Abstract

The purpose of this study is to investigate an effect of angular dependence and calibration field size of MapCHECK 2 on RapidArc QA for 6, 8, 10, and 15 MV The angular dependence was investigated by comparing MapCHECK 2 measurements in MapPHAN‐MC2 to the corresponding Eclipse calculations every 10° using 10 × 10 cm2 and 3 × 3 cm2 fields. Fourteen patients were selected to make RapidArc plans using the four energies, and verification plans were delivered to two phantom setups: MapCHECK 2/MapPHAN phantom (MapPHAN QA) and MapCHECK 2 on an isocentric mounting fixture (IMF QA). Migration of MapCHECK 2 on IMF was simulated by splitting arcs every 10° and displacing an isocenter of each partial arc in the Eclipse system (IMFACTUAL QA). To investigate the effect of calibration field size, MapCHECK 2 was calibrated by two field sizes (10 × 10 cm2 and 3 × 3 cm2) and applied to all QA measurements. The γ test was implemented using criteria of 1%/1 mm, 2%/2 mm, and 3%/3 mm. A mean dose of all compared points for each plan was compared with respect to a mean effective field size of the RapidArc plan. The angular dependence was considerably high at gantry angles of 90° ± 10° and 270° ± 10° (for 10 × 10/3 × 3 cm2 at 90°, 30.6% ± 6.6%/33.4%± 5.8% (6 MV), 17.3% ± 5.3%/15.0% ± 6.8% (8 MV), 8.9% ± 2.9%/7.8% ± 3.2% (10 MV), and 2.2% ± 2.3%/‐1.3% ± 2.6% (15 MV)). For 6 MV, the angular dependence significantly deteriorated the γ passing rate for plans of large field size in MapPHAN QA (< 90% using 3%/3 mm); however, these plans passed the γ test in IMFACTUAL QA (> 95%). The different calibration field sizes did not make any significant dose difference for both MapPHAN QA and IMFACTUAL QA. For 8, 10, and 15 MV, the angular dependence does not make any clinically meaningful impact on MapPHAN QA. Both MapPHAN QA and IMFACTUAL QA presented clinically acceptable γ passing rates using 3%/3 mm. MapPHAN QA showed better passing rates than IMFACTUAL QA for the tighter criteria. The 10 × 10 cm2 calibration showed better agreement for plans of small effective field size (< 5 × 5 cm2) in MapPHAN QA. There was no statistical difference between IMF QA and IMFACTUAL QA. In conclusion, MapPHAN QA is not recommended for plans of large field size, especially for 6 MV, and MapCHECK 2 should be calibrated using a field size similar to a mean effective field size of a RapidArc plan for better agreement for IMF QA.PACS numbers: 87.55.km, 87.55.Qr, 87.56.Fc

Highlights

  • Volumetric-modulated arc therapy (VMAT) has rapidly become routine radiation therapy due to improved efficiency of delivery and reduced treatment time with comparable dose distribution to conventional intensity-modulated radiation treatment (IMRT).(1-6) RapidArc (Varian MedicalSystems, Palo Alto, CA) has become available for the arc-dynamic VMAT, which consists of continuous gantry rotation and variations of dose rate and gantry speed while radiation fields shaped by multileaf collimator (MLC) are dynamically changing

  • The goal of this study is to investigate the effect of the angular dependence and different calibration field sizes of MapCHECK 2 on the RapidArc quality assurance (QA) using four beam energies

  • It has been demonstrated that the center diode can be calibrated with a reference dose that is delivered with an IMRT calibration plan.[18]. Our preliminary study shows that the γ passing rate depends on the effective field size of the IM calibration field

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Summary

Introduction

Volumetric-modulated arc therapy (VMAT) has rapidly become routine radiation therapy due to improved efficiency of delivery and reduced treatment time with comparable dose distribution to conventional intensity-modulated radiation treatment (IMRT).(1-6) RapidArc Palo Alto, CA) has become available for the arc-dynamic VMAT, which consists of continuous gantry rotation and variations of dose rate and gantry speed while radiation fields shaped by multileaf collimator (MLC) are dynamically changing. This intrinsic complexity of RapidArc makes pretreatment quality assurance (QA) onerous. Zhu et al[8] compared four different QA devices for the VMAT QA — electronic portal imaging device (EPID), Seven, Im’RT MatriXX, and Delta4 — and presented similar results. Li et al[9] tested ArcCHECK from Sun Nuclear

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