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A patient-specific quality assurance study on absolute dose verification.pdf

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A patient-specific quality assurance study on absolute dose verification

Medical Dosimetry xx (2012) xxx Medical Dosimetry journal homepage: A patient-specific quality assurance study on absolute dose verification using ionization chambers of different volumes in RapidArc treatments S. A. Syam Kumar, M.Sc., Prabakar Sukumar, M.Sc., Padmanaban Sriram, M.Sc., Dhanabalan Rajasekaran, M.Sc., Srinu Aketi, M.Sc., and Nagarajan Vivekanandan, Ph.D. Department of Medical Physics, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India A R T I C L E I N F O Article history: A B S T R A C T The recalculation of 1 fraction from a patient treatment plan on a phantom and subsequent measurements Received 18 May 2011 Accepted 09 April 2012 have become the norms for measurement-based verification, which combines the quality assurance recommendations that deal with the treatment planning system and the beam delivery system. This type of evaluation has prompted attention to measurement equipment and techniques. Ionization chambers are considered the gold standard because of their precision, availability, and relative ease of use. This study evaluates and compares 5 different ionization chambers: phantom combinations for verification in routine patient-specific quality assurance of RapidArc treatments. Fifteen different RapidArc plans conforming to the clinical standards were selected for the study. Verification plans were then created for each treatment plan with different chamber-phantom combinations scanned by computed tomography. This includes Medtec intensity modulated radiation therapy (IMRT) phantom with micro-ionization chamber (0.007 cm3) and pinpoint chamber (0.015 cm3), PTW-Octavius phantom with semiflex chamber (0.125 cm3) and 2D array (0.125 cm3), and indigenously made Circular wax phantom with 0.6 cm3 chamber. The measured isocenter absolute dose was compared with the treatment planning system (TPS) plan. The micro- ionization chamber shows more deviations when compared with semiflex and 0.6 cm3 with a maximum variation of 4.76%, 1.49%, an