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Detector system dose verification comparisons for arc therapy: couch vs. gantry mount.

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Summary

A couch set detector system is more reliable for quality assurance (QA) testing of multileaf collimator (MLC) positional errors in volumetric-modulated arc therapy (VMAT). This system accurately detects dose variations up to 12.7% in head and neck cases, unlike gantry-mounted systems.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Quality Assurance

Background:

  • Volumetric-modulated arc therapy (VMAT) requires precise delivery of radiation dose.
  • Multileaf collimator (MLC) positional errors can significantly impact dose accuracy.
  • Assessing the performance of different detector systems for MLC positional error testing is crucial for patient safety.

Purpose of the Study:

  • To evaluate the performance of gantry-mounted and couch set detector systems.
  • To assess the impact of a systematic 1 mm MLC positional error on VMAT plans.
  • To determine the most reliable patient-specific quality assurance (QA) system for MLC position error testing.

Main Methods:

  • Four head and neck and esophagus VMAT plans were evaluated.
  • A 1 mm systematic MLC positional error was introduced in the left leaf bank.
  • Measurements were performed using an electronic portal imaging device (EPID) and an ion chamber array for both static and gantry motion scenarios.

Main Results:

  • The couch set detector system (chamber array) demonstrated higher accuracy compared to the EPID.
  • Mean planar dose differences were 5.2% (chamber array, gantry motion), 8.12% (chamber array, static gantry), and 10.9% (EPID, gantry motion).
  • The EPID showed less accuracy due to overresponse to MLC positional errors, especially in the left leaf bank.

Conclusions:

  • A couch set detector system is recommended as the most reliable patient-specific QA system for MLC position error testing.
  • MLC positional errors, even within clinically acceptable limits (1 mm), can lead to significant dose variations (up to 12.7%) in VMAT delivery.
  • Accurate QA is essential to mitigate dose errors in VMAT for head and neck and esophagus treatments.