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Title: SU-F-T-459: ArcCHECK Machine QA : Highly Efficient Quality Assurance Tool for VMAT, SRS & SBRT Linear Accelerator Delivery

Abstract

Purpose: Quality assurance (QA) of complex linear accelerators is critical and highly time consuming. ArcCHECK Machine QA tool is used to test geometric and delivery aspects of linear accelerator. In this study we evaluated the performance of this tool. Methods: Machine QA feature allows user to perform quality assurance tests using ArcCHECK phantom. Following tests were performed 1) Gantry Speed 2) Gantry Rotation 3) Gantry Angle 4)MLC/Collimator QA 5)Beam Profile Flatness & Symmetry. Data was collected on trueBEAM stX machine for 6 MV for a period of one year. The Gantry QA test allows to view errors in gantry angle, rotation & assess how accurately the gantry moves around the isocentre. The MLC/Collimator QA tool is used to analyze & locate the differences between leaf bank & jaw position of linac. The flatness & Symmetry test quantifies beam flatness & symmetry in IEC-y & x direction. The Gantry & Flatness/Symmetry test can be performed for static & dynamic delivery. Results: The Gantry speed was 3.9 deg/sec with speed maximum deviation around 0.3 deg/sec. The Gantry Isocentre for arc delivery was 0.9mm & static delivery was 0.4mm. The maximum percent positive & negative difference was found to be 1.9 % &more » – 0.25 % & maximum distance positive & negative diff was 0.4mm & – 0.3 mm for MLC/Collimator QA. The Flatness for Arc delivery was 1.8 % & Symmetry for Y was 0.8 % & X was 1.8 %. The Flatness for gantry 0°,270°,90° & 180° was 1.75,1.9,1.8 & 1.6% respectively & Symmetry for X & Y was 0.8,0.6% for 0°, 0.6,0.7% for 270°, 0.6,1% for 90° & 0.6,0.7% for 180°. Conclusion: ArcCHECK Machine QA is an useful tool for QA of Modern linear accelerators as it tests both geometric & delivery aspects. This is very important for VMAT, SRS & SBRT treatments.« less

Authors:
; ;  [1]
  1. Sir HN RF Hospital, Mumbai, Maharashtra (India)
Publication Date:
OSTI Identifier:
22649050
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
43 PARTICLE ACCELERATORS; 61 RADIATION PROTECTION AND DOSIMETRY; 60 APPLIED LIFE SCIENCES; BEAM PROFILES; COLLIMATORS; COMMERCIAL BUILDINGS; DELIVERY; LINEAR ACCELERATORS; PERFORMANCE; QUALITY ASSURANCE; RADIOTHERAPY; SYMMETRY; VELOCITY

Citation Formats

Mhatre, V, Patwe, P, and Dandekar, P. SU-F-T-459: ArcCHECK Machine QA : Highly Efficient Quality Assurance Tool for VMAT, SRS & SBRT Linear Accelerator Delivery. United States: N. p., 2016. Web. doi:10.1118/1.4956644.
Mhatre, V, Patwe, P, & Dandekar, P. SU-F-T-459: ArcCHECK Machine QA : Highly Efficient Quality Assurance Tool for VMAT, SRS & SBRT Linear Accelerator Delivery. United States. doi:10.1118/1.4956644.
Mhatre, V, Patwe, P, and Dandekar, P. 2016. "SU-F-T-459: ArcCHECK Machine QA : Highly Efficient Quality Assurance Tool for VMAT, SRS & SBRT Linear Accelerator Delivery". United States. doi:10.1118/1.4956644.
@article{osti_22649050,
title = {SU-F-T-459: ArcCHECK Machine QA : Highly Efficient Quality Assurance Tool for VMAT, SRS & SBRT Linear Accelerator Delivery},
author = {Mhatre, V and Patwe, P and Dandekar, P},
abstractNote = {Purpose: Quality assurance (QA) of complex linear accelerators is critical and highly time consuming. ArcCHECK Machine QA tool is used to test geometric and delivery aspects of linear accelerator. In this study we evaluated the performance of this tool. Methods: Machine QA feature allows user to perform quality assurance tests using ArcCHECK phantom. Following tests were performed 1) Gantry Speed 2) Gantry Rotation 3) Gantry Angle 4)MLC/Collimator QA 5)Beam Profile Flatness & Symmetry. Data was collected on trueBEAM stX machine for 6 MV for a period of one year. The Gantry QA test allows to view errors in gantry angle, rotation & assess how accurately the gantry moves around the isocentre. The MLC/Collimator QA tool is used to analyze & locate the differences between leaf bank & jaw position of linac. The flatness & Symmetry test quantifies beam flatness & symmetry in IEC-y & x direction. The Gantry & Flatness/Symmetry test can be performed for static & dynamic delivery. Results: The Gantry speed was 3.9 deg/sec with speed maximum deviation around 0.3 deg/sec. The Gantry Isocentre for arc delivery was 0.9mm & static delivery was 0.4mm. The maximum percent positive & negative difference was found to be 1.9 % & – 0.25 % & maximum distance positive & negative diff was 0.4mm & – 0.3 mm for MLC/Collimator QA. The Flatness for Arc delivery was 1.8 % & Symmetry for Y was 0.8 % & X was 1.8 %. The Flatness for gantry 0°,270°,90° & 180° was 1.75,1.9,1.8 & 1.6% respectively & Symmetry for X & Y was 0.8,0.6% for 0°, 0.6,0.7% for 270°, 0.6,1% for 90° & 0.6,0.7% for 180°. Conclusion: ArcCHECK Machine QA is an useful tool for QA of Modern linear accelerators as it tests both geometric & delivery aspects. This is very important for VMAT, SRS & SBRT treatments.},
doi = {10.1118/1.4956644},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: To design a versatile, nonhomogeneous insert for the dose verification phantom ArcCHECK{sup Trade-Mark-Sign} (Sun Nuclear Corp., FL) and to demonstrate its usefulness for the verification of dose distributions in inhomogeneous media. As an example, we demonstrate it can be used clinically for routine quality assurance of two volumetric modulated arc therapy (VMAT) systems for lung stereotactic body radiation therapy (SBRT): SmartArc{sup Registered-Sign} (Pinnacle{sup 3}, Philips Radiation Oncology Systems, Fitchburg, WI) and RapidArc{sup Registered-Sign} (Eclipse{sup Trade-Mark-Sign }, Varian Medical Systems, Palo Alto, CA). Methods: The cylindrical detector array ArcCHECK{sup Trade-Mark-Sign} has a retractable homogeneous acrylic insert. In this work, wemore » designed and manufactured a customized heterogeneous insert with densities that simulate soft tissue, lung, bone, and air. The insert offers several possible heterogeneity configurations and multiple locations for point dose measurements. SmartArc{sup Registered-Sign} and RapidArc{sup Registered-Sign} plans for lung SBRT were generated and copied to ArcCHECK{sup Trade-Mark-Sign} for each inhomogeneity configuration. Dose delivery was done on a Varian 2100 ix linac. The evaluation of dose distributions was based on gamma analysis of the diode measurements and point doses measurements at different positions near the inhomogeneities. Results: The insert was successfully manufactured and tested with different measurements of VMAT plans. Dose distributions measured with the homogeneous insert showed gamma passing rates similar to our clinical results ({approx}99%) for both treatment-planning systems. Using nonhomogeneous inserts decreased the passing rates by up to 3.6% in the examples studied. Overall, SmartArc{sup Registered-Sign} plans showed better gamma passing rates for nonhomogeneous measurements. The discrepancy between calculated and measured point doses was increased up to 6.5% for the nonhomogeneous insert depending on the inhomogeneity configuration and measurement location. SmartArc{sup Registered-Sign} and RapidArc{sup Registered-Sign} plans had similar plan quality but RapidArc{sup Registered-Sign} plans had significantly higher monitor units (up to 70%). Conclusions: A versatile, nonhomogeneous insert was developed for ArcCHECK{sup Trade-Mark-Sign} for an easy and quick evaluation of dose calculations with nonhomogeneous media and for comparison of different treatment planning systems. The device was tested for SmartArc{sup Registered-Sign} and RapidArc{sup Registered-Sign} plans for lung SBRT, showing the uncertainties of dose calculations with inhomogeneities. The new insert combines the convenience of the ArcCHECK{sup Trade-Mark-Sign} and the possibility of assessing dose distributions in inhomogeneous media.« less
  • Purpose: Quality assurance (QA) of complex linear accelerators is critical and highly time consuming. Varian’s Machine Performance Check (MPC) uses IsoCal phantom to test geometric and dosimetric aspects of the TrueBeam systems in <5min. In this study we independently tested the accuracy and robustness of the MPC tools. Methods: MPC is automated for simultaneous image-acquisition, using kV-and-MV onboard-imagers (EPIDs), while delivering kV-and-MV beams in a set routine of varying gantry, collimator and couch angles. MPC software-tools analyze the images to test: i) beam-output and uniformity, ii) positional accuracy of isocenter, EPIDs, collimating jaws (CJs), MLC leaves and couch and iii)more » rotational accuracy of gantry, collimator and couch. 6MV-beam dose-output and uniformity were tested using ionization-chamber (IC) and ICarray. Winston-Lutz-Tests (WLT) were performed to measure isocenter-offsets caused by gantry, collimator and couch rotations. Positional accuracy of EPIDs was evaluated using radio-opaque markers of the IsoCal phantom. Furthermore, to test the robustness of the MPC tools we purposefully miscalibrated a non-clinical TrueBeam by introducing errors in beam-output, energy, symmetry, gantry angle, couch translations, CJs and MLC leaves positions. Results: 6MV-output and uniformity were within ±0.6% for most measurements with a maximum deviation of ±1.0%. Average isocenter-offset caused by gantry and collimator rotations was 0.316±0.011mm agreeing with IsoLock (0.274mm) and WLT (0.41mm). Average rotation-induced couch-shift from MPC was 0.378±0.032mm agreeing with WLT (0.35mm). MV-and-kV imager-offsets measured by MPC were within ±0.15mm. MPC predicted all machine miscalibrations within acceptable clinical tolerance. MPC detected the output miscalibrations within ±0.61% while the MLC and couch positions were within ±0.06mm and ±0.14mm, respectively. Gantry angle miscalibrations were detected within ±0.1°. Conclusions: MPC is a useful tool for QA of TrueBeam systems and its automation makes it highly efficient for testing both geometric and dosimetric aspects of the machine. This is very important for hypo-fractionated SBRT treatments. Received support from Varian Medical Systems, Palo Alto, CA 94304-1038.« less
  • Purpose: To implement VMAT in RayStation with the Elekta Synergy linac with the new Agility MLC, and to utilize the same vendor softwares to determine the optimum Elekta VMAT machine parameters in RayStation for accurate modeling and robust delivery. Methods: iCOMCat is utilized to create various beam patterns with user defined dose rate, gantry, MLC and jaw speed for each control point. The accuracy and stability of the output and beam profile are qualified for each isolated functional component of VMAT delivery using ion chamber and Profiler2 with isocentric mounting fixture. Service graphing on linac console is used to verifymore » the mechanical motion accuracy. The determined optimum Elekta VMAT machine parameters were configured in RayStation v4.5.1. To evaluate the system overall performance, TG-119 test cases and nine retrospective VMAT patients were planned on RayStation, and validated using both ArcCHECK (with plug and ion chamber) and MapCHECK2. Results: Machine output and profile varies <0.3% when only variable is dose rate (35MU/min-600MU/min). <0.9% output and <0.3% profile variation are observed with additional gantry motion (0.53deg/s–5.8deg/s both directions). The output and profile variation are still <1% with additional slow leaf motion (<1.5cm/s both direction). However, the profile becomes less symmetric, and >1.5% output and 7% profile deviation is seen with >2.5cm/s leaf motion. All clinical cases achieved comparable plan quality as treated IMRT plans. The gamma passing rate is 99.5±0.5% on ArcCheck (<3% iso center dose deviation) and 99.1±0.8% on MapCheck2 using 3%/3mm gamma (10% lower threshold). Mechanical motion accuracy in all VMAT deliveries is <1°/1mm. Conclusion: Accurate RayStation modeling and robust VMAT delivery is achievable on Elekta Agility for <2.5cm/s leaf motion and full range of dose rate and gantry speed determined by the same vendor softwares. Our TG-119 and patient results have provided us with the confidence to use VMAT clinically.« less
  • Purpose: To discuss several factors surrounding the decision on when to recalibrate the ArcCHECK device as well as present a simple and efficient monthly check to evaluate ArcCHECK calibrations. Methods: ArcCheck (Sun Nuclear) calibrations were evaluated monthly by measuring a 25×25cm{sup 2} field with 100 MU. Since ArcCHECK measurements are run on an almost nightly basis, such additional square field measurements are obtained with minimal additional effort. An in-house MATLAB script compares two radial (y-direction) profiles from the top/center of the new measurement relative to a baseline measurement acquired at the last device calibration. The program automatically generates PDF profilemore » and percent difference comparisons for inspection. Recalibration is based on inspection of measurement profile shapes and percent differences from the baseline measurement. Results: The method presented here shows the utility of a simple monthly check for evaluating ArcCHECK calibrations, and in addition shows the importance of recalibrating after Linac beam steering. Our device required recalibration approximately every 8–10 months. However, for ease of scheduling, we propose a bi-annual recalibration interval. Clinics with a lighter/heavier IMRT/VMAT QA case load may require different recalibration intervals, which are easily determined using the single-field method presented. Analysis of additional square fields is also easily incorporated, if desired. We further illustrate the importance of array recalibration given that diode irradiation is not uniform over the entire device, with central diodes receiving more than 900 Gy over the course of 10 months and peripheral diodes receiving as little as 50 Gy (in our experience). Finally, we show that timely device recalibration decreases spread in clinical IMRT/VMAT QA gamma passing rates. Conclusion: Quality assurance for ArcCHECK array calibrations is important to ensure quality IMRT/VMAT QA comparisons. For many clinics, calibrations should be performed at least annually, if not more frequently, based on use of the proposed monthly check.« less
  • Radiation therapy requires delivery quality assurance (DQA) to ensure that treatment is accurate and closely follows the plan. We report our experience with the ArcCHECK phantom and investigate its potential optimization for the DQA process. One-hundred seventy DQA plans from 84 patients were studied. Plans were classified into 2 groups: those with the target situated on the diodes of the ArcCHECK (D plans) and those with the target situated at the center (C plans). Gamma pass rates for 8 target sites were examined. The parameters used to analyze the data included 3%/3 mm with the Van Dyk percent difference criteriamore » (VD) on, 3%/3 mm with the VD off, 2%/2 mm with the VD on, and x/3 mm with the VD on and the percentage dosimetric agreement “x” for diode plans adjusted. D plans typically displayed maximum planned dose (MPD) on the cylindrical surface containing ArcCHECK diodes than center plans, resulting in inflated gamma pass rates. When this was taken into account by adjusting the percentage dosimetric agreement, C plans outperformed D plans by an average of 3.5%. ArcCHECK can streamline the DQA process, consuming less time and resources than radiographic films. It is unnecessary to generate 2 DQA plans for each patient; a single center plan will suffice. Six of 8 target sites consistently displayed pass rates well within our acceptance criteria; the lesser performance of head and neck and spinal sites can be attributed to marginally lower doses and increased high gradient of plans.« less