A multi-institutional dosimetry audit of rotational intensity-modulated radiotherapy

Background: Rotational IMRT (VMAT and Tomotherapy) has now been implemented in many radiotherapy centres. An audit to verify treatment planning system modelling and treatment delivery has been undertaken to ensure accurate clinical implementation. Material and methods: 34 institutions with 43 treatment delivery systems took part in the audit. A virtual phantom planning exercise (3DTPS test) and a clinical trial planning exercise were planned and independently measured in each institution using a phantom and array combination. Point dose differences and global gamma index (gamma) were calculated in regions corresponding to PTVs and OARs. Results: Point dose differences gave a mean (+/- sd) of 0.1 +/- 2.6% and 0.2 +/- 2.0% for the 3DTPS test and clinical trial plans, respectively. 34/43 planning and delivery combinations achieved all measured planes with >95% pixels passing gamma < 1 at 3%/3 mm and rose to 42/43 for clinical trial plans. A statistically significant difference in gamma pass rates (p < 0.01) was seen between planning systems where rotational IMRT modelling had been designed for the manufacturer's own treatment delivery system and those designed independently of rotational IMRT delivery. Conclusions: A dosimetry audit of rotational radiotherapy has shown that TPS modelling and delivery for rotational IMRT can achieve high accuracy of plan delivery. (C) 2014 Elsevier Ireland Ltd. All rights reserved.