An effective patient quality assurance (QA) program for intensity‐modulated radiation therapy (IMRT) requires accurate and realistic plan acceptance criteria—that is, action limits. Based on dose measurements performed with a commercially available two‐dimensional (2D) diode array, we analyzed 747 fluence maps resulting from a routine patient QA program for IMRT plans. The fluence maps were calculated by three different commercially available (ADAC, CMS, Eclipse) treatment planning systems (TPSs) and were delivered using 6‐MV X‐ray beams produced by linear accelerators. To establish reasonably achievable and clinically acceptable limits for the dose deviations, the agreement between the measured and calculated fluence maps was evaluated in terms of percent dose error (PDE) for a few points and percent of passing points (PPP) for the isodose distribution. The analysis was conducted for each TPS used in the study (365 ADAC, 162 CMS, 220 Eclipse), for multiple treatment sites (prostate, pelvis, head and neck, spine, rectum, anus, lung, brain), at the normalization point for 3% percentage difference (%Diff) and 3‐mm distance to agreement (DTA) criteria. We investigated the treatment‐site dependency of PPP and PDE. The results show that, at 3% and 3‐mm criteria, a 95% PPP and 3% PDE can be achieved for prostate treatments and a 90% PPP and 5% PDE are attainable for any treatment site.PACS Numbers: 87.53Dq, 87.53Tf, 87.53Xd, 87.56Fc

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Our purpose in this paper is to present an in vivo dosimetry program designed both for measuring the rectal dose and for avoiding misadministrations in gynecological intracavitary implants. A device containing an energy compensated diode was specially designed for these measurements. Our calibration procedure as well as the clinical protocol is described. Measurements have been performed for 50 treatments delivered with a Fletcher Suit Delclos applicator. The calculated and in vivo measured values for the "20% reading," i.e., the dose delivered to the diode by the initial 20% of the total dwell time, agreed to within 15%.