Evaluation of a High-Resolution Large-Area Two-Dimensional Detector Array for Pre-Treatment Verification of Multiple-Target SRS Plans Using a Single Isocenter

Abstract

<h3>Purpose/Objective(s)</h3> Pre-treatment verification of multiple-target SRS plans using a single isocenter is challenging because of small target sizes and multiple off-isocenter targets. Targets located further away from the isocenter are more sensitive to rotational setup variations, increasing the risk of geometrical miss. It demands high-resolution detector for small target sizes and large detector area for measuring multiple targets at once. The purpose of this study is to evaluate a high-resolution large-area two-dimensional (2D) detector array for pre-treatment verification of multiple-target SRS plans using a single isocenter. <h3>Materials/Methods</h3> A 2D detector array was evaluated for this purpose. It is based on a silicon complementary metal-oxide-semiconductor platform, which enables a compact design, fast read-out, and high pixel density with each pixel comprising a radiation-sensitive photodiode, a capacitor and three transistors. Its spatial resolution is 0.4 mm, with 105,000 pixels across a large active area of 120 × 140 mm². Ten multiple-target SRS plans were selected such that each plan has at least 2 targets appear on a longitudinal plane cross the isocenter. All plans were created in a treatment planning system using 6 MV flattening filter free photon beam. The typical plan consisted of one or two coplanar arcs, and two to three non-coplanar arcs. All plans were delivered in patient geometry with the detector center aligned to the plan isocenter. The detector plane was rotated to the corresponding desired longitudinal plane to measure the composite dose in a single measurement. The smallest target measured was 0.12 cc. The largest center-to-center target separation measured was 12 cm. Six of the plans in which the target separations were relatively short were able to be cross verified with a patient-specific quality assurance (PSQA) tool, whose detector area is of 77 × 77 mm². The measured 2D dose distributions in true composite were compared with the calculated dose distributions. Gamma index analysis was performed using 3%/1 mm criteria with a 10% dose threshold. <h3>Results</h3> With the 2D detector array, the gamma passing rates are all greater than 95% except one, which is 93%. The average gamma-passing rate is 97.7%. For the 6 plans cross verified, the average gamma-passing rates are 98.2% and 96.1% with the 2D detector array and PSQA tool, respectively. <h3>Conclusion</h3> The 2D detector array was demonstrated to be suitable and offers an efficient way for pre-treatment verification of multiple-target SRS plans using a single isocenter. The advantages of this 2D array include: 1) High-resolution of 0.4 mm avoids dose interpolations for plans calculated with 0.5 -1.0 mm dose grid and potentially avoids "false positive" results due to more measured points; 2) Large active area of 120 × 140 mm² allows simultaneous verification of multiple targets in true composite in patient geometry.