Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-11T09:04:46.206Z Has data issue: false hasContentIssue false
  • English
  • Français

RapidArc treatment planning quality assurance using electronic portal imaging device for cervical cancer

Published online by Cambridge University Press:  30 July 2019

Hafiz Muhibb ullah Zulkafal Open the ORCID record for Hafiz Muhibb ullah Zulkafal [Opens in a new window] ,
Allah Ditta Khalid ,
Sajid Anees Minhas ,
Umair Zafar ,
Rizwan Hameed ,
Muhammad Afzal Khan  and
Khalid Iqbal
Hafiz Muhibb ullah Zulkafal*
Affiliation:
Department of Physics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan Department of Clinical and Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Lahore, Pakistan
Allah Ditta Khalid
Affiliation:
Department of Physics, University of Lahore, Lahore, Pakistan
Sajid Anees Minhas
Affiliation:
Department of Clinical and Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Lahore, Pakistan
Umair Zafar
Affiliation:
Department of Clinical and Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Lahore, Pakistan
Rizwan Hameed
Affiliation:
Department of Clinical and Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Lahore, Pakistan
Muhammad Afzal Khan
Affiliation:
Department of Physics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
Khalid Iqbal
Affiliation:
Department of Physics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan Department of Clinical and Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Lahore, Pakistan
*
Author for correspondence: Hafiz Muhibb ullah Zulkafal, Department of Physics, Baghdad Al Jadeed Campus, The Islamia University of Bahawalpur, Punjab, Pakistan. Tel: +92-3024388245. E-mail: muhibbiub@yahoo.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Purpose:

The main objective of this study is to assure the quality of cervical cancer treatment plans using an electronic portal imaging device (EPID) in RapidArc techniques.

Materials and Methods:

Fifteen cases of cervical cancer patients undergoing RapidArc technique were selected to evaluate the quality assurance (QA) of their treatment. The computed tomography (CT) of each patient was obtained with 3-mm-slice thickness and transferred to the Eclipse treatment planning system. The prescribed dose (PD) of 50·4 Gy with 1·8 Gy per fraction to planning target volume (PTV) was used for each patient. The aim of treatment planning was to achieve 95% of PD to cover 97%, and dose to the PTV should not receive 105% of the PD. All RapidArc plans were created using the AAA algorithm and treated on Varian DHX using 6 MV photon beam, with two full arcs. Gamma analysis was used to evaluate the quality of the treatment plans with accepting criteria of 95% at 3%/3 mm.

Results:

In this study, maximum and average gamma values were 2·53 ± 0·409 and 0·195 ± 0·059 showing very small deviation and indicating the smaller difference between both predicted and portal doses. Gamma Area changes from > 0·8 to > 1·2. SD increased to 5·4% and mean standard error increased to 4·67%.

Conclusion:

On the basis of these outcomes, we can summarise that the EPID is a useful tool for QA in standardising and evaluating RapidArc treatment plans of cervical cancer in routine clinical practice.

Keywords

gamma indexportal dosimetryQA of cervical cancerRapidArc treatment technique
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 2 , June 2020 , pp. 139 - 144
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Podgorsak, E B. Radiation Oncology Physics. Vienna: International Atomic Energy Agency, 2005: 123–271.Google Scholar
Fogliata, A, Clivio, A, Fenoglietto, Pet al.Quality assurance of RapidArc in clinical practice using portal dosimetry. Br J Radiol 2011; 84 (1002): 534–545.CrossRefGoogle ScholarPubMed
Otto, K.Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys 2008; 35 (1): 310–317.CrossRefGoogle Scholar
Roxby, K J, Crosbie, J C.Pre-treatment verification of intensity modulated radiation therapy plans using a commercial electronic portal dosimetry system. Australas Phys Eng Sci Med 2010; 33 (1): 51–57.CrossRefGoogle ScholarPubMed
Zulkafal, H, Khan, M, Ahmad, M, Akram, M, Buzdar, S, Iqbal, K.Volumetric modulated arc therapy treatment planning assessment for low-risk prostate cancer in radiotherapy. Clin Cancer Investig J 2017; 6 (4): 179–183.CrossRefGoogle Scholar
Mohan, R, Wu, Q, Manning, M, Schmidt-Ullrich, R.Radiobiological considerations in the design of fractionation strategies for intensity-modulated radiation therapy of head and neck cancers. Int J Radiat Oncol Biol Phys 2000; 46 (3): 619–630.CrossRefGoogle ScholarPubMed
Jin, X, Yi, J, Zhou, Y, Yan, H, Han, C, Xie, C.Comparison of whole-field simultaneous integrated boost VMAT and IMRT in the treatment of nasopharyngeal cancer. Med Dosim 2013; 38 (4): 418–423.CrossRefGoogle ScholarPubMed
Stieler, F, Wolff, D, Schmid, H, Welzel, G, Wenz, F, Lohr, F.A comparison of several modulated radiotherapy techniques for head and neck cancer and dosimetric validation of VMAT. Radiother Oncol 2011; 101 (3): 388–393.CrossRefGoogle ScholarPubMed
Guckenberger, M, Richter, A, Krieger, T, Wilbert, J, Baier, K, Flentje, M.Is a single arc sufficient in volumetric-modulated arc therapy (VMAT) for complex-shaped target volumes? Radiother Oncol 2009; 93 (2): 259–265.CrossRefGoogle ScholarPubMed
Jemal, A, Bray, F, Center, M M, Ferlay, J, Ward, E, Forman, D.Global cancer statistics. CA Cancer J Clin 2011; 61 (2): 69–90.CrossRefGoogle ScholarPubMed
Vieira, S C, Dirkx, M L, Heijmen, B J, de Boer, H C.SIFT: a method to verify the IMRT fluence delivered during patient treatment using an electronic portal imaging device. Int J Radiat Oncol Biol Phys 2004; 60 (3): 981–993.CrossRefGoogle ScholarPubMed
Sharma, D S, Mhatre, V, Heigrujam, M, Talapatra, K, Mallik, S.Portal dosimetry for pretreatment verification of IMRT plan: a comparison with 2D ion chamber array. J Appl Clin Med Phys 2010; 11 (4): 238–248.CrossRefGoogle ScholarPubMed
Low, D A, Moran, J M, Dempsey, J F, Dong, L, Oldham, M.Dosimetry tools and techniques for IMRT. Med Phys 2011; 38 (3): 1313–1338.CrossRefGoogle ScholarPubMed
Nichita, E. A study of IMRT pre-treatment dose verification using a-Si electronic portal imaging devices (Doctoral Dissertation), 2013. Hamilton, Ontario: McMaster University.Google Scholar
Merheb, C, Chevillard, C, Ksouri, W, Fawzi, M, Bollet, M, Toledano, A.Comparison between two different algorithms used for pretreatment QA via aSi portal images. J Appl Clin Med Phys 2015; 16 (3): 141–153.CrossRefGoogle ScholarPubMed
Iqbal, K, Gillin, M, Summers, P A, Dhanesar, S, Gifford, K A, Buzdar, S A.Quality assurance evaluation of spot scanning beam proton therapy with an anthropomorphic prostate phantom. Br J Radiol 2013; 86 (1031): 20130390.CrossRefGoogle ScholarPubMed
Nalbant, N, Kesen, D, Hatice, B.Pre-treatment dose verification of IMRT using Gafchromic EBT3 film and 2D array. J Nucl Med Radiat Ther 2014; 5 (182): 2.Google Scholar
Depuydt, T, Van Esch, A, Huyskens, D P.A quantitative evaluation of IMRT dose distributions: refinement and clinical assessment of the gamma evaluation. Radiother Oncol 2002; 62 (3): 309–319.CrossRefGoogle ScholarPubMed
Low, DA, Mutic, S, Dempsey, J Fet al.Quantitative dosimetric verification of an IMRT planning and delivery system. Radiother Oncol 1998; 49 (3): 305–316.CrossRefGoogle ScholarPubMed
Van Esch, A, Depuydt, T, Huyskens, D P.The use of an aSi-based EPID for routine absolute dosimetric pre-treatment verification of dynamic IMRT fields. Radiother Oncol 2004; 71 (2): 223–234.CrossRefGoogle ScholarPubMed
Son, J, Baek, T, Lee, Bet al.A comparison of the quality assurance of four dosimetric tools for intensity modulated radiation therapy. Radiother Oncol 2015; 49 (3): 307–313.CrossRefGoogle ScholarPubMed
Low, D A, Harms, W B, Mutic, S, Purdy, J A.A technique for the quantitative evaluation of dose distributions. Med Phys 1998; 25 (5): 656–661.CrossRefGoogle ScholarPubMed
Caivano, R, Califano, G, Fiorentino, Aet al.Clinically relevant quality assurance for intensity modulated radiotherapy plans: gamma maps and DVH-based evaluation. Cancer Invest 2014; 32 (3): 85–91.CrossRefGoogle ScholarPubMed
Jia, M X, Zhang, X, Yin, Cet al.Peripheral dose measurements in cervical cancer radiotherapy: a comparison of volumetric modulated arc therapy and step-and-shoot IMRT techniques. Radiat Oncol 2014; 9 (1): 61.CrossRefGoogle ScholarPubMed
Iqbal, K, Isa, M, Buzdar, S A, Gifford, K A, Afzal, M.Treatment planning evaluation of sliding window and multiple static segments technique in intensity modulated radiotherapy. Rep Pract Oncol Radiother 2013; 18 (2): 101–106.CrossRefGoogle Scholar
Ezzell, G A, Burmeister, J W, Dogan, Net al.IMRT commissioning: multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119. Med Phys 2009; 36 (11): 5359–5373.CrossRefGoogle ScholarPubMed
Alber, M, De Wagter, M, Eichwurzel, Iet al.ESTRO Booklet No. 9: Guidelines for the Verification of IMRT. Brussels: ESTRO, 2008.Google Scholar
Yusen, R D, Edwards, L B, Kucheryavaya, A Yet al.The Registry of the International Society for Heart and Lung Transplantation: thirty-second official adult lung and heart-lung transplantation report—2015; focus theme: early graft failure. J Heart Lung Transplant 2015; 34 (10): 1264–1277.CrossRefGoogle ScholarPubMed
Zulkafal, H M, Iqbal, M M, Akhtar, M W, Iqbal, K, Khan, M A.Evaluation of three dimensional conformal radiation therapy of oesophageal cancer: a dosimetric study. J Radiother Pract 2018; 1–5.CrossRefGoogle Scholar
Howell, R M, Smith, I P, Jarrio, C S.Establishing action levels for EPID‐based QA for IMRT. J Appl Clin Med Phys 2008; 9 (3): 16–25.CrossRefGoogle ScholarPubMed