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Technical note: TROG 15.01 SPARK trial multi-institutional imaging dose measurement.

Kimberley Legge1, Peter B Greer1,2, Paul J Keall3

  • 1School of Mathematical and Physical Sciences, University of Newcastle, Callaghan, New South Wales, Australia.

Journal of Applied Clinical Medical Physics
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PubMed
Summary

Kilovoltage Intrafraction Monitoring (KIM) enhances prostate radiation therapy accuracy and enables hypofractionation. The additional imaging dose from KIM is minimal, representing at most 1.3% of the prescribed treatment dose.

Keywords:
dose intercomparisondose measurementintrafraction motion monitoringkilovoltage imaging dose

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Radiotherapy Technology

Background:

  • The Trans-Tasman Radiation Oncology Group (TROG) 15.01 SPARK trial investigates adaptive radiotherapy for prostate cancer.
  • Kilovoltage Intrafraction Monitoring (KIM) improves treatment accuracy by tracking prostate position during radiation delivery.
  • KIM facilitates hypofractionation but introduces additional imaging dose.

Purpose of the Study:

  • To standardize and determine the imaging dose per frame delivered by KIM during prostate radiation therapy.
  • To assess the feasibility and safety of KIM across multiple centers and linear accelerator types.

Main Methods:

  • Dose per frame was measured in air at isocenter using an ion chamber across four radiation therapy centers.
  • Measurements were performed on Varian (Clinac iX, Trilogy, Truebeam) and Elekta Synergy linear accelerators.
  • Imaging parameters included specific kV, mA, and ms settings, with absorbed doses estimated per IPEMB protocol.

Main Results:

  • The average dose per kilovoltage (kV) frame to the skin was 0.24 ± 0.03 mGy.
  • Estimated average absorbed doses to the prostate varied with imaging frequency: 39.9 ± 2.6 mGy (1 Hz), 199.7 ± 13.2 mGy (5 Hz), and 439.3 ± 29.0 mGy (11 Hz).
  • All measured machines showed agreement within 20%.

Conclusions:

  • The additional dose to the prostate from using KIM is minimal, not exceeding 1.3% of the prescribed 36.25 Gy dose over five fractions.
  • KIM is a viable and safe technology for enhancing prostate radiation therapy accuracy and enabling hypofractionation.