title: Retrospective evaluation of dosimetric quality for prostate carcinomas treated with 3D conformal, intensity modulated and volumetric modulated arc radiotherapy.
abstract: BACKGROUND
  This study examines and compares the dosimetric quality of radiotherapy treatment plans for prostate carcinoma across a cohort of 163 patients treated across five centres: 83 treated with three-dimensional conformal radiotherapy (3DCRT), 33 treated with intensity modulated radiotherapy (IMRT) and 47 treated with volumetric modulated arc therapy (VMAT).
  
  
  METHODS
  Treatment plan quality was evaluated in terms of target dose homogeneity and organs at risk (OAR), through the use of a set of dose metrics. These included the mean, maximum and minimum doses; the homogeneity and conformity indices for the target volumes; and a selection of dose coverage values that were relevant to each OAR. Statistical significance was evaluated using two-tailed Welch's T-tests. The Monte Carlo DICOM ToolKit software was adapted to permit the evaluation of dose metrics from DICOM data exported from a commercial radiotherapy treatment planning system.
  
  
  RESULTS
  The 3DCRT treatment plans offered greater planning target volume dose homogeneity than the other two treatment modalities. The IMRT and VMAT plans offered greater dose reduction in the OAR: with increased compliance with recommended OAR dose constraints, compared to conventional 3DCRT treatments. When compared to each other, IMRT and VMAT did not provide significantly different treatment plan quality for like-sized tumour volumes.
  
  
  CONCLUSIONS
  This study indicates that IMRT and VMAT have provided similar dosimetric quality, which is superior to the dosimetric quality achieved with 3DCRT.
authors.affiliation: Science and Engineering Faculty, Queensland University of Technology Brisbane, Queensland, Australia.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Crowe
authors.affiliation: Science and Engineering Faculty, Queensland University of Technology Brisbane, Queensland, Australia ; Premion, Wesley Medical Centre Brisbane, Queensland, Australia.
authors.forename: Tanya
authors.initials: T
authors.lastname: Kairn
authors.affiliation: Premion, Wesley Medical Centre Brisbane, Queensland, Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: Middlebrook
authors.affiliation: Premion, Wesley Medical Centre Brisbane, Queensland, Australia.
authors.forename: Brendan
authors.initials: B
authors.lastname: Hill
authors.affiliation: Premion, Wesley Medical Centre Brisbane, Queensland, Australia.
authors.forename: David R H
authors.initials: DR
authors.lastname: Christie
authors.affiliation: Premion, Wesley Medical Centre Brisbane, Queensland, Australia.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Knight
authors.affiliation: Australian Clinical Dosimetry Services, Australian Radiation Protection and Nuclear Safety Agency Melbourne, Victoria, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Kenny
authors.affiliation: Science and Engineering Faculty, Queensland University of Technology Brisbane, Queensland, Australia.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Langton
authors.affiliation: Science and Engineering Faculty, Queensland University of Technology Brisbane, Queensland, Australia.
authors.forename: Jamie V
authors.initials: JV
authors.lastname: Trapp
keywords: Dosimetric quality; intensity modulated radiotherapy; prostate carcinoma; volumetric modulated arc therapy