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Title: SU-G-BRB-16: Vulnerabilities in the Gamma Metric

Abstract

Purpose: To explore vulnerabilities in the gamma index metric that undermine its wide use as a radiation therapy quality assurance tool. Methods: 2D test field pairs (images) are created specifically to achieve high gamma passing rates, but to also include gross errors by exploiting the distance-to-agreement and percent-passing components of the metric. The first set has no requirement of clinical practicality, but is intended to expose vulnerabilities. The second set exposes clinically realistic vulnerabilities. To circumvent limitations inherent to user-specific tuning of prediction algorithms to match measurements, digital test cases are manually constructed, thereby mimicking high-quality image prediction. Results: With a 3 mm distance-to-agreement metric, changing field size by ±6 mm results in a gamma passing rate over 99%. For a uniform field, a lattice of passing points spaced 5 mm apart results in a passing rate of 100%. Exploiting the percent-passing component, a 10×10 cm{sup 2} field can have a 95% passing rate when an 8 cm{sup 2}=2.8×2.8 cm{sup 2} highly out-of-tolerance (e.g. zero dose) square is missing from the comparison image. For clinically realistic vulnerabilities, an arc plan for which a 2D image is created can have a >95% passing rate solely due to agreement in the lateralmore » spillage, with the failing 5% in the critical target region. A field with an integrated boost (e.g whole brain plus small metastases) could neglect the metastases entirely, yet still pass with a 95% threshold. All the failure modes described would be visually apparent on a gamma-map image. Conclusion: The %gamma<1 metric has significant vulnerabilities. High passing rates can obscure critical faults in hypothetical and delivered radiation doses. Great caution should be used with gamma as a QA metric; users should inspect the gamma-map. Visual analysis of gamma-maps may be impractical for cine acquisition.« less

Authors:
;  [1]
  1. University of Virginia Health System, Charlottesville, VA (United States)
Publication Date:
OSTI Identifier:
22649287
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:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; IMAGES; METRICS; QUALITY ASSURANCE; RADIATION DOSES; RATS; VULNERABILITY

Citation Formats

Neal, B, and Siebers, J. SU-G-BRB-16: Vulnerabilities in the Gamma Metric. United States: N. p., 2016. Web. doi:10.1118/1.4956923.
Neal, B, & Siebers, J. SU-G-BRB-16: Vulnerabilities in the Gamma Metric. United States. doi:10.1118/1.4956923.
Neal, B, and Siebers, J. 2016. "SU-G-BRB-16: Vulnerabilities in the Gamma Metric". United States. doi:10.1118/1.4956923.
@article{osti_22649287,
title = {SU-G-BRB-16: Vulnerabilities in the Gamma Metric},
author = {Neal, B and Siebers, J},
abstractNote = {Purpose: To explore vulnerabilities in the gamma index metric that undermine its wide use as a radiation therapy quality assurance tool. Methods: 2D test field pairs (images) are created specifically to achieve high gamma passing rates, but to also include gross errors by exploiting the distance-to-agreement and percent-passing components of the metric. The first set has no requirement of clinical practicality, but is intended to expose vulnerabilities. The second set exposes clinically realistic vulnerabilities. To circumvent limitations inherent to user-specific tuning of prediction algorithms to match measurements, digital test cases are manually constructed, thereby mimicking high-quality image prediction. Results: With a 3 mm distance-to-agreement metric, changing field size by ±6 mm results in a gamma passing rate over 99%. For a uniform field, a lattice of passing points spaced 5 mm apart results in a passing rate of 100%. Exploiting the percent-passing component, a 10×10 cm{sup 2} field can have a 95% passing rate when an 8 cm{sup 2}=2.8×2.8 cm{sup 2} highly out-of-tolerance (e.g. zero dose) square is missing from the comparison image. For clinically realistic vulnerabilities, an arc plan for which a 2D image is created can have a >95% passing rate solely due to agreement in the lateral spillage, with the failing 5% in the critical target region. A field with an integrated boost (e.g whole brain plus small metastases) could neglect the metastases entirely, yet still pass with a 95% threshold. All the failure modes described would be visually apparent on a gamma-map image. Conclusion: The %gamma<1 metric has significant vulnerabilities. High passing rates can obscure critical faults in hypothetical and delivered radiation doses. Great caution should be used with gamma as a QA metric; users should inspect the gamma-map. Visual analysis of gamma-maps may be impractical for cine acquisition.},
doi = {10.1118/1.4956923},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
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