Abstract

In VMAT treatment delivery the ability of the linear accelerator (linac) to accurately control dose versus gantry angle is critical to delivering the plan correctly. A new VMAT test delivery was developed to specifically test the dose versus gantry angle with the full range of allowed gantry speeds and dose rates. The gantry‐mounted IBA MatriXX with attached inclinometer was used in movie mode to measure the instantaneous relative dose versus gantry angle during the plan every 0.54 s. The results were compared to the expected relative dose at each gantry angle calculated from the plan. The same dataset was also used to compare the instantaneous gantry speeds throughout the delivery compared to the expected gantry speeds from the plan. Measurements performed across four linacs generally show agreement between measurement and plan to within 1.5% in the constant dose rate regions and dose rate modulation within 0.1 s of the plan. Instantaneous gantry speed was measured to be within 0.11∘/s of the plan (1 SD). An error in one linac was detected in that the nominal gantry speed was incorrectly calibrated. This test provides a practical method to quality‐assure critical aspects of VMAT delivery including dose versus gantry angle and gantry speed control. The method can be performed with any detector that can acquire time‐resolved dosimetric information that can be synchronized with a measurement of gantry angle. The test fulfils several of the aims of the recent Netherlands Commission on Radiation Dosimetry (NCS) Report 24, which provides recommendations for comprehensive VMAT quality assurance.PACS number(s): 87.55.Qr

Highlights

  • RapidArc is the Varian version of volumetric-modulated arc therapy (VMAT) that was first proposed by Otto.[1]. VMAT is an extension of IMRT where in addition to dynamic MLC motion and dose rate modulation the treatment is delivered as a gantry arc with gantry speed modulation

  • When greater MU/degree is to be delivered, the maximum dose rate will be applied and the gantry speed will slow down.[3]. If during plan delivery the MLC leaves cannot reach their required position within the set Dynamic Leaf Tolerance, the delivery will be stopped with an MLC interlock instead of modulating the dose rate to continue the delivery, as is done with IMRT

  • A new test to directly measure the accuracy of dose versus gantry angle and gantry speed for VMAT quality assurance was developed and tested

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Summary

Introduction

RapidArc is the Varian version of volumetric-modulated arc therapy (VMAT) that was first proposed by Otto.[1] VMAT is an extension of IMRT where in addition to dynamic MLC motion and dose rate modulation the treatment is delivered as a gantry arc with gantry speed modulation. The treatment console controls the dose versus gantry angle by varying the dose rate and gantry speed as required to deliver the plan. When greater MU/degree is to be delivered, the maximum dose rate will be applied and the gantry speed will slow down.[3] If during plan delivery the MLC leaves cannot reach their required position within the set Dynamic Leaf Tolerance, the delivery will be stopped with an MLC interlock instead of modulating the dose rate to continue the delivery, as is done with IMRT

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