title: Quality assurance methodology for Varian RapidArc treatment plans.
abstract: With the commercial introduction of the Varian RapidArc, a new modality for treatment planning and delivery, the need has arisen for consistent and efficient techniques for performing patient-specific quality assurance (QA) tests. In this paper we present our methodology for a RapidArc treatment plan QA procedure. For our measurements we used a 2D diode array (MapCHECK) embedded at 5 cm water equivalent depth in MapPHAN 5 phantom and an Exradin A16 ion chamber placed in six different positions in a cylindrical homogeneous phantom (QUASAR). We also checked the MUs for the RapidArc plans by using independent software (RadCalc). The agreement between Eclipse calculations and MapCHECK/MapPHAN5 measurements was evaluated using both absolute distance-to-agreement (DTA) and gamma index with 10% dose threshold (TH), 3% dose difference (DD), and 3 mm DTA. The average agreement was 94.4% for the DTA approach and 96.3% for the gamma index approach. In high-dose areas, the discrepancy between calculations and ion chamber measurements using the QUASAR phantom was within 4.5% for prostate cases. For the RadCalc calculations, we used the average SSD along the arc; however, for some patients the agreement for the MUs obtained with RadCalc versus Eclipse was inadequate (discrepancy > 5%). In these cases, the plan was divided into partial arc plans so that RadCalc could perform a better estimation of the MUs. The discrepancy was further reduced to within ~4% using this approach. Regardless of the variation in prescribed dose and location of the treated areas, we obtained very good results for all patients studied in this paper.
authors.affiliation: Radiation Oncology Department, Lahey Clinic, Burlington, MA, USA. ileana.n.iftimia@lahey.org
authors.forename: Ileana
authors.initials: I
authors.lastname: Iftimia
authors.forename: Eileen T
authors.initials: ET
authors.lastname: Cirino
authors.forename: Li
authors.initials: L
authors.lastname: Xiong
authors.forename: Herbert W
authors.initials: HW
authors.lastname: Mower
mesh_terms: D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D008297:Male; D019047:Phantoms, Imaging; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D011786:Quality Control; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000295:instrumentation / Q000379:methods*; D014134:Tracheal Neoplasms / Q000532:radiotherapy