To investigate the patient-specific dose verification method using ArcCHECK for total marrow irradiation (TMI) with Volumetric Modulated Arc Therapy (VMAT) and Helical Tomotherapy (HT). The kVCT images collected from 8 patients were respectively designed for RapidArc and Tomotherapy plans in total marrow irradiation. ArcCHECK was used for dose verification for the head-neck, chest-abdomen and pelvic. The merging function of ArcCHECK was used in VMAT and the method of double plans (reference and delivery plans) were used in HT. The γ-analysis passing rates for the head-neck, chest-abdomen, pelvic were 98.9% ± 1.9%, 98.4% ± 1.8%, 97.4% ± 2.1% for VMAT plans and 94.3% ± 1.5%, 96.5 ± 1.2%, 94.1% ± 1.9% for HT plans. The results show that using the merging function of ArcCHECK can achieve the dose verification well for VMAT plans with TMI. The method of double plans was done for the dose verification of HT plans with TMI as well as the plans with the targets keeping away from the set-up center.
Bone Marrow ; radiation effects ; Humans ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated

Objective To study the difference of the constructed doses between electronic portal imaging device (EPID) and dynalogs files of linac for in vivo phantom dosimetry.Methods Twelve pelvic patients treated with volumetric modulated arc therapy (VMAT) plans were selected and the information of each plan was copied to theCheese phantom to recalculate the doses before delivered on Varian RapidArc Linac.TheCheese phantom was placed on the isocenter and the electronic portal image (EPI) formed by the EPID was sent to EPIgray software to reconstruct the actual delivered doses.Meanwhile,dynalogs files were respectively imported to the Mobius software to reconstruct the actual delivered doses too.The point dose in the center of each VMAT plan (the center of the effective sensitive volume of ionization chamber) was measured by the A1SL ionization chamber.At the same time,the dose of sensitive volume of ionization chamber from treatment planning systcm (TPS) was recorded.Results The relative deviation between the dose from TPS and the measurement results by the ionization chamber was 1.13％.The difference between the reconstructed doses of EPID-based or the dynalogs file-based with the measurement results by the ionization chamber was not statistically significant (P ＞ 0.05).Conclusions The two methods of dose reconstruction can provide reference for in vivo dosimetry of VMAT.

To investigate the dose effect of isocenter difference during IMRT dose verification with the 2D chamber array. The samples collected from 10 patients were respectively designed for IMRT plans, the isocenter of which was independently defined as P(o), P(x) and P(y). P(o) was fixed on the target center and the other points shifted 8cm from the target center in the orientation of x/y. The PTW729 was used for 2D dose verification in the 3 groups which beams of plans were set to 0 degrees. The γ-analysis passing rates for the whole plan and each beam were gotten using the different standards in the 3 groups, The results showed the mean passing rate of γ-analysis was highest in the P(o) group, and the mean passing rate of the whole plan was better than that of each beam. In addition, it became worse with the increase of dose leakage between the leaves in P(y) group. Therefore, the determination of isocenter has a visible effect for IMRT dose verification of the 2D chamber array, The isocenter of the planning design should be close to the geometric center of target.
Gamma Rays ; Humans ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated ; instrumentation ; methods

Objective To investigate the plan quality between two treatment planning systems (TPSs) for volumetric modulated arc therapy (VMAT). Methods VMAT plans based on Varian Eclipse and Philips Pinnacle TPS were designed for 10 cervical cancer patients (2, 3 Arcs) and 10 prostate cancer patients ( 1, 2 Arcs) . The delivery system of VMAT was Varian ClinaciX machine, and RapidArc was used. The treatment plan quality between the two TPSs was evaluated based on dose distribution, delivery efficiency, and parameter settings. The differences between the two TPSs were compared using paired t-test. Results For cervical cancer patients, the 2-Arc VMAT plans based on the Pinnacle was slightly better than those based on the Eclipse in terms of the conformal index ( CI) of planning target volume ( PTV) , rectum V30 and V40 , and bladder V30 and V40 , and the homogeneity index ( HI) of PTV and PTV1 as well as CI of PTV1 in the Eclips were slightly better than those in the Pinnacle( P<005) Pinnacle were slightly worse than those in the Eclipse ( P>005) . The number of monitor units with 2-Arcs and 3-Arcs plans of the Eclipse was significantly smaller than those in the Pinnacle (P<005). For prostate cancer patients, The 1-arc VMAT plans of the Pinnacle TPS were slightly superior to those of the Eclipse TPS in terms of the HI of PTV, rectumV30 and V40 , and bladderV30 and V40 , but the former was slight inferior to the latter in terms of the CI of PTV (P<005). The number of monitor units of 1-arc and 2-Arcs plans showed no significant difference between the two TPSs (P>005). Conclusions For patients with cervical cancer and prostate cancer, the VMAT plans based on Varian Eclipse and Philips Pinnacle TPS can achieve a clinically acceptable dose distribution and show a little difference in the treatment plan quality. However, we will still need more cases to further study and determine the performance characteristics of the commercial TPSs for optimizing VMAT.

Objective To explore the feasibility of the volume modulated arc therapy ( VMAT) auto-planning based on template library ( TL). Methods VMAT plans of 68 patients diagnosed with postoperative rectal cancer in Eclipse system were retrospectively selected. The prescription dose was 50 Gy/25F. In 19 patients, the feature values of target and organs at risk were extracted as the vectors. The final optimized restricted conditions were saved as the TL. Then, the plans of 15 rectal cancer patients (10 cases from TL and 5 outside TL) were automatically optimized. According to the multi-dimensional vector similarity principle, the similarity parameter αwas defined. The designed program automatically selected the optimal-object template in an in-house software developed with Matlab. The dosimetric parameters of the auto-optimized plans with the optimal-object template (ATP) and the clinical plan (CP) were compared by the paired t-test. The changes in the dosimetric parameters and similarity parameter α were statistically compared by Pearson′s correlation analysis. The linear fitting of the dosimetric parameters with α was used by least squares method to explore the tendency of the ATP dosimetric parameters relative to CP. Results The dosimetric parameters of ATP for 13 cases were slightly worse than those of CP. The conformal index (P=0. 004), heterogeneous index (P= 0. 015),V40(P= 0. 003) and mean dose (P= 0. 022) of the intestine significantly differed. The α values of these 13 cases were 2. 67,2. 60,2. 60,2. 49,2. 67,2. 74,2. 72,2. 48, 2. 53,2. 86,2. 68,2. 56 and 2. 63. The α value was significantly correlated with the V40 or mean dose of the bladder (r= 0. 649 and 0. 603,P= 0. 016 and 0. 029).Along with the increase of α value ,V40 and mean dose of the intestine for ATP were gradually deteriorated than those of CP . The remaining dosimetric para-meters of ATP were close to or superior to those of CP. Conclusions The results of ATP are slightly worse than those of CP, whereas can satisfy the clinical requirements. The TL, the quality of TL and ATP remain to be further optimized.

To investigate the patient-specific dose verification method using ArcCHECK for total marrow irradiation (TMI) with Volumetric Modulated Arc Therapy(VMAT) and Helical Tomotherapy(HT) . The kVCT images col ected from 8 patients were respectively designed for RapidArc and Tomotherapy plans in total marrow irradiation. ArcCHECK was used for dose verification for the head-neck, chest-abdomen and pelvic. The merging function of ArcCHECK was used in VMAT and the method of double plans(reference and delivery plans) were used in HT. The γ-analysis passing rates for the head-neck, chest-abdomen, pelvic were 98.9%±1.9%, 98.4%±1.8%, 97.4%±2.1% for VMAT plans and 94.3%±1.5%, 96.5±1.2%, 94.1%±1.9% for HT plans. The results show that using the merging function of ArcCHECK can achieve the dose verification wel for VMAT plans with TMI, The method of double plans was done for the dose verification of HT plans with TMI as wel as the plans with the targets keeping away from the set-up center.

Objective To evaluate the cone beam CT (CBCT) image quality and its long-term stability for HUs under different scanning conditions.Methods With the OBI system, Catphan 504 phantom using the different modes was scanned through one year. Analysis of variance (ANOVA) was used to evaluate the CBCT images.Results The results of contrast resolution under different scanning conditions met the requirements of acceptance test procedure. Spatial contrast resolution(≥5 lp/cm) of half-fan scanning conditions were inferior to those (≥7 lp/cm) of ful-fan mode. The accuracies of spatial linear distance and angle were within±1%. HUs in air density plug were constant, but HUs of other plugs with different conditions had the signifi cant difference (F=660.84,P=0). Under different conditions in a year, the mean HUs showed a good agreement.Conclusions HUs of CBCT image under different scanning conditions exist a little difference, but there is a good consistency for the long term stability analysis. It is helpful for CBCT images directly used for dose re-calculation in adaptive radiation therapy (ART).

Objective Evaluation of intensity-modulated radiation therapy(IMRT) delivery quality assurance(DQA) using EDOSE software based on accelerator electronic portal imaging device (EPID).Methods Analysed the dose response uniformity correction of EPID imaging plate in different fields and the gamma pass rates about the fields; And compared the calculated parameters of the EDOSE and the Pinnacle planning station.Results The uniformities on the homogeneous region of thefi elds are good after who corrected by EDOSE. The gamma(γ, 3mm/3%) pass rates are in the ideal range. The volume of the organs at risk(OAR) have no statistical signifi cance except the right lung; A part of the parameters have statistical signifi cance.Conclusions The results of the calculation and analysis of EDOSE has a high agreement with the planning system.

This study describes the development and implementation of EDR2 film and electronic portal imaging device (EPID) during RapidArc QA. The tests were designed to evaluate RapidArc performance using EDR2 film and EPID tools. The accuracy of MLC position during gantry rotation, the ability to vary and control the dose-rate and gantry speed, the synchronization of variable MLC speed and dose-rate were examined. The picket fence test of MLC in stationary gantry and RapidArc modes were implemented. The film and EPID showed a good consistency. During the evaluation of MLC speed, gantry speed and dose-rates, the dose of different parts in a field showed a good agreement, with the mean deviation of 0.24%vs 0.19%. The analysis of dose value was less than 2%. This study demonstrated that EDR2 film and EPID system can be used as reliable and efficient quality assurance tools for RapidArc delivery performance. Of course, the use of VMAT QA with EPID increases the efficiency of routine QA.

Helical tomotherapy (HT), as a new IMRT technology, utilizes a fan beam of radiation for treatment. It combines the main characteristics of a modern CT scanner and a linear accelerator to achieve the function of helical tomotherapy. Due to the complexity of the system with a highly integrated and automated features, monitoring its operation, continuing to improve the stability and reliability, and simplifying its quality control procedures has become an important part of quality assurance (QA) for HT. Based on the results of afi ve-year quality control (QC) program, and the initial application of new QA equipment, this study wil summarize the standardization mode of its QA and explore the changes of QA mode.