TY - JOUR
T1 - Time-resolved versus time-integrated portal dosimetry: the role of an object's position with respect to the isocenter in volumetric modulated arc therapy
AU - Schyns, Lotte E. J. R.
AU - Persoon, Lucas C. G. G.
AU - Podesta, Mark
AU - van Elmpt, Wouter J. C.
AU - Verhaegen, Frank
PY - 2016/5/21
Y1 - 2016/5/21
N2 - The aim of this work is to compare time-resolved (TR) and time-integrated (TI) portal dosimetry, focussing on the role of an object's position with respect to the isocenter in volumetric modulated arc therapy (VMAT). Portal dose images (PDIs) are simulated and measured for different cases: a sphere (1), a bovine bone (2) and a patient geometry (3). For the simulated case (1) and the experimental case (2), several transformations are applied at different off-axis positions. In the patient case (3), three simple plans with different isocenters are created and pleural effusion is simulated in the patient. The PDIs before and after the sphere transformations, as well as the PDIs with and without simulated pleural effusion, are compared using a TI and TR gamma analysis. In addition, the performance of the TI and TR gamma analyses for the detection of real geometric changes in patients treated with clinical plans is investigated and a correlation analysis is performed between gamma fail rates and differences in dose volume histogram (DVH) metrics. The TI gamma analysis can show large differences in gamma fail rates for the same transformation at different off-axis positions (or for different plan isocenters). The TR gamma analysis, however, shows consistent gamma fail rates. For the detection of real geometric changes in patients treated with clinical plans, the TR gamma analysis has a higher sensitivity than the TI gamma analysis. However, the specificity for the TR gamma analysis is lower than for the TI gamma analysis. Both the TI and TR gamma fail rates show no correlation with changes in DVH metrics. This work shows that TR portal dosimetry is fundamentally superior to TI portal dosimetry, because it removes the strong dependence of the gamma fail rate on the off-axis position/plan isocenter. However, for 2D TR portal dosimetry, it is still difficult to interpret gamma fail rates in terms of changes in DVH metrics for patients treated with VMAT.
AB - The aim of this work is to compare time-resolved (TR) and time-integrated (TI) portal dosimetry, focussing on the role of an object's position with respect to the isocenter in volumetric modulated arc therapy (VMAT). Portal dose images (PDIs) are simulated and measured for different cases: a sphere (1), a bovine bone (2) and a patient geometry (3). For the simulated case (1) and the experimental case (2), several transformations are applied at different off-axis positions. In the patient case (3), three simple plans with different isocenters are created and pleural effusion is simulated in the patient. The PDIs before and after the sphere transformations, as well as the PDIs with and without simulated pleural effusion, are compared using a TI and TR gamma analysis. In addition, the performance of the TI and TR gamma analyses for the detection of real geometric changes in patients treated with clinical plans is investigated and a correlation analysis is performed between gamma fail rates and differences in dose volume histogram (DVH) metrics. The TI gamma analysis can show large differences in gamma fail rates for the same transformation at different off-axis positions (or for different plan isocenters). The TR gamma analysis, however, shows consistent gamma fail rates. For the detection of real geometric changes in patients treated with clinical plans, the TR gamma analysis has a higher sensitivity than the TI gamma analysis. However, the specificity for the TR gamma analysis is lower than for the TI gamma analysis. Both the TI and TR gamma fail rates show no correlation with changes in DVH metrics. This work shows that TR portal dosimetry is fundamentally superior to TI portal dosimetry, because it removes the strong dependence of the gamma fail rate on the off-axis position/plan isocenter. However, for 2D TR portal dosimetry, it is still difficult to interpret gamma fail rates in terms of changes in DVH metrics for patients treated with VMAT.
KW - radiotherapy
KW - VMAT
KW - portal dosimetry
KW - gamma analysis
KW - DVH metrics
U2 - 10.1088/0031-9155/61/10/3969
DO - 10.1088/0031-9155/61/10/3969
M3 - Article
C2 - 27156786
SN - 0031-9155
VL - 61
SP - 3969
EP - 3984
JO - Physics in Medicine and Biology
JF - Physics in Medicine and Biology
IS - 10
ER -