Abstract
HI-ART II system can generate CT images from the same megavoltage X-ray beam used for treatment. These megavoltage CT (MVCT) images not only provide verification of the patient position prior to and potentially during radiation therapy, but they are also used for dose calculation. Dose calculations based on MVCT images require an image value to electron density calibration to remain stable over the course of treatment time. In this work, we have investigated the dosimetric effects on TomoTherapy treatment plans due to variation in image value to density table (IVDT) curve, such as time, MVCT parameters, phantom material and arrangement. We also have evaluated the reliability and stability of dose calculation during adaptive radiation therapy and dose verification using MVCT images. Among the tests, dose calculation using MVCT images was well consistent with that using kVCT. The differences in dose calculation on the phantom plan were up to almost 3% and typically the dosimetric points varied by less than 2%. Hence, the reliability of dose calculation for MVCT provides a basis of adaptive radiation therapy. It is recommended to measure the IVDT curves on a regular basis.KeywordsTomoTherapyIVDTdose calculationMVCT
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