Fast, simple, and informative patient-specific dose verification method for intensity modulated total marrow irradiation with helical tomotherapy.
BACKGROUND
Patient-specific dose verification for treatment planning in helical tomotherapy is routinely performed using a homogeneous virtual water cylindrical phantom of 30 cm diameter and 18 cm length (Cheese phantom). Because of this small length, treatment with total marrow irradiation (TMI) requires multiple deliveries of the dose verification procedures to cover a wide range of the target volumes, which significantly prolongs the dose verification process. We propose a fast, simple, and informative patient-specific dose verification method which reduce dose verification time for TMI with helical tomotherapy.


METHODS
We constructed a two-step solid water slab phantom (length 110 cm, height 8 cm, and two-step width of 30 cm and 15 cm), termed the Whole Body Phantom (WB phantom). Three ionization chambers and three EDR-2 films can be inserted to cover extended field TMI treatment delivery. Three TMI treatment plans were conducted with a TomoTherapy HiArt Planning Station and verified using the WB phantom with ion chambers and films. Three regions simulating the head and neck, thorax, and pelvis were covered in a single treatment delivery. The results were compared to those with the cheese phantom supplied by Accuray, Inc. following three treatment deliveries to cover the body from head to pelvis.


RESULTS
Use of the WB phantom provided point doses or dose distributions from head and neck to femur in a single treatment delivery of TMI. Patient-specific dose verification with the WB phantom was 62% faster than with the cheese phantom. The average pass rate in gamma analysis with the criteria of a 3-mm distance-to-agreement and 3% dose differences was 94% ± 2% for the three TMI treatment plans. The differences in pass rates between the WB and cheese phantoms at the upper thorax to abdomen regions were within 2%. The calculated dose agreed with the measured dose within 3% for all points in all five cases in both the WB and cheese phantoms.


CONCLUSIONS
Our dose verification method with the WB phantom provides simple and rapid quality assurance without limiting dose verification information in total marrow irradiation with helical tomotherapy.
Yutaka
Y
Takahashi
Masonic Cancer Center, University of Minnesota, 424 Harvard Street SE, Minneapolis 55455, MN, USA. huixx019@umn.edu.
Susanta K
SK
Hui
D019046:Bone Marrow Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007206:Individuality; D019047:Phantoms, Imaging; D057285:Precision Medicine; D011874:Radiometry; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000295:instrumentation* / Q000379:methods*; D013997:Time Factors; D014916:Whole-Body Irradiation / Q000295:instrumentation / Q000379:methods