Multi-institutional comparison of secondary check of treatment planning using computer-based independent dose calculation for non-C-arm linear accelerators

Hidenobu Tachibana, Yukihiro Uchida, Ryuta Miyakawa, Mikiko Yamashita, Aya Sato, Satoshi Kito, Daiki Maruyama, Shigetoshi Noda, Toru Kojima, Hiroshi Fukuma, Ryosuke Shirata, Hiroyuki Okamoto, Mitsuhiro Nakamura, Yuma Takada, Hironori Nagata, Naoki Hayashi, Ryo Takahashi, Daisuke Kawai, Masanobu Itano

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Purpose: This report covers the first multi-institutional study of independent monitor unit (MU)/dose calculation verification for the CyberKnife, Vero4DRT, and TomoTherapy radiotherapy delivery systems. Methods: A total of 973 clinical treatment plans were collected from 12 institutions. Commercial software employing the Clarkson algorithm was used for verification after a measurement validation study, and the doses from the treatment planning systems (TPSs) and verification programs were compared on the basis of the mean value ± two standard deviations. The impact of heterogeneous conditions was assessed in two types of sites: non-lung and lung. Results: The dose difference for all locations was 0.5 ± 7.2%. There was a statistically significant difference (P < 0.01) in dose difference between non-lung (−0.3 ± 4.4%) and lung sites (3.5 ± 6.7%). Inter-institutional comparisons showed that various systematic differences were associated with the proportion of different treatment sites and heterogeneity correction. Conclusions: This multi-institutional comparison should help to determine the departmental action levels for CyberKnife, Vero4DRT, and TomoTherapy, as patient populations and treatment sites may vary between the modalities. An action level of ±5% could be considered for intensity-modulated radiation therapy (IMRT), non-IMRT, and volumetric modulated arc radiotherapy using these modalities in homogenous and heterogeneous conditions with a large treatment field applied to a large region of homogeneous media. There were larger systematic differences in heterogeneous conditions with a small treatment field because of differences in heterogeneity correction with the different dose calculation algorithms of the primary TPS and verification program.

Original languageEnglish
Pages (from-to)58-65
Number of pages8
JournalPhysica Medica
Volume56
DOIs
Publication statusPublished - 12-2018

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Radiology Nuclear Medicine and imaging
  • Physics and Astronomy(all)

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