Abstract

Purpose: To develop a comprehensive end-to-end test for Varian's TrueBeam linear accelerator for head and neck IMRT using a custom phantom designed to utilize multiple dosimetry devices. Methods: The initial end-to-end test and custom H&N phantom were designed to yield maximum information in anatomical regions significant to H&N plans with respect to: i) geometric accuracy, ii) dosimetric accuracy, and iii) treatment reproducibility. The phantom was designed in collaboration with Integrated Medical Technologies. A CT image was taken with a 1mm slice thickness. The CT was imported into Varian's Eclipse treatment planning system, where OARs and the PTV were contoured. A clinical template was used to create an eight field static gantry angle IMRT plan. After optimization, dose was calculated using the Analytic Anisotropic Algorithm with inhomogeneity correction. Plans were delivered with a TrueBeam equipped with a high definition MLC. Preliminary end-to-end results were measured using film and ion chambers. Ion chamber dose measurements were compared to the TPS. Films were analyzed with FilmQAPro using composite gamma index. Results: Film analysis for the initial end-to-end plan with a geometrically simple PTV showed average gamma pass rates >99% with a passing criterion of 3% / 3mm. Film analysis of a plan with a more realistic, ie. complex, PTV yielded pass rates >99% in clinically important regions containing the PTV, spinal cord and parotid glands. Ion chamber measurements were on average within 1.21% of calculated dose for both plans. Conclusion: trials have demonstrated that our end-to-end testing methods provide baseline values for the dosimetric and geometric accuracy of Varian's TrueBeam system.

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