Copenhagen, Denmark
Onsite/Online

ESTRO 2022

Session Item

Implementation of new technology and techniques
Poster (digital)
Physics
A pre-treatment patient specific QA alternative approach for HyperArc treatments.
Nina Cavalli, Italy
PO-1639

Abstract

A pre-treatment patient specific QA alternative approach for HyperArc treatments.
Authors:

Nina Cavalli1, Elisa Bonanno2, Giuseppe Stella3, Giuseppina Borzì1, Lucia Zirone1, Martina Pace1, Carmelo Marino1

1Humanitas-Istituto Clinico Catanese, Medical Physics Department, Misterbianco, Italy; 2Humanitas-Istituto Clinico Catanese, Medical Physics Department, Misterbianco , Italy; 3University of Catania, Physics and Astronomy "E. Majorana" Department, Catania, Italy

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Purpose or Objective

Mobius3D system was validated with the purpose to use it as a modern second – check dosimetry system. Our objective has been to determine the appropriateness of M3D as pre-treatment patient specific QA for HyperArc (HA) treatments, establishing if Mobius3D can safely replace the measurements based patient specific QA for this kind of treatments.

Material and Methods

30 Stereotactic Radiosurgey (SRS) HA plans for brain were delivered across the ionization chamber located inside homogeneous Mobius Verification Phantom (MVP).

The measured dose inside the MVP was compared with M3D calculated dose and then with TPS calculated one.

In a second step for all 30 plans, dose distributions calculated on the patient’s CT- dataset by Mobius and our algorithm (AcurosXB v.15.6) were compared using the following metrics: target Dmean percent difference, target D90% percent difference and global 3D gamma passing rate over the entire dataset. The used gamma criteria were 3%-2mm.

All 30 plans were then delivered across radiochromic film (EBT3) and electronic portal imaging device (EPID) and analysed with Portal Dosimetry (PD), in terms of gamma analysis (3%-2mm). Results were evaluated considering a gamma passing rate >90 %.

The appropriateness of M3D as an alternative to measurement-based patient specific QA, was evaluated as the percentage of verified plans that passing 3D global gamma analysis with Mobius3D and the conventional methods at the indicated level.

Results

All 30 analyzed plans showed good agreement between MVP measured point dose and dose calculated by M3D and Eclipse TPS. In fact, the average point dose difference on MVP between our algorithms and measurements with ionization chamber was 1.85 % [min 1.16%-max 2.55%], while concerning M3D, the average point dose difference was 2.32 % [min 1.05%-max 3.44%].

Concerning comparison on the CT-dataset between TPS and Mobius3D we found an average target Dmean percent difference of 1.83% [min 1.16%-max 2.55%]. The average D90% difference was 2.83% [min 2.6%-max 3.1%]; 3D global gamma passing rate ranged from 89.2% to 99.6 % at the specified gamma criteria.

 

Tab I shows results about plans with a gamma passing rate >90% and about the agreement between M3D gamma evaluation (3%-2mm) and conventional methods.


Plans passing gamma analysis with M3D system were the same plans that passing radiochromic film and portal dosimetry pre-treatment QA.

Conclusion

The study shows Mobius3D to be a suitable alternative to conventional measured based QA methods for SRS HyperArc treatments when using the 3%/2mm gamma criterion.

The evaluation based on M3D system has the advantages to be resource and time sparing.