title: Validation of a modern second-check dosimetry system using a novel verification phantom.
abstract: OBJECTIVE
  To evaluate the Mobius second-check dosimetry system by comparing it to ionization-chamber dose measurements collected in the recently released Mobius Verification Phantom™ (MVP). For reference, a comparison of these measurements to dose calculated in the primary treatment planning system (TPS), Varian Eclipse with the AcurosXB dose algorithm, is also provided. Finally, patient dose calculated in Mobius is compared directly to Eclipse to demonstrate typical expected results during clinical use of the Mobius system.
  
  
  METHODS
  Seventeen anonymized intensity-modulated clinical treatment plans were selected for analysis. Dose was recalculated on the MVP in both Eclipse and Mobius. These calculated doses were compared to doses measured using an A1SL ionization-chamber in the MVP. Dose was measured and analyzed at two different chamber positions for each treatment plan. Mobius calculated dose was then compared directly to Eclipse using the following metrics; target mean dose, target D95%, global 3D gamma pass rate, and target gamma pass rate. Finally, these same metrics were used to analyze the first 36 intensity modulated cases, following clinical implementation of the Mobius system.
  
  
  RESULTS
  The average difference between Mobius and measurement was 0.3 ± 1.3%. Differences ranged from -3.3 to + 2.2%. The average difference between Eclipse and measurement was -1.2 ± 0.7%. Eclipse vs. measurement differences ranged from -3.0 to -0.1%. For the 17 anonymized pre-clinical cases, the average target mean dose difference between Mobius and Eclipse was 1.0 ± 1.1%. Average target D95% difference was -0.9 ± 2.0%. Average global gamma pass rate, using a criteria of 3%, 2 mm, was 94.4 ± 3.3%, and average gamma pass rate for the target volume only was 80.2 ± 12.3%. Results of the first 36 intensity-modulated cases, post-clinical implementation of Mobius, were similar to those seen for the 17 pre-clinical test cases.
  
  
  CONCLUSIONS
  Mobius correctly calculated dose for each tested intensity modulated treatment plan, agreeing with measurement to within 3.5% for all cases analyzed. The dose calculation accuracy and independence of the Mobius system is sufficient to provide a rigorous second-check of a modern TPS.
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: McDonald
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Dustin J
authors.initials: DJ
authors.lastname: Jacqmin
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Mart
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Koch
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Peng
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Ashenafi
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Fugal
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Kenneth N
authors.initials: KN
authors.lastname: Vanek
mesh_terms: D000465:Algorithms; D005373:Film Dosimetry / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D019047:Phantoms, Imaging; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated
keywords: 
  IMRT
  ; 
  VMAT
  ; Mobius; Mobius verification phantom; eclipse acuros