Abstract
Patient specific pretreatment measurement for IMRT and VMAT QA should preferably give information with a high resolution in 3D. The ability to distinguish complex treatment plans, i.e. treatment plans with a difference between measured and calculated dose distributions that exceeds a specified tolerance, puts high demands on the dosimetry system used for the pretreatment measurements and the results of the measurement evaluation needs a clinical interpretation. There are a number of commercial dosimetry systems designed for pretreatment IMRT QA measurements. 2D arrays such as MapCHECK® (Sun Nuclear), MatriXXEvolution (IBA Dosimetry) and OCTAVIOUS® 1500 (PTW), 3D phantoms such as OCTAVIUS® 4D (PTW), ArcCHECK® (Sun Nuclear) and Delta4 (ScandiDos) and software for EPID dosimetry and 3D reconstruction of the dose in the patient geometry such as EPIDoseTM (Sun Nuclear) and Dosimetry CheckTM (Math Resolutions) are available. None of those dosimetry systems can measure the 3D dose distribution with a high resolution (full 3D dose distribution). Those systems can be called quasi 3D dosimetry systems. To be able to estimate the delivered dose in full 3D the user is dependent on a calculation algorithm in the software of the dosimetry system. All the vendors of the dosimetry systems mentioned above provide calculation algorithms to reconstruct a full 3D dose in the patient geometry. This enables analyzes of the difference between measured and calculated dose distributions in DVHs of the structures of clinical interest which facilitates the clinical interpretation and is a promising tool to be used for pretreatment IMRT QA measurements. However, independent validation studies on the accuracy of those algorithms are scarce. Pretreatment IMRT QA using the quasi 3D dosimetry systems mentioned above rely on both measurement uncertainty and accuracy of calculation algorithms. In this article, these quasi 3D dosimetry systems and their use in patient specific pretreatment IMRT/VMAT QA will be discussed.
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