Verification of daily dose recalculation accuracy for an adaptive radiation therapy monitoring tool in helical tomotherapy for nasopharyngeal carcinoma.

Abstract

PreciseART, an adaptive radiation therapy (ART) software for helical tomotherapy (HT), was integrated into the Precision treatment planning system (Accuray, Inc., Sunnyvale, CA). It supports automatic monitoring of dose variations to both the target and organs at risk (OARs) throughout the treatment course. This study aims to verify the accuracy of PreciseART's automatic dose recalculation and assess the effectiveness of its notification function. The Radixact X9's kVCT image-guided system (ClearRT) was used to acquire daily images for dose recalculations. We assessed the accuracy of PreciseART's automatic dose recalculation by comparing it with the treatment planning system (TPS) recalculation for the PTV70, spinal cord, and bilateral parotid glands. We also evaluated the efficacy of its notification function by comparing each dose metric for each notification color to TPS recalculation, assessing its role as a trigger tool. In the phantom study, dosimetric analysis indicated no statistically significant differences between TPS and PreciseART recalculations (p>0.05), with dose variations under 1.5%. Similarly, in the patient study (n=10), no significant dosimetric discrepancies were found (p>0.05), with a maximum variation of 2.3%. The notification system performed effectively, providing accurate notifications in accordance with predefined dose criteria. PreciseART's daily dose recalculation demonstrated good agreement with TPS recalculation, and its notification function is effective for identifying dose threshold compliance, supporting its use in clinical ART.