PURPOSE: Intensity-modulated radiotherapy (IMRT) represents an important method for improving RT. The IMRT relative dosimetry checks are well established; however, open questions remain in reference dosimetry with ionization chambers (ICs). The main problem is the departure of the measurement conditions from the reference ones; thus, additional uncertainty is introduced into the dose determination. The goal of this study was to assess this effect systematically. METHODS AND MATERIALS: Monte Carlo calculations and dosimetric measurements with five different detectors were performed for a number of representative IMRT cases, covering both step-and-shoot and dynamic delivery. RESULTS: Using ICs with volumes of about 0.125 cm(3) or less, good agreement was observed among the detectors in most of the situations studied. These results also agreed well with the Monte Carlo-calculated nonreference correction factors (c factors). Additionally, we found a general correlation between the IC position relative to a segment and the derived correction factor c, which can be used to estimate the expected overall uncertainty of the treatment. CONCLUSION: The increase of the reference dose relative standard uncertainty measured with ICs introduced by nonreference conditions when verifying an entire IMRT plan is about 1-1.5%, provided that appropriate small-volume chambers are used. The overall standard uncertainty of the measured IMRT dose amounts to about 2.3%, including the 0.5% of reproducibility and 1.5% of uncertainty associated with the beam calibration factor. Solid state detectors and large-volume chambers are not well suited to IMRT verification dosimetry because of the greater uncertainties. An action level of 5% is appropriate for IMRT verification. Greater discrepancies should lead to a review of the dosimetric procedure, including visual inspection of treatment segments and energy fluence.
PURPOSE: Intensity-modulated radiotherapy (IMRT) represents an important method for improving RT. The IMRT relative dosimetry checks are well established; however, open questions remain in reference dosimetry with ionization chambers (ICs). The main problem is the departure of the measurement conditions from the reference ones; thus, additional uncertainty is introduced into the dose determination. The goal of this study was to assess this effect systematically. METHODS AND MATERIALS: Monte Carlo calculations and dosimetric measurements with five different detectors were performed for a number of representative IMRT cases, covering both step-and-shoot and dynamic delivery. RESULTS: Using ICs with volumes of about 0.125 cm(3) or less, good agreement was observed among the detectors in most of the situations studied. These results also agreed well with the Monte Carlo-calculated nonreference correction factors (c factors). Additionally, we found a general correlation between the IC position relative to a segment and the derived correction factor c, which can be used to estimate the expected overall uncertainty of the treatment. CONCLUSION: The increase of the reference dose relative standard uncertainty measured with ICs introduced by nonreference conditions when verifying an entire IMRT plan is about 1-1.5%, provided that appropriate small-volume chambers are used. The overall standard uncertainty of the measured IMRT dose amounts to about 2.3%, including the 0.5% of reproducibility and 1.5% of uncertainty associated with the beam calibration factor. Solid state detectors and large-volume chambers are not well suited to IMRT verification dosimetry because of the greater uncertainties. An action level of 5% is appropriate for IMRT verification. Greater discrepancies should lead to a review of the dosimetric procedure, including visual inspection of treatment segments and energy fluence.
Authors: David M Klein; Ramesh C Tailor; Louis Archambault; Lilie Wang; Francois Therriault-Proulx; A Sam Beddar Journal: Med Phys Date: 2010-10 Impact factor: 4.071
Authors: D González-Castaño; J Pena; F Sánchez-Doblado; G H Hartmann; F Gómez; A Leal Journal: Med Biol Eng Comput Date: 2007-09-08 Impact factor: 2.602
Authors: Iqbal Al Amri; Ramamoorthy Ravichandran; Somangili Satyamoorthi Sivakumar; Johnson Pichi Binukumar; Chirayathmanjiyil Antony Davis; Zakia Al Rahbi; Khalsa Al Shukeili; Fatima Al Kindi Journal: J Med Phys Date: 2012-10
Authors: You Zhang; Anh H Le; Zhen Tian; Zohaib Iqbal; Tsuicheng Chiu; Xuejun Gu; Andrei Pugachev; Robert Reynolds; Yang K Park; Mu-Han Lin; Strahinja Stojadinovic Journal: J Appl Clin Med Phys Date: 2019-08-30 Impact factor: 2.102