TU‐C‐BRE‐08: IMRT QA: Selecting Meaningful Gamma Criteria Based On Error Detection Sensitivity

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Purpose:To develop a strategy for defining meaningful tolerance limits and studying the sensitivity of IMRT QA gamma criteria by inducing known errors in QA plans.Methods:IMRT QA measurements (ArcCHECK, Sun Nuclear) were compared to QA plan calculations with induced errors. Many (>24) gamma comparisons between data and calculations were performed for each of several kinds of cases and classes of induced error types with varying magnitudes (e.g. MU errors ranging from ‐10% to +10%), resulting in over 3,000 comparisons. Gamma passing rates for each error class and case were graphed against error magnitude to create error curves in order to represent the range of missed errors in routine IMRT QA using various gamma criteria.Results:This study demonstrates that random, case‐specific, and systematic errors can be detected by the error curve analysis. Depending on location of the peak of the error curve (e.g., not centered about zero), 3%/3mm threshold=10% criteria may miss MU errors of up to 10% and random MLC errors of up to 5 mm. Additionally, using larger dose thresholds for specific devices may increase error sensitivity (for the same X%/Ymm criteria) by up to a factor of two. This analysis will allow clinics to select more meaningful gamma criteria based on QA device, treatment techniques, and acceptable error tolerances.Conclusion:We propose a strategy for selecting gamma parameters based on the sensitivity of gamma criteria and individual QA devices to induced calculation errors in QA plans. Our data suggest large errors may be missed using conventional gamma criteria and that using stricter criteria with an increased dose threshold may reduce the range of missed errors. This approach allows quantification of gamma criteria sensitivity and is straightforward to apply to other combinations of devices and treatment techniques.