Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea.
Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.
PLoS One. 2020 Dec 29;15(12):e0244690. doi: 10.1371/journal.pone.0244690. eCollection 2020.
The aim of this study was to investigate the correlations of the gamma passing rates (GPR) with the dose-volumetric parameter changes between the original volumetric modulated arc therapy (VMAT) plans and the actual deliveries of the VMAT plans (DV errors). We compared the correlations of the TrueBeam STx system to those of a C-series linac.
A total of 20 patients with head and neck (H&N) cancer were retrospectively selected for this study. For each patient, two VMAT plans with the TrueBeam STx and Trilogy (C-series linac) systems were generated under similar modulation degrees. Both the global and local GPRs with various gamma criteria (3%/3 mm, 2%/2 mm, 2%/1 mm, 1%/2 mm, and 1%/1 mm) were acquired with the 2D dose distributions measured using the MapCHECK2 detector array. During VMAT deliveries, the linac log files of the multi-leaf collimator positions, gantry angles, and delivered monitor units were acquired. The DV errors were calculated with the 3D dose distributions reconstructed using the log files. Subsequently, Spearman's rank correlation coefficients (rs) and the corresponding p values were calculated between the GPRs and the DV errors.
For the Trilogy system, the rs values with p < 0.05 showed weak correlations between the GPRs and the DV errors (rs<0.4) whereas for the TrueBeam STx system, moderate or strong correlations were observed (rs≥0.4). The DV errors in the V20Gy of the left parotid gland and those in the mean dose of the right parotid gland showed strong correlations (always with rs > 0.6) with the GPRs with gamma criteria except 3%/3 mm. As the GPRs increased, the DV errors decreased.
The GPRs showed strong correlations with some of the DV errors for the VMAT plans for H&N cancer with the TrueBeam STx system.
本研究旨在探讨伽马通过率(GPR)与原始容积调强弧形治疗(VMAT)计划与实际VMAT 计划剂量-体积参数变化(DV 误差)之间的相关性。我们比较了 TrueBeam STx 系统与 C 系列直线加速器的相关性。
本研究回顾性选择了 20 例头颈部(H&N)癌症患者。对于每位患者,使用 TrueBeam STx 和 Trilogy(C 系列直线加速器)系统生成两个调制程度相似的 VMAT 计划。使用 MapCHECK2 探测器阵列测量的 2D 剂量分布,获得了各种伽马标准(3%/3mm、2%/2mm、2%/1mm、1%/2mm 和 1%/1mm)的全局和局部 GPR。在 VMAT 输送过程中,获取多叶准直器位置、旋转机架角度和输送监测单位的直线加速器日志文件。使用日志文件重建的 3D 剂量分布计算 DV 误差。随后,计算 GPR 与 DV 误差之间的 Spearman 秩相关系数(rs)和相应的 p 值。
对于 Trilogy 系统,GPR 与 DV 误差之间呈弱相关(rs<0.4,p<0.05),而对于 TrueBeam STx 系统,则呈中度或高度相关(rs≥0.4)。左腮腺 V20Gy 和右腮腺平均剂量的 DV 误差与除 3%/3mm 外的所有伽马标准的 GPR 均呈强相关(rs 始终大于 0.6)。随着 GPR 的增加,DV 误差减小。
对于 TrueBeam STx 系统的 H&N 癌症 VMAT 计划,GPR 与一些 DV 误差呈强相关。