Szeverinski Philipp, Kowatsch Matthias, Künzler Thomas, Meinschad Marco, Clemens Patrick, DeVries Alexander F
Institute of Medical Physics, Academic Teaching Hospital Feldkirch, Feldkirch, Austria.
Private University in the Principality of Liechtenstein, Triesen, Liechtenstein.
J Appl Clin Med Phys. 2020 Nov;21(11):163-171. doi: 10.1002/acm2.13051. Epub 2020 Oct 23.
Integrating log file analysis with LINACWatch® (LW) into clinical routine as part of the quality assurance (QA) process could be a time-saving strategy that does not compromise on quality. The purpose is to determine the error sensitivity of log file analysis using LINACWatch® compared with a measurement device (ArcCHECK®, AC) for VMAT delivery QA.
Multi-leaf collimator (MLC) errors, collimator angle errors, MLC shift errors and dose errors were inserted to analyze error detection sensitivity. A total of 36 plans were manipulated with different magnitudes of errors. The gamma index protocols for AC were 3%/3 mm/Global and 2%/2 mm/Global, as well as 2%/2 mm/Global, and 1.5%/1.5 mm/Global for LW. Additionally, deviations of the collimator and monitor units between TPS and log file were calculated as RMS values. A 0.125 cm ionization chamber was used to independently examine the effect on dose.
The sensitivity for AC was 20.4% and 49.6% vs 63.0% and 86.5% for LW, depending on the analysis protocol. For MLC opening and closing errors, the detection rate was 19.0% and 47.7% for AC vs 50.5% and 75.5% for LW. For MLC shift errors, it was 29.6% and 66.7% for AC vs 66.7% and 83.3% for LW. AC could detect 25.0% and 44.4% of all collimator errors. Log file analysis detected all collimator errors using 1° detection level. 13.2% and 42.4% of all dose errors were detected by AC vs 59.0% and 92.4% for LW using gamma analysis. Using RMS value, all dose errors were detected by LW (1% detection level).
The results of this study clearly show that log file analysis is an excellent complement to phantom-based delivery QA of VMAT plans. We recommend a 1.5%/1.5 mm/Global criteria for log file-based gamma calculations. Log file analysis was implemented successfully in our clinical routine for VMAT delivery QA.
将日志文件分析与LINACWatch®(LW)整合到临床常规工作中作为质量保证(QA)流程的一部分,可能是一种节省时间且不影响质量的策略。目的是确定与用于容积调强放疗(VMAT)交付QA的测量设备(ArcCHECK®,AC)相比,使用LINACWatch®进行日志文件分析的误差敏感性。
插入多叶准直器(MLC)误差、准直器角度误差、MLC位移误差和剂量误差以分析误差检测敏感性。总共对36个计划进行了不同大小误差的处理。AC的伽马指数协议为3%/3毫米/全局和2%/2毫米/全局,以及2%/2毫米/全局,LW的为1.5%/1.5毫米/全局。此外,计算了TPS和日志文件之间准直器和监测单位的偏差作为均方根(RMS)值。使用0.125厘米电离室独立检查对剂量的影响。
根据分析协议,AC的敏感性为20.4%和49.6%,而LW为63.0%和86.5%。对于MLC的打开和关闭误差,AC的检测率为19.0%和47.7%,LW为50.5%和75.5%。对于MLC位移误差,AC为29.6%和66.7%,LW为66.7%和83.3%。AC可以检测到所有准直器误差的25.0%和44.4%。日志文件分析使用1°检测水平检测到所有准直器误差。使用伽马分析,AC检测到所有剂量误差的13.2%和42.4%,LW为59.0%和92.4%。使用RMS值,LW检测到所有剂量误差(1%检测水平)。
本研究结果清楚地表明,日志文件分析是VMAT计划基于模体的交付QA的出色补充。我们建议基于日志文件的伽马计算采用1.5%/1.5毫米/全局标准。日志文件分析已成功应用于我们VMAT交付QA的临床常规工作中。