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Title: Poster — Thur Eve — 17: In-phantom and Fluence-based Measurements for Quality Assurance of Volumetric-driven Adaptation of Arc Therapy

During volumetric modulated arc therapy (VMAT) of head and neck cancer, some patients lose weight which may result in anatomical deviations from the initial plan. If these deviations are substantial a new treatment plan can be designed for the remainder of treatment (i.e., adaptive planning). Since the adaptive treatment process is resource intensive, one possible approach to streamlining the quality assurance (QA) process is to use the electronic portal imaging device (EPID) to measure the integrated fluence for the adapted plans instead of the currently-used ArcCHECK device (Sun Nuclear). Although ArcCHECK is recognized as the clinical standard for patient-specific VMAT plan QA, it has limited length (20 cm) for most head and neck field apertures and has coarser detector spacing than the EPID (10 mm vs. 0.39 mm). In this work we compared measurement of the integrated fluence using the EPID with corresponding measurements from the ArcCHECK device. In the past year nine patients required an adapted plan. Each of the plans (the original and adapted) is composed of two arcs. Routine clinical QA was performed using the ArcCHECK device, and the same plans were delivered to the EPID (individual arcs) in integrated mode. The dose difference between the initialmore » plan and adapted plan was compared for ArcCHECK and EPID. In most cases, it was found that the EPID is more sensitive in detecting plan differences. Therefore, we conclude that EPID provides a viable alternative for QA of the adapted head and neck plans and should be further explored.« less
Authors:
;  [1] ;  [2] ;  [3]
  1. London Regional Cancer Program, Department of Oncology, Medical Biophysics, Western University (Canada)
  2. Medical Biophysics, Western University (Canada)
  3. Physics and Astronomy, Western University (Canada)
Publication Date:
OSTI Identifier:
22407641
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 41; Journal Issue: 8; Other Information: (c) 2014 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; EQUIPMENT; HEAD; NECK; NEOPLASMS; PATIENTS; PHANTOMS; QUALITY ASSURANCE; THERAPY