Abstract

Purpose:SRS/SBRT combines hypofractionation with excellent dose distributions. However, extremely steep gradients across the target along with dose escalation, if not administered accurately, may lead to serious complications, recurrences, or even fatalities. Existing commercial QA products either lack adequate spatial resolution or the 3D aspect. By contrast, the new CrystalBall™ mailed high‐resolution 3D dosimetry service removes the above limitations while reducing the overall workload on medical physics staff. The exposed dosimeters, which change optical density in proportion to local dose, are sent back to the manufacturer (MGS Research Inc., Madison, CT) for sub‐millimeter‐resolution laser‐CT scanning and QA data analysis. QA report is returned electronically within 24 hours. The purpose of this study was to evaluate the dose calibration accuracy in this system.Methods:Two spherical CrystalBall™ polymer gel dosimeters from the same batch, 166 mm diameter, with embedded 3D image registration markers, were mounted in a special phantom designed for reproducible positioning. For full end to end testing, the optical guidance array was mounted onto the phantom and a CT was taken. Two separate Rapid Arc SRS plans were designed. Varian Medical Systems optical guidance system was used to position the phantom and the SRS treatment plans were delivered to the two spheres on Varian's Trilogy Accelerator. Exposed dosimeters were mailed back to the manufacturer for laser CT scanning and analysis.Results:For each plan, 3D gamma passing rate was 100% for 2%/2mm distance‐to‐agreement criteria above 50% isodose level. The two calibration curves, generated using volumetric dose and optical density data, showed excellent mutual agreement (max difference 2.2%, median difference 0.75%).Conclusion:The clinical utility of new CrystalBall™ mailed QA service for SRS/SBRT and high accuracy of dose calibration have been validated. The workflow associated with the use of the CrystalBall™ in clinical setting was found to be minimal.The presenting author is the founder of and has an ownership in MGS Research Inc which manufactures the CrystalBall system for 3D dosimetry.

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