of the IQM on the beam quality (in particular 4‐MV X‐ray has not verified before) was tested and introduced a slight beam perturbation at the surface and build‐up region and the edge of the crossline/inline profiles. To use IQM in pre‐ and intra‐treatment quality assurance, a tray factor should be put into treatment planning systems for the dose calculation for the 4‐, 6‐, 10‐, and 6‐MV flattening filter‐free photon beams to compensate the beam attenuation of the IQM detector.

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Deep learning‐based synthetic CT generation for MR‐only radiotherapy of prostate cancer patients with 0.35T MRI linear accelerator

Farjam

Nagar

Zhou

et al. 2021

J Applied Clin Med Phys

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Estimating dose delivery accuracy in stereotactic body radiation therapy: A review of in-vivo measurement methods

Cited by 41 publications

References 112 publications

In vivo dosimetry in external beam photon radiotherapy: Requirements and future directions for research, development, and clinical practice

In vivo dosimetry in external beam photon radiotherapy: Requirements and future directions for research, development, and clinical practice

Effect of an integral quality monitor on 4‐, 6‐, 10‐MV, and 6‐MV flattening filter‐free photon beams

Deep learning‐based synthetic CT generation for MR‐only radiotherapy of prostate cancer patients with 0.35T MRI linear accelerator

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