Open Access
Sumanta Manna
Abstract
This study aims to evaluate the application of dose volume histogram (DVH) metrics within the patient-specific quality assurance (PSQA) protocol in various sites for RapidArc treatment delivery. Forty patients were included in this study, of which twenty each Head and Neck (H&N) and Pelvis Rapid Arc plans were evaluated. Octavius 4D 1500 detector array with vented parallel plate ion chambers was used for this study, which reconstruct the pre-treatment measured doses into threedimensional (3D) during pre-treatment quality assurance. The verisoft DVH application was utilized to estimate the dose administered to the patient’s volume, explicitly focusing on the errors associated in the DVH. The measured data were compared with the treatment planning system created verification plan. Three-dimensional local and global gamma were evaluated using different gamma criteria of 3 mm/3%, 3 mm/2%, 2 mm/3% and 2 mm/2%, respectively. In addition, the agreement score was analysed for axial, coronal, and sagittal planes in addition to the volumetric analysis. All plans meet the action level requirement of >95% with 3%/3 mm gamma acceptance criteria. In addition, the DVH demonstrated that the doses administered to the target volumes and organs at risk remained within the specified dose tolerances for all cases. The DVH analysis will be applied to identify the instances where patient dose errors surpass the predetermined established action threshold. The gamma index did not initially identify these and may have utility in determining the reason for failed plans. Further, it enables identifying and managing dose errors associated with the patient’s anatomy. Finally, this study has showcased the incorporation of DVH metrics into RapidArc PSQA protocol may deliver clinically meaningful outcomes in close proximity to the gamma index.
Keywords: DVH, PSQA, Radiotherapy, Action Level, RapidArc
[This article belongs to Special Issue under section in Journal of Polymer and Composites(jopc)]
Browse Figures
References
1. Stasi M, Bresciani S, Miranti A, Maggio A, Sapino V, Gabriele P. Pretreatment patient-specific IMRT quality assurance: A correlation study between gamma index and patient clinical dose volume histogram. Med Phys. 2012;39(12):7626–34.
2. Ansari S, Satpathy SK. Dose distribution analysis of rapid arc and intensity modulated radiotherapy plan in head and neck cancer. Iran J Med Phys. 2019;16(2):139–44.
3. Mohamed Yoosuf AB, AlShehri S, Alhadab A, Alqathami M. DVH analysis using a transmission detector and model-based dose verification system as a comprehensive pretreatment QA tool for VMAT plans: Clinical experience and results. J Appl Clin Med Phys. 2019;20(11):80–7.
4. Low DA, Harms WB, Mutic S, Purdy JA. A technique for the quantitative evaluation of dose distributions. Med Phys. 1998;25(5):656–61.
5. Coleman L, Skourou C. Sensitivity of volumetric modulated arc therapy patient specific QA results to multileaf collimator errors and correlation to dose volume histogram based metrics. Med Phys. 2013;40(11).
6. Miften M, Olch A, Mihailidis D, Moran J, Pawlicki T, Molineu A, et al. Tolerance limits and methodologies for IMRT measurement-based verification QA: Recommendations of AAPM Task Group No. 218. Med Phys. 2018;45(4):e53–83.
7. Song JH, Shin HJ, Kay CS, Son SH. Dosimetric verification by using the ArcCHECK system and 3DVH software for various target sizes. PLoS One. 2015;10(3):1–12.
8. Douama S, Youssoufi MA, Bougtib M, Bouzekraoui Y, Erraisee MA, Abboud FZ, et al. Validation and comparison of intensity modulated radiation therapy patient plans with octavius 4d phantom using the gamma index analysis in 2d and 3d. Onkol i Radioter. 2021;15(8):5–10.
9. Tang D, Yang Z, Dai X, Cao Y. Evaluation of Delta4DVH Anatomy in 3D Patient-Specific IMRT Quality Assurance. Technol Cancer Res Treat. 2020;19(87).
10. Anetai Y, Sumida I, Kumazaki Y, Kito S, Kurooka M, Ueda Y, et al. Assessment of using a gamma index analysis for patient-specific quality assurance in Japan. J Appl Clin Med Phys. 2022;23(10).
11. Urso P, Lorusso R, Marzoli L, Corletto D, Imperiale P, Pepe A, et al. Practical application of Octavius®-4D: Characteristics and criticalities for IMRT and VMAT verification. J Appl Clin Med Phys. 2018;19(5):517–24.
12. Das S, Kharade V, Pandey V, KV A, Pasricha RK, Gupta M. Gamma Index Analysis as a Patient-Specific Quality Assurance Tool for High-Precision Radiotherapy: A Clinical Perspective of Single Institute Experience. Cureus. 2022;14(Dd).
13. Low C, Toye W, Phung P, Huston C. Patient-Specific quality assurance protocol for volumetric modulated arc therapy using dose volume histogram. J Med Phys. 2018;43(2):112–8.
14. Zhang H, Lu W, Cui H, Li Y, Yi X. Assessment of Statistical Process Control Based DVH Action Levels for Systematic Multi-Leaf Collimator Errors in Cervical Cancer RapidArc Plans. Front Oncol. 2022;12(May):1–11.
15. Visser R, Wauben DJL, De Groot M, Steenbakkers RJHM, Bijl HP, Godart J, et al. Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT. Radiother Oncol [Internet]. 2014;112(3):389–95. Available from: http://dx.doi.org/10.1016/j.radonc.2014.08.002
Journal of Polymer and Composites
| Volume | 11 |
| Special Issue | 07 |
| Received | August 14, 2023 |
| Accepted | August 31, 2023 |
| Published | November 13, 2023 |