Abstract

Purpose: The purpose of this work was to evaluate limits and capabilities in the transit dosimetry software for use with the TomoTherapy system by irradiating a heterogeneous phantom. Methods: Helical TomoTherapy plan was created using CIRS phantom (model 062M) with nine various tissue equivalent inserts (lung inhale 0.2 g/cm3, lung exhale 0.5 g/cm3, adipose 0.96 g/cm3, breast 0.99 g/cm3, water 1.01 g/cm3, muscle 1.06 g/cm3, liver 1.07 g/cm3, trabecular bone 1.16 g/cm3, and dense bone 1.53 g/cm3). Targets were contoured within every insert. The phantom was scanned with a 50 cm field of view and 3 mm slice width. Images were imported into the TomoTherapy TPS. A plan was generated to deliver 20 Gy to every insert (2 Gy per fraction) with a jaw width of 2.5 cm, a pitch of 0.430 and an actual modulation factor of 2.621. After the radiation delivery the planning CT, the RT structure, the RT plan, and the RT dose (DICOM format) as well as the exit detector sinogram were imported into the Dosimetry Check software (Math Resolutions, LLC). The 3D delivered doses were reconstructed from the exit detector data by correcting for phantom and couch attenuation. The resulting dose distribution were compared with the TPS planned dose using gamma index. Results: Using the clinical gamma criteria, 3% and 3 mm, all tissue equivalent inserts had a passing percentage of 100% except for 0.2 g/cm3 and 0.5 g/cm3 density inserts (gamma value of 81.67% and 99.18% respectively). Conclusion: The evaluated transit dosimetry software provides an independent verification of helical TomoTherapy plans giving additional confidence in the treatment delivery, however, an overestimation of the reconstructed dose in low density materials has been revealed. Implementation of Monte Carlo algorithm for exit dose reconstruction should improve dosimetric accuracy in heterogeneous patient tissues. Agreement with Math Resolutions

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