title: Modulation factors calculated with an EPID-derived MLC fluence model to streamline IMRT/VMAT second checks.
abstract: This work outlines the development of a robust method of calculating modulation factors used for the independent verification of MUs for IMRT and VMAT treatments, to replace onerous ion chamber measurements. Two-dimensional fluence maps were calculated for dynamic MLC fields that include MLC interleaf leakage, transmission, and tongue-and-groove effects, as characterized from EPID-acquired images. Monte Carlo-generated dose kernels were then used to calculate doses for a modulated field and that field with the modulation removed at a depth specific to the calculation point in the patient using in-house written software, Mod_Calc. The ratio of these two doses was taken to calculate modulation factors. Comparison between Mod_Calc calculation and ion chamber measurement of modulation factors for 121 IMRT fields yielded excellent agreement, where the mean difference between the two was -0.3% ± 1.2%. This validated use of Mod_Calc clinically. Analysis of 5,271 dynamic fields from clinical use of Mod_Calc gave a mean difference of 0.3% ± 1.0% between Mod_Calc and Eclipse-generated factors. In addition, 99.3% and 96.5% fields pass 5% and 2% criteria, respectively, for agreement between these two predictions. The development and use of Mod_Calc at our clinic has considerably streamlined our QA process for IMRT and RapidArc fields, compared to our previous method based on ion chamber measurements. As a result, it has made it feasible to maintain our established and trusted current in-house method of MU verification, without resorting to commercial software alternatives.
authors.affiliation: University of Alberta, Cross Cancer Institute. ssteciw@ualberta.ca.
authors.forename: Stephen
authors.initials: S
authors.lastname: Steciw
authors.forename: Satyapal
authors.initials: S
authors.lastname: Rathee
authors.forename: Brad
authors.initials: B
authors.lastname: Warkentin
mesh_terms: D000465:Algorithms; D003198:Computer Simulation; D055615:Electrical Equipment and Supplies; D006801:Humans; D008962:Models, Theoretical; D009010:Monte Carlo Method; D009369:Neoplasms / Q000532:radiotherapy*; D010315:Particle Accelerators; D019047:Phantoms, Imaging; D011874:Radiometry / Q000295:instrumentation*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D061089:Radiotherapy, Image-Guided / Q000295:instrumentation*; D050397:Radiotherapy, Intensity-Modulated / Q000295:instrumentation*