Three-dimensional Patient-specific Quality Assurance Using Beam Delivery Log Data for Pencil Beam Scanning Carbon-ion Radiotherapy

Background/Aim: In the pencil beam scanning carbon-ion radiotherapy, spot positions are arranged in three dimensions throughout the entire target region. Therefore, dose deviations can occur due to spot position errors in the target. However, performing three-dimensional measurements for routine patient-specific quality assurance (PSQA) is difficult because a simple measurement method has not been established. This study aimed to establish a three-dimensional dose verification method using beam delivery log data. Materials and Methods: Pencil beam dose distributions in water were generated through Monte Carlo (MC) calculations. Treatment beam dose distribution was calculated by superposing the pencil beam dose distributions, considering given spot positions and monitor units (referred to as semi-MC, SMC). The aim of this study was to perform gamma analysis (GA) using dose distributions of log data-based SMC instead of measured dose for PSQA. To verify SMC, the SMC depth-dose curves were compared with the measured dose. To assess the equivalence between the proposed and measurement-based methods, pass rates of two-dimensional GA were compared. Furthermore, a three-dimensional GA was performed to investigate clinically suitable criteria. Results: The SMC dose curves were consistent with measured dose, with a deviation <5%. In two-dimensional GA, pass rates for the proposed method were generally lower than those for measurement-based method. The results of the three-dimensional GA indicated that the proposed method, with criteria of 3%-3 mm and 3%-2 mm, had capabilities comparable to the measurement-based method. Conclusion: The developed three-dimensional log data-based PSQA method with criteria of 3%-3 mm and 3%-2 mm is clinically applicable.