Thoelking Johannes, Fleckenstein Jens, Sekar Yuvaraj, Boggula Ramesh, Lohr Frank, Wenz Frederik, Wertz Hansjoerg
Department of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Germany.
Department of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Germany.
Radiother Oncol. 2016 May;119(2):351-6. doi: 10.1016/j.radonc.2016.04.003. Epub 2016 Apr 16.
Since IMRT-techniques lead to an increasingly complicated environment, a patient specific IMRT-plan verification is recommended. Furthermore, verifications during patient irradiation and 3D dose reconstruction have the potential to improve treatment delivery, accuracy and safety. This study provides a detailed investigation of the new transmission detector (DTD) Dolphin (IBA Dosimetry, Germany) for online dosimetry.
The clinical performance of the DTD was tested by dosimetric plan verification in 2D and 3D for 18 IMRT-sequences. In 2D, DTD measurements were compared to a pre-treatment verification method and a treatment planning system by gamma index and dose difference evaluations. In 3D, dose-volume-histogram (DVH) indices and gamma analysis were evaluated. Furthermore, the error detection ability was tested with leaf position uncertainties and deviations in the linear accelerator (LINAC) output.
The DTD measurements were in excellent agreement to reference measurements in both 2D (γ3%,3mm=(99.7±0.6)% <1, ΔD±5%=(99.5±0.5)%) and 3D. Only a small dose underestimation (<2%) within the target volume was observed when analyzing DVH-indices. Positional errors of the leaf banks larger than 1mm and errors in LINAC output larger than 2% were identified with the DTD.
The DTD measures the delivered dose with sufficient accuracy and is therefore suitable for clinical routine.
由于调强放疗技术导致环境日益复杂,建议进行患者特异性调强放疗计划验证。此外,在患者放疗和三维剂量重建过程中进行验证有可能提高治疗的实施、准确性和安全性。本研究对用于在线剂量测定的新型透射探测器(DTD)Dolphin(德国IBA剂量测定公司)进行了详细研究。
通过对18个调强放疗序列进行二维和三维剂量测定计划验证,测试了DTD的临床性能。在二维中,通过伽马指数和剂量差异评估,将DTD测量结果与治疗前验证方法和治疗计划系统进行比较。在三维中,评估剂量体积直方图(DVH)指标和伽马分析。此外,还通过叶片位置不确定性和直线加速器(LINAC)输出偏差测试了误差检测能力。
DTD测量结果在二维(γ3%,3mm =(99.7±0.6)% <1,ΔD±5% =(99.5±0.5)%)和三维中均与参考测量结果高度一致。分析DVH指标时,仅在靶区内观察到小剂量低估(<2%)。DTD能够识别叶片库大于1mm的位置误差和直线加速器输出大于2%的误差。
DTD能够以足够的精度测量所输送的剂量,因此适用于临床常规应用。