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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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Establishing an optimized patient-specific verification program for volumetric modulated arc therapy.

Alfredo Serna¹, Fernando Mata, Vicente Puchades

¹Department of Medical Physics, Hospital Universitario Santa Lucía, Cartagena, Spain. alfredo.serna@carm.es

Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists

|April 2, 2013

Summary

Efficient volumetric modulated arc therapy (VMAT) quality assurance (QA) was established by comparing four methods. Electronic portal dosimetry (EPID) 2D analysis and independent dose calculation offer the best balance of accuracy and efficiency for VMAT QA.

Keywords:

Electronic portal dosimetry Independent dose calculation Ion chamber array Pretreatment quality assurance Volumetric modulated arc therapy

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Area of Science:

Medical Physics
Radiation Oncology

Background:

Volumetric Modulated Arc Therapy (VMAT) is a complex radiation therapy technique.
Quality Assurance (QA) is crucial for VMAT but can be time-consuming.
Optimizing VMAT QA protocols is essential to reduce workload without compromising patient safety.

Purpose of the Study:

To compare the efficiency and accuracy of four different pretreatment verification methods for VMAT.
To establish an optimized VMAT QA protocol balancing accuracy, safety, and workload.
To identify the most efficient methods for VMAT quality assurance.

Main Methods:

Four VMAT QA methods were evaluated: ion chamber array (PTW729), electronic portal dosimetry (EPID), ion chamber measurements, and independent dose calculation (Diamond program).
Pretreatment verifications were performed on 40 VMAT patient plans.
Gamma analysis (3mm/3%) was used for 2D evaluations, and time efficiency was measured by linac occupancy.

Main Results:

Electronic portal dosimetry (EPID) and independent dose calculation (Diamond) were found to be the most time-efficient QA methods.
PTW729 required an average of 43.5 minutes (26.5 min linac time), EPID 14.5 minutes (2.5 min linac time), ion chamber 34.5 minutes (26.5 min linac time), and Diamond 12.0 minutes (0 min linac time).
All methods yielded consistent results, supporting the reliability of the chosen optimized protocol.

Conclusions:

An optimized VMAT QA protocol was established using EPID 2D analysis and independent dose calculation.
This optimized protocol effectively balances treatment accuracy, safety, and reduced workload.
The findings support the adoption of EPID and independent dose calculation for efficient VMAT quality assurance.