The influence of the IMRT QA set-up error on the 2D and 3D gamma evaluation method as obtained by using Monte Carlo simulations

Abstract

The phantom-alignment error is one of the factors affecting delivery quality assurance (QA) accuracy in intensity-modulated radiation therapy (IMRT). Accordingly, a possibility of inadequate use of spatial information in gamma evaluation may exist for patient-specific IMRT QA. The influence of the phantom-alignment error on gamma evaluation can be demonstrated experimentally by using the gamma passing rate and the gamma value. However, such experimental methods have a limitation regarding the intrinsic verification of the influence of the phantom set-up error because experimentally measuring the phantom-alignment error accurately is impossible. To overcome this limitation, we aimed to verify the effect of the phantom set-up error within the gamma evaluation formula by using a Monte Carlo simulation. Artificial phantom set-up errors were simulated, and the concept of the true point (TP) was used to represent the actual coordinates of the measurement point for the mathematical modeling of these effects on the gamma. Using dose distributions acquired from the Monte Carlo simulation, performed gamma evaluations in 2D and 3D. The results of the gamma evaluations and the dose difference at the TP were classified to verify the degrees of dose reflection at the TP. The 2D and the 3D gamma errors were defined by comparing gamma values between the case of the imposed phantom set-up error and the TP in order to investigate the effect of the set-up error on the gamma value. According to the results for gamma errors, the 3D gamma evaluation reflected the dose at the TP better than the 2D one. Moreover, the gamma passing rates were higher for 3D than for 2D, as is widely known. Thus, the 3D gamma evaluation can increase the precision of patient-specific IMRT QA by applying stringent acceptance criteria and setting a reasonable action level for the 3D gamma passing rate.