A distance to dose difference tool for estimating the required spatial accuracy of a displacement vector field

To introduce a tool, termed distance to dose difference (DTD), which estimates the required spatial accuracy of displacement vector fields (DVFs) used for mapping four dimensional dose values.

Dose mapping maps dose values from an irradiated geometry to a reference geometry. DVF errors result in dose being mapped from the wrong spatial location in the irradiated geometry, with a dose error equal to the dose difference between the error-free and sampled spatial locations. The DTD, defined as the distance to observe a given dose difference in the irradiated geometry, quantifies the permitted DVF error to ensure a prespecified desired dose mapping accuracy is achieved. To demonstrate the DTD, a treatment plan is generated with a 5 mm internal target volume-to-planning target volume margin for an intensity modulated radiation therapy lung patient. The DTD is evaluated for mapping dose from the end of inhale image with a dose error tolerance of 3.30 Gy, which equals 5% of the 66 Gy prescription dose. The DTD is loaded into the treatment planning system to visualize positional dependencies of permissible DVF errors overlaid on the patient's anatomy and DTD-volume-histograms are generated.

DTD values vary with location in the patient anatomy. For the test case, DTD analysis indicates that accurate DVFs (approximately 1 mm) are required in high dose gradient regions while large DVF errors (>20 mm) are acceptable in low dose gradient regions. Within the clinical target volume (CTV), tolerated DVF uncertainties range from 1 to 12 mm, depending on location. Ninety percent of the CTV volume had DTD values less than 4 mm.

The DVF spatial accuracy required to meet a dose mapping accuracy tolerance depends on the spatial location within the dose distribution. For dose mapping, DVFs accuracy must be highest in dose gradient regions, while less accurate DVFs can be tolerated in uniform dose regions. The DTD tool provides a useful first estimate of DVF required spatial accuracy.