The feasibility of using dual bias metal oxide semiconductor field effect transistor (MOSFET) detectors with the new hemispherical brass buildup cap for in vivo dose measurements in prostate intensity‐modulated radiotherapy (IMRT) treatments was investigated and achieved. In this work, MOSFET detectors with brass buildup caps placed on the patient's skin surface on the central axis of the individual IMRT beams are used to determine the maximum entrance dose (Dmax) from the prostate IMRT fields. A general formalism with various correction factors taken into account to predict Dmax entrance dose for the IMRT fields with MOSFETs was developed and compared against predicted dose from the treatment‐planning system (TPS). We achieved an overall accuracy of better than ±5% on all measured fields for both 6‐MV and 10‐MV beams when compared to predicted doses from the Philips Pinnacle 3 and CMS XiO TPSs, respectively. We also estimate the total uncertainty in estimation of MOSFET dose in the high‐sensitivity mode for IMRT therapy to be 4.6%.PACS numbers: 87.53Xd, 87.56Fc
Purpose: To develop a general formalism with various correction factors to predict dmax entrance dose with the new hemispherical brass buildup caps to be used with MOSFET detectors in anterior prostate IMRT fields and thereby integrate in vivo IMRT dose measurement as part of routine QA process in IMRT radiotherapy Method and Materials: We have used the new wide energy hemispherical build‐up caps for this study. Due to its high density and high atomic number it provides the minimal amount of metal needed to achieve full build‐up at Dmax for a range of photon energies. We have developed a general formalism to predict Dmax entrance dose by applying necessary correction factors after studying the response of MOSFET with brass build up caps for energy, dose rate, dose reproducibility, SSD and patient specific IMRT correction factor. Results: In vivo Prostate IMRT dose measurements with MOSFET detectors using brass buildup caps was performed and compared against dose predicted by two different treatment planning systems. We used both 6 MV and 10 MV for this study and compared the in vivo MOSFET detector reading with dose predicted by Philips Pinnacle (6 MV) and CMS XiO (10 MV) treatment planning systems respectively. We achieved a overall accuracy of better than ± 5% on measured patient doses. Conclusion: Routine IMRT QA in most institutions today only involves verifying the optimized fluence map delivered to the patient in a test phantom at a certain preset depth. Based on our work here, we believe adding in vivo IMRT dosimetry with MOSFET detectors using the new brass build up caps along with routine fluence map verification in phantoms and MLC quality assurance offers greater accuracy and confidence in actual dose delivered to the patient.
Purpose: To compare the plan quality between Eclipse (Varian) and Monaco (Elekta) TPS. To ascertain, if SBRT lung treatment could be delivered in a single coplanar arc (360 degrees) with both Elekta and Varian platforms. To assess if the smaller leaf width in Varian Millennium and Elekta Agility MLC heads have a dosimetric advantage over Elekta MLCi2 head Methods: Ten SBRT lung patients (PTV volumes ranging from 11 cc to 103cc) who were previously treated on Varian Linac with non‐coplanar arcs and received 50Gy in 5 fractions were chosen for this study. The patients were replanned in Eclipse TPS (AAA algorithm) using a 360 degree coplanar single arc (SA) delivery technique and 2 partial complimentary 180 degree arcs (PA). Treatment planning using single coplanar arc (360 degree arc) was also done on Monaco TPS (Montecarlo) for both Agility (160 leaf) and MLCi2 (80 leaf) Elekta MLC heads Results: The average monitor units to deliver 10 Gy across all delivery methods were 3000 ± 474 MU and did not vary with PTV size. Coplanar single arc and partial arc techniques did not compromise either the RTOG 0813 or 0915 low dose spillage criteria for R50% or the maximum dose to any point 2cm away from the PTV. OAR doses to spinal cord, heart, great vessels, esophagus, rib and lung were comparable on both Eclipse (Varian) and Monaco (Elekta) platforms regardless of the delivery method. Conclusion: SBRT lung tumors can be treated with a single coplanar 360 degree arc in both Varian and Elekta platforms. Non coplanar arcs and increasing arc degrees more than 360 degrees had no benefit in this study regardless of the volume of PTV. 0.5 cm leaf width used in Millennium and Agility MLC heads had no significant dosimetric improvement over 1 cm leaves in the MLCi2 head.
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