Multi-institution validation of a new high spatial resolution diode array for SRS and SBRT plan pretreatment quality assurance.

PURPOSE: The SRS MapCHECK® , a recently developed patient-specific quality assurance (PSQA) tool for end-to-end testing of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT), was evaluated in a multi-institution study and compared with radiochromic film. METHODS: The SRS MapCHECK was used to collect data on 84 SBRT or SRS PSQA plans/fields at nine institutions on treatment delivery devices (TDD) manufactured by Varian and Elekta. PSQA plans from five different treatment planning software (TPS) were selected and executed on TDDs operating at beam energies of 6 and 10 MV with and without a flattening filter. The patient plans were all VMAT except for ten conformal arc therapy fields. The plans were selected to encompass a range of size and tumor sites including brain, lung, spine, abdomen, ear, pancreas, and liver. Corresponding radiochromic film data was acquired in 50 plans/fields. Results were evaluated using gamma analysis with absolute dose criterion of 3% global dose-difference (DD) and 1 mm distance-to-agreement (DTA). RESULTS: The mean 3% DD/1 mm DTA Gamma pass rate of SRS MapCHECK in comparison to film was 95.9%, whereas comparison of SRS MapCHECK to the treatment planning software was 94.7%. 80% of SRS MapCHECK comparisons against film exceed 95% pass rate, and about 30% of SRS MapCHECK comparisons against film exceed 99% pass rate. To maintain good agreement between SRS MapCHECK and film or TPS, authors recommend avoiding plans with a modified modulation complexity score (MMCS) <0.1 arbitrary units (a.u.). In the examples presented, this coincides with avoiding plans with a mu/dose limit of >3 µ/cGy. CONCLUSIONS: Stereotactic radiosurgery MapCHECK has been validated for PSQA for a variety of clinical SRS/SBRT plans in a wide range of treatment delivery conditions. The SRS MapCHECK comparison with film demonstrates near-equivalence for analysis of patient-specific QA deliveries comprised of small field measurements.

Assessment of the setup dependence of detector response functions for mega-voltage linear accelerators.

PURPOSE: Accurate modeling of beam profiles is important for precise treatment planning dosimetry. Calculated beam profiles need to precisely replicate profiles measured during machine commissioning. Finite detector size introduces perturbations into the measured profiles, which, in turn, impact the resulting modeled profiles. The authors investigate a method for extracting the unperturbed beam profiles from those measured during linear accelerator commissioning. METHODS: In-plane and cross-plane data were collected for an Elekta Synergy linac at 6 MV using ionization chambers of volume 0.01, 0.04, 0.13, and 0.65 cm3 and a diode of surface area 0.64 mm2. The detectors were orientated with the stem perpendicular to the beam and pointing away from the gantry. Profiles were measured for a 10 x 10 cm2 field at depths ranging from 0.8 to 25.0 cm and SSDs from 90 to 110 cm. Shaping parameters of a Gaussian response function were obtained relative to the Edge detector. The Gaussian function was deconvolved from the measured ionization chamber data. The Edge detector profile was taken as an approximation to the true profile, to which deconvolved data were compared. Data were also collected with CC13 and Edge detectors for additional fields and energies on an Elekta Synergy, Varian Trilogy, and Siemens Oncor linear accelerator and response functions obtained. Response functions were compared as a function of depth, SSD, and detector scan direction. Variations in the shaping parameter were introduced and the effect on the resulting deconvolution profiles assessed. RESULTS: Up to 10% setup dependence in the Gaussian shaping parameter occurred, for each detector for a particular plane. This translated to less than a +/- 0.7 mm variation in the 80%-20% penumbral width. For large volume ionization chambers such as the FC65 Farmer type, where the cavity length to diameter ratio is far from 1, the scan direction produced up to a 40% difference in the shaping parameter between in-plane and cross-plane measurements. This is primarily due to the directional difference in penumbral width measured by the FC65 chamber, which can more than double in profiles obtained with the detector stem parallel compared to perpendicular to the scan direction. For the more symmetric CC13 chamber the variation was only 3% between in-plane and cross-plane measurements. CONCLUSIONS: The authors have shown that the detector response varies with detector type, depth, SSD, and detector scan direction. In-plane vs. cross-plane scanning can require calculation of a direction dependent response function. The effect of a 10% overall variation in the response function, for an ionization chamber, translates to a small deviation in the penumbra from that of the Edge detector measured profile when deconvolved. Due to the uncertainties introduced by deconvolution the Edge detector would be preferable in obtaining an approximation of the true profile, particularly for field sizes where the energy dependence of the diode can be neglected. However, an averaged response function could be utilized to provide a good approximation of the true profile for large ionization chambers and for larger fields for which diode detectors are not recommended.

A rapid communication from the AAPM Task Group 201: recommendations for the QA of external beam radiotherapy data transfer. AAPM TG 201: quality assurance of external beam radiotherapy data transfer.

The transfer of radiation therapy data among the various subsystems required for external beam treatments is subject to error. Hence, the establishment and management of a data transfer quality assurance program is strongly recommended. It should cover the QA of data transfers of patient specific treatments, imaging data, manually handled data and historical treatment records. QA of the database state (logical consistency and information integrity) is also addressed to ensure that accurate data are transferred.