Abstract
Purpose:Intensity modulated radiotherapy requires a comprehensive quality assurance program in general and ideally independent verification of dose delivery. Since conventional 2D detector arrays allow only pre‐treatment verification, there is a debate concerning the need of online dose verification. This study presents the clinical performance, including dosimetric plan verification in 2D as well as in 3D and the error detection abilities of a new transmission detector (TD) for online dose verification of 6MV photon beam.Methods:To validate the dosimetric performance of the new device, dose reconstruction based on TD measurements were compared to a conventional pre‐treatment verification method (reference) and treatment planning system (TPS) for 18 IMRT and VMAT treatment plans. Furthermore, dose reconstruction inside the patient based on TD read‐out was evaluated by comparing various dose volume indices and 3D gamma evaluations against independent dose computation and TPS. To investigate the sensitivity of the new device, different types of systematic and random errors for leaf positions and linac output were introduced in IMRT treatment sequences.Results:The 2D gamma index evaluation of transmission detector based dose reconstruction showed an excellent agreement for all IMRT and VMAT plans compared to reference measurements (99.3±1.2)% and TPS (99.1±0.7)%. Good agreement was also obtained for 3D dose reconstruction based on TD read‐out compared to dose computation (mean gamma value of PTV = 0.27±0.04). Only a minimal dose underestimation within the target volume was observed when analyzing DVH indices (<1%). Positional errors in leaf banks larger than 1mm and errors in linac output larger than 2% could clearly identified with the TD.Conclusion:Since 2D and 3D evaluations for all IMRT and VMAT treatment plans were in excellent agreement with reference measurements and dose computation, the new TD is suitable to qualify for routine treatment plan verification.Funding Support, Disclosures, and Conflict of Interest: COIs: Frank Lohr: Elekta: research grant, travel grants, teaching honoraria IBA: research grant, travel grants, teaching honoraria, advisory board C‐Rad: board honoraria, travel grants Frederik Wenz: Elekta: research grant, teaching honoraria, consultant, advisory board Zeiss: research grant, teaching honoraria, patent Hansjoerg Wertz: Elekta: research grant, teaching honoraria IBA: research grant
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