Verification of the Delivered Patient Radiation Dose for Non-coplanar Beam Therapy

Overview

Journal J Appl Clin Med Phys

Specialties Biophysics
General Medicine

Date 2021 May 22

PMID 34021713

Authors

Ivan Kutuzov

Timothy Van Beek

Boyd M C McCurdy

Affiliations

Soon will be listed here.

Abstract

Purpose: There is an increased interest in using non-coplanar beams for radiotherapy, including SBRT and SRS. This approach can significantly reduce doses to organs-at-risk, however, it requires stringent quality assurance, especially when a dynamic treatment couch is used. In this work, new functionality that allows using non-coplanar beam arrangements in addition to conventional coplanar beams was added and validated to the previously developed in vivo dose verification system.

Methods: The existing program code was modified to manage the additional treatment couch parameters: angle and positions. Ten non-coplanar test plans that use a static couch were created in the treatment planning system. Also, two plans that use a dynamic treatment couch were created and delivered using Varian Developer mode, since the treatment planning system does not support a dynamic couch. All non-coplanar test trajectories were delivered on a simple geometric phantom, using an Edge linear accelerator (Varian Medical Systems) with the megavoltage imager deployed and acquiring megavoltage transmission images that were used to calculate the delivered 3D dose distributions in the phantom with the updated dose calculation algorithm. The reconstructed dose distributions were compared using the 3D chi-comparison test with 2%/2mm tolerances to the corresponding reference dose distributions obtained from the treatment planning system.

Results: The chi-comparison test resulted in at least a 97.0% pass rate over the entire 3D volume for all tested trajectories. For static gantry, static couch non-coplanar fields, and non-coplanar arcs using dynamic couch the pass rates observed were at least 98%, while for the static couch, non-transverse coplanar arc fields, pass rates were at least 97%.

Conclusions: A model-based 3D dose calculation algorithm has been extended and validated for a variety of non-coplanar beam trajectories of different complexities. This system can potentially be applied for quality assurance of treatment delivery systems that use complex, non-coplanar beam arrangements.

Citing Articles

Benchmarking MapRT and first clinical experience: A novel solution for collision-free non-coplanar treatment planning.

Gonod M, Achag I, Farah J, Aubignac L, Bessieres I J Appl Clin Med Phys. 2025; 26(3):e14572.

PMID: 39907187 PMC: 11905235. DOI: 10.1002/acm2.14572.

Long-term performance monitoring of a-Si 1200 electronic portal imaging device for dosimetric applications.

Kutuzov I, Rivest R, VanUytven E, McCurdy B J Appl Clin Med Phys. 2024; 26(1):e14551.

PMID: 39374243 PMC: 11713653. DOI: 10.1002/acm2.14551.

References

Rwigema J, Nguyen D, Heron D, Chen A, Lee P, Wang P . 4π noncoplanar stereotactic body radiation therapy for head-and-neck cancer: potential to improve tumor control and late toxicity. Int J Radiat Oncol Biol Phys. 2014; 91(2):401-9. DOI: 10.1016/j.ijrobp.2014.09.043. View

Dong P, Lee P, Ruan D, Long T, Romeijn E, Yang Y . 4π non-coplanar liver SBRT: a novel delivery technique. Int J Radiat Oncol Biol Phys. 2012; 85(5):1360-6. DOI: 10.1016/j.ijrobp.2012.09.028. View

Fahimian B, Yu V, Horst K, Xing L, Hristov D . Trajectory modulated prone breast irradiation: a LINAC-based technique combining intensity modulated delivery and motion of the couch. Radiother Oncol. 2013; 109(3):475-81. DOI: 10.1016/j.radonc.2013.10.031. View

Smyth G, Evans P, Bamber J, Mandeville H, Welsh L, Saran F . Non-coplanar trajectories to improve organ at risk sparing in volumetric modulated arc therapy for primary brain tumors. Radiother Oncol. 2016; 121(1):124-131. DOI: 10.1016/j.radonc.2016.07.014. View

Bojechko C, Ford E . Quantifying the performance of in vivo portal dosimetry in detecting four types of treatment parameter variations. Med Phys. 2015; 42(12):6912-8. DOI: 10.1118/1.4935093. View

Alongi F, Fiorentino A, Gregucci F, Corradini S, Giaj-Levra N, Romano L . First experience and clinical results using a new non-coplanar mono-isocenter technique (HyperArc™) for Linac-based VMAT radiosurgery in brain metastases. J Cancer Res Clin Oncol. 2018; 145(1):193-200. DOI: 10.1007/s00432-018-2781-7. View

Vazquez Quino L, Chen X, Fitzpatrick M, Shi C, Stathakis S, Gutierrez A . Patient specific pre-treatment QA verification using an EPID approach. Technol Cancer Res Treat. 2013; 13(1):1-10. DOI: 10.7785/tcrt.2012.500351. View

Chytyk-Praznik K, VanUytven E, vanBeek T, Greer P, McCurdy B . Model-based prediction of portal dose images during patient treatment. Med Phys. 2013; 40(3):031713. DOI: 10.1118/1.4792203. View

Benedict S, Yenice K, Followill D, Galvin J, Hinson W, Kavanagh B . Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys. 2010; 37(8):4078-101. DOI: 10.1118/1.3438081. View

10.

Bresciani S, Poli M, Miranti A, Maggio A, Di Dia A, Bracco C . Comparison of two different EPID-based solutions performing pretreatment quality assurance: 2D portal dosimetry versus 3D forward projection method. Phys Med. 2018; 52:65-71. DOI: 10.1016/j.ejmp.2018.06.005. View

11.

McCowan P, Van Uytven E, Van Beek T, Asuni G, McCurdy B . An in vivo dose verification method for SBRT-VMAT delivery using the EPID. Med Phys. 2015; 42(12):6955-63. DOI: 10.1118/1.4935201. View

12.

Podgorsak E, Olivier A, Pla M, Lefebvre P, Hazel J . Dynamic stereotactic radiosurgery. Int J Radiat Oncol Biol Phys. 1988; 14(1):115-26. DOI: 10.1016/0360-3016(88)90059-4. View

13.

Dong P, Lee P, Ruan D, Long T, Romeijn E, Low D . 4π noncoplanar stereotactic body radiation therapy for centrally located or larger lung tumors. Int J Radiat Oncol Biol Phys. 2013; 86(3):407-13. DOI: 10.1016/j.ijrobp.2013.02.002. View

14.

Ahnesjo A . Collapsed cone convolution of radiant energy for photon dose calculation in heterogeneous media. Med Phys. 1989; 16(4):577-92. DOI: 10.1118/1.596360. View

15.

Bakai A, Alber M, Nusslin F . A revision of the gamma-evaluation concept for the comparison of dose distributions. Phys Med Biol. 2003; 48(21):3543-53. DOI: 10.1088/0031-9155/48/21/006. View

16.

Olaciregui-Ruiz I, Rozendaal R, van Oers R, Mijnheer B, Mans A . Virtual patient 3D dose reconstruction using in air EPID measurements and a back-projection algorithm for IMRT and VMAT treatments. Phys Med. 2017; 37:49-57. DOI: 10.1016/j.ejmp.2017.04.016. View

17.

Bojechko C, Phillps M, Kalet A, Ford E . A quantification of the effectiveness of EPID dosimetry and software-based plan verification systems in detecting incidents in radiotherapy. Med Phys. 2015; 42(9):5363-9. DOI: 10.1118/1.4928601. View

18.

Smyth G, Bamber J, Evans P, Bedford J . Trajectory optimization for dynamic couch rotation during volumetric modulated arc radiotherapy. Phys Med Biol. 2013; 58(22):8163-77. DOI: 10.1088/0031-9155/58/22/8163. View

19.

Popescu C, Beckham W, Patenaude V, Olivotto I, Vlachaki M . Simultaneous couch and gantry dynamic arc rotation (CG-Darc) in the treatment of breast cancer with accelerated partial breast irradiation (APBI): a feasibility study. J Appl Clin Med Phys. 2013; 14(1):4035. PMC: 5713922. DOI: 10.1120/jacmp.v14i1.4035. View

20.

Yang Y, Zhang P, Happersett L, Xiong J, Yang J, Chan M . Choreographing couch and collimator in volumetric modulated arc therapy. Int J Radiat Oncol Biol Phys. 2011; 80(4):1238-47. DOI: 10.1016/j.ijrobp.2010.10.016. View