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Abstract
PurposeTo evaluate the Edose system, a novel three-dimensional (3D) in vivo dose monitoring system based on electronic portal imaging device (EPID), prior to clinical application, we analyzed the preliminary clinical data using Edose system in patients receiving intensity-modulated radiation therapy (IMRT).Materials and methodsAfter the physical modeling, the measured results from the Edose system were examined in homogeneous and inhomogeneous phantoms, respectively. To verify the accuracy of the Edose system, we compared its results with testing results from ionization chamber, measurement matrix (Delta4) and dosimetric films. The dosimetric performance of the Edose system was evaluated in 12 randomly selected patients with IMRT and VMAT, and the measured results were compared with the treatment plans.ResultsCompared with the measured results, the dose difference at the center of target volume was (0.12±0.91)% and (0.03±0.85)%, the γ pass rate was (94.18±1.69)% and (95.24±1.62)% (3mm/3%)for homogeneous and inhomogeneous phantoms, respectively. For IMRT patients, the dose difference at the center of target volume was (0.75±1.53)%, and the γ pass rates were (89.11±3.24)% (3mm/3%) and (96.40±1.47)% (3mm/5%), respectively. Compared with the results of DVH, the maximum differences of PTVs and mostly organs at risk were all within 3%. For VMAT patients, the γ pass rates were (93.04 ± 2.62)% (3mm/3%) and (97.92 ± 1.38)% (3mm/5%), respectively.ConclusionsIn vivo dose monitoring may further improve the safety and quality assurance for radiation therapy. But rigorous clinical testing is required before putting the existing commercial systems into clinical application. In addition, more clinical experiences and better workflows for using the Edose system are needed.
Highlights
With the rapid progress of the radiation therapy techniques such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), the radiation treatment delivery becomes more complex
Results of comparison for dose profiles, percentage depth dose (PDDs) and output factors between results of electronic portal imaging device (EPID) calculation and scanning results of 3D water tank were shown in Figure 1, Figure 2 and Figure 3, respectively
Weight given to photons with different energy and the final physical parameters were shown in Tables 1 and 2, respectively
Summary
With the rapid progress of the radiation therapy techniques such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), the radiation treatment delivery becomes more complex This brings more uncertainties and variations in the treatment process such as gantry rotation speed, collimator angle, dose rate, moving speed and position accuracy of multi-leaf collimator (MLC), etc. All these factors can result in the real radiation dose deviating from the original planned www.impactjournals.com/oncotarget dose These errors, if severe, may even lead to radiotherapy accidents [3]. Physical modeling and in vivo dose monitoring processes of Edose system The 3D dose reconstruction of Edose system is based on the algorithm model, physical modeling is www.impactjournals.com/oncotarget required in accordance with the conditions before application.
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