Al-Murshedi Ghassan, Radzi Yasmin Md, Rizan Noor Naslinda Noor, Abdul Rahman Azhar
From School of Physics (Al-Murshedi, Radzi, Abdul Rahman), University Sains Malaysia, Minden; from the Department of Radiotherapy and Oncology (Rizan), Gleneagles Medical Centre, Georgetown, Penang, Malaysia; and from University of Babylon (Al-Murshedi), College of Education for Pure Science, Physics department, Iraq.
Saudi Med J. 2025 Aug;46(8):926-932. doi: 10.15537/smj.2025.46.8.20240844.
To evaluate the effectiveness of in-vivo dosimetry (IVD) utilizing an electronic portal imaging device (EPID) in conjunction with EPIgray software (DOSIsoft, Cachan, France) for assessing the accuracy of dose delivery for the patient when undertaking head and neck (H&N) treatments.
Using cross-sectional analysis, data were collected from the linear accelerator of twenty patients undergoing (H&N) radiotherapy treatments using the Volumetric Modulated Arc Therapy (VMAT) modality from June 2019 to October 2023 at Gleneagles Hospital Penang, Penang, Malaysia. EPIgray software reconstructed the delivered dose based on EPID images. These reconstructed doses were compared with the planned doses to evaluate dose accuracy, specifically looking at how many patient doses fell within the set tolerance range. In addition, RTsafe PseudoPatient™ phantom was involved in this study, and the reconstructed dose with EPIgray was compared with the delivered dose and was established as a benchmark for accuracy.
The percentage difference between the reconstructed doses and planned doses (ΔD%) for patients ranged from (1.96) to (-11.1), and the results showed that 60% of the patients' doses were within the tolerance range (±5%). The phantom study resulted in a percentage dose difference (ΔD%) of -1.73%, and this was established as a benchmark for accuracy.
The study proves that using EPID-based in-vivo dosimetry with EPIgray software is a precise way to check that the right amount of radiation is being delivered for patients during radiotherapy to head and neck (H&N) treatments. Integrating EPIgray into clinical practice enhances dose accuracy and patient safety.
评估利用电子射野影像装置（EPID）结合EPIgray软件（DOSIsoft，法国卡尚）进行体内剂量测定（IVD），以评估头颈部（H&N）治疗时患者剂量输送准确性的有效性。
采用横断面分析，收集了2019年6月至2023年10月在马来西亚槟城鹰阁医院接受容积调强弧形治疗（VMAT）模式的头颈部（H&N）放射治疗的20例患者直线加速器的数据。EPIgray软件根据EPID图像重建输送剂量。将这些重建剂量与计划剂量进行比较，以评估剂量准确性，特别关注有多少患者剂量落在设定的耐受范围内。此外，RTsafe PseudoPatient™模体参与了本研究，并将EPIgray重建剂量与输送剂量进行比较，并将其确立为准确性的基准。
患者重建剂量与计划剂量之间的百分比差异（ΔD%）范围为（1.96）至（-11.1），结果显示60%的患者剂量在耐受范围内（±5%）。模体研究得出的剂量百分比差异（ΔD%）为-1.73%，并将其确立为准确性的基准。
该研究证明，使用基于EPID的体内剂量测定结合EPIgray软件是一种精确的方法，可用于检查头颈部（H&N）放疗期间患者是否接受了正确剂量的辐射。将EPIgray整合到临床实践中可提高剂量准确性和患者安全性。
