Quality assurance of non-coplanar, volumetric-modulated arc therapy employing a C-arm linear accelerator, featuring continuous patient couch rotation

被引:7
作者
Hirashima, Hideaki [1 ]
Nakamura, Mitsuhiro [2 ]
Miyabe, Yuki [1 ]
Mukumoto, Nobutaka [1 ]
Ono, Tomohiro [1 ]
Iramina, Hiraku [1 ]
Mizowaki, Takashi [1 ]
机构
[1] Kyoto Univ, Grad Sch Med, Dept Radiat Oncol & Image Appl Therapy, Sakyo Ku, 54 Kawahara Cho, Kyoto 6068507, Japan
[2] Kyoto Univ, Grad Sch Med, Dept Informat Technol & Med Engn, Div Med Phys,Human Hlth Sci,Sakyo Ku, 53 Kawahara Cho, Kyoto 6068507, Japan
关键词
Non-coplanar VMAT; Continuous couch rotation; Developer mode; Quality assurance; BODY RADIATION-THERAPY; BREAST IRRADIATION; DELIVERY; CANCER; MOTION;
D O I
10.1186/s13014-019-1264-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To perform quality assurance of non-coplanar, volumetric-modulated arc therapy featuring continuous couch rotation (CCR-VMAT) using a C-arm linear accelerator. Methods: We planned and delivered CCR-VMAT using the TrueBeam Developer Mode. Treatment plans were created for both a C-shaped phantom and five prostate cancer patients using seven CCR trajectories that lacked collisions; we used RayStation software (ver. 4.7) to this end. Subsequently, verification plans were generated. The mean absolute error (MAE) between the center of an MV-imaged steel ball and the radiation field was calculated using the Winston-Lutz test. The MAEs between planned and actual irradiation values were also calculated from trajectory logs. In addition, correlation coefficients (r values) among the MAEs of gantry angle, couch angle, and multi-leaf collimator (MLC) position, and mechanical parameters including gantry speed, couch speed, MLC speed, and beam output, were estimated. The dosimetric accuracies of planned and measured values were also assessed using ArcCHECK. Results: The MAEs 2 standard deviations as revealed by the Winston-Lutz test for all trajectories were 0.3 +/- 0.3 mm in two dimensions. The MAEs of the gantry, couch, and MLC positions calculated from all trajectory logs were within 0.04 degrees, 0.08 degrees, and 0.02 mm, respectively. Deviations in the couch angle (r = 0.98, p < 0.05) and MLC position (r = 0.86, p < 0.05) increased significantly with speed. The MAE of the beam output error was less than 0.01 MU. The mean ga mma passing rate +/- 2 SD (range) of the 3%/3 mm, 3%/1 mm, and 5%/1 mm was 98.1 +/- 1.9% (95.7-99.6%), 87.2 +/- 2.8% (80.2-96.7%), and 96.3 +/- 2.8% (93.9-99.6%), respectively. Conclusions: CCR-VMAT delivered via the TrueBeam Developer Mode was associated with high-level geometric and mechanical accuracy, thus affording to high dosimetric accuracy. The CCR-VMAT performance was stable regardless of the trajectory chosen.
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页数:10
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