Faculty, Staff and Student Publications

Language

English

Publication Date

10-1-2024

Journal

Physics and Imaging in Radiation Oncology

DOI

10.1016/j.phro.2024.100666

PMID

39624392

PMCID

PMC11609462

PubMedCentral® Posted Date

11-1-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Background and purpose: With the availability of commercial electronic portal imaging detector-based in vivo dosimetry (EPID-based IVD) solutions, many radiotherapy departments are adopting this technology. However, comprehensive commissioning guidance is lacking. This study aims to provide a protocol for testing the accuracy and sensitivity of EPID-based IVD systems.

Material and methods: The protocol was tested across four institutions using two different systems. Accuracy was evaluated with homogeneous slab phantoms using different square regular fields, and clinical plans in a CIRS lung phantom. Multiple forward and back-projected algorithm implementations were assessed for different energies. Sensitivity analysis in the lung phantom examined responses to setup errors, anatomical variations, and delivery errors.

Results: In homogeneous phantoms, over 85 % of pixels passed the 5 %/2mm gamma criteria, except for the 2x2 cm2 field. In the lung phantom, all systems and implementations achieved over 95 %-pixel pass rates at the 2 %/2mm criterion for volumetric modulated arc therapy (VMAT) plans. For conformal radiation therapy (3DCRT) plans, one system implementation showed poor accuracy, with over 90 % agreement only at the 5 %/2mm criterion. Considering all systems and implementations, average sensitivity and specificity for CRT plans ranged from 0.92 and 0.42 (at 2 %/2mm) to 0.71 and 0.52 (at 5 %/2mm), while for VMAT plans ranged from 0.41 and 0.81 (at 2 %2mm) to 0.37 and 0.81 (at 5 %/2mm).

Conclusion: We successfully developed a protocol to commission EPID IDV systems. It was found that not all systems and implementations achieved satisfactory accuracy and sensitivity, emphasising the need for thorough commissioning and benchmarking.

Keywords

“In vivo” dose measurements, EPID, QA, Dosimetry

Published Open-Access

yes

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