Fast motion-including dose error reconstruction for VMAT with and without MLC tracking.
Multileaf collimator (MLC) tracking is a promising and clinically emerging treatment modality for radiotherapy of mobile tumours. Still, new quality assurance (QA) methods are warranted to safely introduce MLC tracking in the clinic. The purpose of this study was to create and experimentally validate a simple model for fast motion-including dose error reconstruction applicable to intrafractional QA of MLC tracking treatments of moving targets.MLC tracking experiments were performed on a standard linear accelerator with prototype MLC tracking software guided by an electromagnetic transponder system. A three-axis motion stage reproduced eight representative tumour trajectories; four lung and four prostate. Low and high modulation 6 MV single-arc volumetric modulated arc therapy treatment plans were delivered for each trajectory with and without MLC tracking, as well as without motion for reference. Temporally resolved doses were measured during all treatments using a biplanar dosimeter. Offline, the dose delivered to each of 1069 diodes in the dosimeter was reconstructed with 500 ms temporal resolution by a motion-including pencil beam convolution algorithm developed in-house. The accuracy of the algorithm for reconstruction of dose and motion-induced dose errors throughout the tracking and non-tracking beam deliveries was quantified. Doses were reconstructed with a mean dose difference relative to the measurements of-0.5% (5.5% standard deviation) for cumulative dose. More importantly, the root-mean-square deviation between reconstructed and measured motion-induced 3%/3 mm γ failure rates (dose error) was 2.6%. The mean computation time for each calculation of dose and dose error was 295 ms. The motion-including dose reconstruction allows accurate temporal and spatial pinpointing of errors in absorbed dose and is adequately fast to be feasible for online use. An online implementation could allow treatment intervention in case of erroneous dose delivery in both tracking and non-tracking treatments.
Department of Oncology, Aarhus University Hospital, 8000 Aarhus C, Denmark. Institute of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark.
Thomas
T
Ravkilde
Paul J
PJ
Keall
Cai
C
Grau
Morten
M
Høyer
Per R
PR
Poulsen
D000465:Algorithms; D006801:Humans; D008297:Male; D010315:Particle Accelerators; D019047:Phantoms, Imaging; D011874:Radiometry / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000295:instrumentation / Q000379:methods*