ABSTRACT
Objective To measure the positioning accuracy of multi-leaf collimators (MLC) leaves by using radiochromic films,with aim to providing data in support of IAEA's methodology validation.Methods The present study focused on 8 accelerators (Varian,Elekta and Siemens machines) at 6 hospitals in Henan province with highly skilled physicists.The 25 cm × 25 cm radiochromic films were put on 30 cm × 30 cm homogeneous solid phantoms and covered with a 2.0-cm-thick homogeneous solid phantom slabs.The CT-scanned images were transmitted to TPS for plan formulation.With 6 MV X-ray,MLC created 5 strip 3 cm × 0.6 cm picket fence field,each with 3.0 cm strip separation.The SSD was 100 cm at the maximum dose point,with a 250 MU to each strip.The irradiated radiochromic films were returned to IAEA for analysis within one week and compared with the values given by IAEA.Results The difference of film-measured and TPS-planned positions of MLC leaves for each strip picket fence should be within ± 0.5 mm as required by IAEA.For 7 of 8 accelerators selected,the differences of accurately measured MLC leaf positions were all within ±0.5 mm,which were in line with the IAEA requirements,with only other one being beyond-0.5 mm,not consistent with the IAEA requirements.The differences of film-measured actual widths between each pair and all pairs of leaves were within ±0.75 mm as required by IAEA for 7 accelerators,whereas the other one was outside ± 0.75 mm,not consistent with the IAEA requirements.The standard deviation of film-measured actual width of MCL leaf between each pair and all pairs for 7 accelerators were ≤ 0.3 mm as required by IAEA,whereas the other one was 0.5 mm,not consistent with IAEA requirements.Conclusions The MLC positioning accuracy of a few of medical accelerators in Henan is not qualified.It is of great significance to carry out regular quality examination as well as third-party verification to ensure precise delivery of radiotherapy.
ABSTRACT
Objective To measure the accuracy of multi-leaves collimator (MLC) leaves positions in intensity modulated radiation therapy (IMRT) for verification purpose.Methods Solid water homogeneous phantom with size of 30 cm× 30 cm was scanned by CT scanner.The scanned images were delivered to radiation therapy plan system (TPS) to formulate the therapy plan.The MLC leaves created 5 strips of exposure field,each 3 cm long and 0.6 cm wide.The strip-to-strip distance was 3 cm.With 6 MV X-rays,the SSD was 100 cm at the maximum dose point.The MU per strip was 250 MU.EBT2 radiochromic films each of 25 cm×25 cm were placed on the 30 cm×30 cm homogeneous solid phantom and covered with 1 cm thick solid phantom slabs for delivering of IMRT.Results For 7 of 8 accelerators,the differences of film-measured and TPS-planned MLC leaf position for every fence field were within ± 0.5 mm as required by IAEA,with only other one being-0.6 mm,not consistent with the IAEA requirements.The film-measured position difference between each pair and all pairs of leaves for 8 accelerators were all in line with IAEA's requirements.The film-measured actual width difference between each pair and all pairs of leaves was within ±0.75 mm as required by IAEA for 4 accelerators and outside ±0.75 mm for the other three,not consistent with the IAEA requirements.The standard deviation of film-measured actual width between each pair and all pairs of leaves for 6 accelerators were ≤ 0.3 mm,as required by IAEA,whereas ＞0.3 mm for the other two,not consistent with IAEA requirements.Conclusions The film dosimetric verification of IMRT is an important part of its quality assurance,featuring simple,reliable and highly accurate positioning and can meet measurement requirement.
ABSTRACT
Objective To develop measurement methodology using film for the positioning accuracy of MLC leaves in IMRT.Methods The solid water phantom of 30 cm x 30 cm was scanned and the scanned images were transferred to TPS for treatment plan formulation.The five MLC strip picket fence pattern was formed by MLC leaves,each 3.0 cm long × 6.0 mm wide.The separation between strip and strip is 3.0 cm.SAD is 100 cm at dmax for 6 MV X-ray,with 250 MU per MLC strip.EBT2 radiochomic film was put on the phantom for delivery of IMRT,for each MLC strip.The present study focused on 30 accelerators of Varian,Elekta and Siemens designs at 27 hospitals with highly skilled physicists all over Jiangsu,Sichuan,Hubei and Henan provinces.The study was conducted in the same way as used in international multi-radiotherapy center (IMRC).The irradiated films were sent respectively to IAEA dosimetry laboratory and external audit group (EGA) of China for measurement,analysis and calculation.Results According to IAEA requirements,the differenc of film-measured and TPS-planned of MLC leaf position for each strip should be within ±0.5 mm.China had participated in the research of IMRC,with the result of 0.3,0.2,0.0,-0.1,and-0.2 mm,respectively.For 30 accelerators in four provinces involved in the study,the IAEA's verification results of MLC leaf position were within 0.6-1.0 mm for 5 accelerators and within ± 0.5 mm for other 25 ones.Whereas the verification results of EAG were within 0.6-1.0 mm for 6 accelerators and within ±0.5 mm for other 24 ones.According to IAEA requirements,the film-measured MLC leaf position deviation for each pair of leaves and average all pairs of leaves should be within ±0.5 mm.China had participated in IMRC's research,with the measured result being 0.04 mm.The verification result of EGA for 30 accelerators showed the measured MLC leaf position deviations were all ＜0.3 mm per strip,consistent with IAEA requirements.The IAEA's result showed the measured deviations of MLC leaf position for 29 accelerators were within ±0.5 mm,with only other one being-0.7 mm not consistent with the IAEA requirements.As required by IAEA,the difference of film-measured difference of MLC opening width should be within ±0.75 mm between each pair and average all pairs of leaves.China's result in research of IMRC showed the difference of minimum width to mean width was-0.2 mm whereas the difference of maximum width to mean width was 0.4 mm.For 30 accelerators involved in IAEA'verification study,the measured result shown that the difference between maximum and average of filmmeasured of MLC leaf width,and between minmum and average,were within ± 0.75 mm for 24 accelerators,in line with the IAEA requirements.For other 6 ones,the values were beyond ±0.75 mm,not in line with the IAEA requirements.For the verification result of EAG,the difference between maximum and average widths and between minmum and average widths for 25 accelerators were within ±0.75 mm as required by IAEA,whereas for other 5 ones the value were beyond ±0.75 mm,not consistent with IAEA requirements.The standard deviation of film-measured MLC opening width between each pair and average all pairs should be within 0.3 mm as required by IAEA.China's IMRC result was 0.12 mm.The verification result of IAEA shown the standard deviation of MLC opening position were ＜0.3 mm for 26 accelerators and ＞ 0.3 mm for other 4 accelerators.EAG verification result were the same as IAEA result.Conclusions The method using radiochromic film for measuring accuracy of MLC leaf position is convenient and practicable as a quality audit.It is suitable for quality verification in medical institutions owing to easy to post and repeated measurements.
ABSTRACT
Objective To develop the methodology for using TLDs and films to measure absorbed dose and 2D dose distribution produced by the multi-leaf collimator (MLC) in intensity modulated radiotherapy (IMRT),in order to provide the guidance on dose quality audit in IMRT.Methods A total of 30 different-typed accelerators were selected from 27 hospitals in Jiangsu,Sichuan,Hubei and Henan provinces,including 17 Varian accelerators,10 Elektas and 3 Simens.The same batch of films and TLDs were put in a 2 cm-thick solid plate for fixation and then loaded in a 15 cm × 15 cm × 15 cm polysyrene solid phantom supplied by International Atomic Energy Agency(IAEA) in terms of 90 cm SSD,19 cm depth,10 cm × 10 cm field at different doses.The standard dose curves wcrc established for film and TLD,respectively.The irradiated film was measured and then sent to the External Audit Group (EAG) in China.The TLD-and film-absorbed doses were compared with TPS-calculated doses.The 2D dose distribution on the IRMT MLC field was measured using films.The homogeneous phanton of 30 cn × 30 cm was scanned by CT and the image was transferred to the TPS.The IMRT was implemented with 6 Gy fractionated irradiation by placing a 25 cm × 25 cm film on the phantom surface at 95 cm SSD and at 5 cm depth.The irradiated film was sent to the IAEA dosimetry laboratory for measurement and calculation.2D dose distribution verification was conducted in thc same way consistent with the procedure of international multi-radiotherapy center.The 3 mm/3％ passing rate was calculated for 2D dose distribution and compared with the film-measured and TPS calculated result.Results IAEA requires the relative deviation of TLD and film measured absorbed dose are with in ± 5％.The relative deviation of TLD-and filmmeasured to TPS-calculated absorbed dose was within the range of ±0.7％-± 8.5％ and within ±0.3％ ±7.8％ in Jiangsu,Sichuan,Hubei and Henan provinces,respectively.IAEA requires the 3 mm/3％ passing rate of film-measured 2D distribution to be 90％.The result of the present study were up to 94.0％.The verification result of 2D dose distribution were within 70.0％-99.9％ in Sichuan,Jiangsu,Hubei and Henan provinces.Conclusions The adsorbed dose and 2D distribution can be audited using TLDs and films for MLC in IRMT.The method is scientific and applicable,economical and convenient for development of dose quality audit for a wide range of IRMT.