A multi-institutional initiative on patient-related quality assurance: Independent computational dose verification of fluence-modulated treatment techniques |
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| Institution: | 1. Department of Radiation Oncology, University Hospital Jena, Bachstraße 18, 07743, Jena, Germany;2. Department of Radiation Oncology, Helios Hospital Erfurt, Nordhäuser Straße 74, 99089, Erfurt, Germany;3. Department of Radiation Oncology, University Hospital Leipzig, Stephanstraße 9a, 04103, Leipzig, Germany;4. Department of Radiation Oncology, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany;5. Department of Radiation Oncology, University Hospital Halle, Ernst-Grube-Straße 40, 06120 Halle, Saale, Germany;6. Department of Radiation Oncology, SRH Hospital Gera, Straße des Friedens 122, 07548, Gera, Germany;7. Department of Radiation Oncology, SRH Central Hospital Suhl, Albert-Schweitzer-Straße 2, 98527, Suhl, Germany;8. Department of Radiation Oncology, Hospital of Chemnitz, Bürgerstraße 2, 09113, Chemnitz, Germany;9. MVZ Center for Radiation Oncology Halle GmbH, Niemeyerstraße 24, 06110 Halle, Saale, Germany;10. Department of Radiation Oncology, Community Hospital Dresden-Friedrichstadt, Friedrichstraße 41, 01067, Dresden, Germany;11. Department of Radiosurgery and High Precision Robotic Treatments, Cyberknife Center Mitteldeutschland, Nordhäuserstraße 74, 99089 Erfurt, Germany;1. UT Health Graduate School of Biomedical Sciences, Houston, Texas;2. IROC Houston Quality Assurance Center, Houston, Texas;3. Department of Radiation Physics, Houston, Texas;4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas;1. Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland;2. Ruprecht-Karls-Universität, Heidelberg, Deutschland;3. Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Deutschland;4. Carl von Ossietzky Universität, Oldenburg, Deutschland;5. Universitätsklinikum, Würzburg, Deutschland;6. Physikalisch-Technische Werkstätten (PTW), Freiburg, Deutschland;7. Technische Hochschule Mittelhessen, Gießen, Deutschland;1. Department of Chemical and Process Engineering, University of Surrey, Guildford, UK;2. Radiotherapy Physics, University College London Hospitals, London, UK;3. National Physical Laboratory, Teddington, UK;4. Department of Medical Physics and Biomedical Engineering, University College London, London, UK |
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| Abstract: | PurposeThis multi-institutional study investigates whether computational verification of fluence-modulated treatment plans using independent software with its own Strahlerkopfmodel is an appropriate method for patient-related quality assurance (PRQA) in the context of various combinations of linear accelerators (linacs), treatment techniques and treatment planning systems (TPS).Materials and methodsThe PRQA-software's (Mobius3D) recalculations of 9 institutions’ treatment plans were analyzed for a horseshoe-shaped planning target volume (PTV) inside a phantom. The recomputed dose distributions were compared to a) the dose distributions as calculated by all TPS's and b) the measured dose distributions, which were acquired using the same independent measuring system for all institutions. Furthermore, dose volume histograms were examined. The penumbra deviations and mean gamma values were quantified using Verisoft (PTW). Additionally, workflow requirements for computational verification were discussed.ResultsMobius3D is compatible with all examined TPSs, treatment techniques and linacs. The mean PTV dose differences (Mobius3D-TPS, <3.0%) and 3D gamma passing rates (>95.0%) led to a positive plan acceptance result in all cases. These results are similar to the outcome of the dosimetric measurements with one exception. The mean gamma values (<0.5) show a good agreement between Mobius3D and the TPS dose distributions.ConclusionUsing Mobius3D was proven to be an appropriate computational PRQA method for the tested combinations of linacs, treatment techniques and TPS's. The clinical use of Mobius3D has to be complemented with regular dosimetric measurements and thorough linac and TPS QA. Mobius3D's computational verification reduced measurement effort and personnel needs in comparison to dosimetric verifications. |
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| Keywords: | Computational dose verification Fluence-modulated Mobius3D Multi-institutional initiative |
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