PURPOSE: To investigate delivery quality assurance (DQA) discrepancies observed for a subset of helical tomotherapy patients. METHODS AND MATERIALS: Six tomotherapy patient plans were selected for analysis. Three had passing DQA ion chamber (IC) measurements, whereas 3 had measurements deviating from the expected dose by more than 3.0%. All plans used similar parameters, including: 2.5 cm field-width, 15-s gantry period, and pitch values ranging from 0.143 to 0.215. Preliminary analysis suggested discrepancies were associated with plans having predominantly small leaf open times (LOTs). To test this, patients with failing DQA measurements were replanned using an increased pitch of 0.287. New DQA plans were generated and IC measurements performed. Exit fluence data were also collected during DQA delivery for dose reconstruction purposes. RESULTS: Sinogram analysis showed increases in mean LOTs ranging from 29.8% to 83.1% for the increased pitch replans. IC measurements for these plans showed a reduction in dose discrepancies, bringing all measurements within +/-3.0%. The replans were also more efficient to deliver, resulting in reduced treatment times. Dose reconstruction results were in excellent agreement with IC measurements, illustrating the impact of leaf-timing inaccuracies on plans having predominantly small LOTs. CONCLUSIONS: The impact of leaf-timing inaccuracies on plans with small mean LOTs can be considerable. These inaccuracies result from deviations in multileaf collimator latency from the linear approximation used by the treatment planning system and can be important for plans having a 15-s gantry period. The ability to reduce this effect while improving delivery efficiency by increasing the pitch is demonstrated.
PURPOSE: To investigate delivery quality assurance (DQA) discrepancies observed for a subset of helical tomotherapy patients. METHODS AND MATERIALS: Six tomotherapy patient plans were selected for analysis. Three had passing DQA ion chamber (IC) measurements, whereas 3 had measurements deviating from the expected dose by more than 3.0%. All plans used similar parameters, including: 2.5 cm field-width, 15-s gantry period, and pitch values ranging from 0.143 to 0.215. Preliminary analysis suggested discrepancies were associated with plans having predominantly small leaf open times (LOTs). To test this, patients with failing DQA measurements were replanned using an increased pitch of 0.287. New DQA plans were generated and IC measurements performed. Exit fluence data were also collected during DQA delivery for dose reconstruction purposes. RESULTS: Sinogram analysis showed increases in mean LOTs ranging from 29.8% to 83.1% for the increased pitch replans. IC measurements for these plans showed a reduction in dose discrepancies, bringing all measurements within +/-3.0%. The replans were also more efficient to deliver, resulting in reduced treatment times. Dose reconstruction results were in excellent agreement with IC measurements, illustrating the impact of leaf-timing inaccuracies on plans having predominantly small LOTs. CONCLUSIONS: The impact of leaf-timing inaccuracies on plans with small mean LOTs can be considerable. These inaccuracies result from deviations in multileaf collimator latency from the linear approximation used by the treatment planning system and can be important for plans having a 15-s gantry period. The ability to reduce this effect while improving delivery efficiency by increasing the pitch is demonstrated.
Authors: T R Mackie; J Balog; K Ruchala; D Shepard; S Aldridge; E Fitchard; P Reckwerdt; G Olivera; T McNutt; M Mehta Journal: Semin Radiat Oncol Date: 1999-01 Impact factor: 5.934
Authors: K S Chao; J O Deasy; J Markman; J Haynie; C A Perez; J A Purdy; D A Low Journal: Int J Radiat Oncol Biol Phys Date: 2001-03-15 Impact factor: 7.038
Authors: T R Mackie; T Holmes; S Swerdloff; P Reckwerdt; J O Deasy; J Yang; B Paliwal; T Kinsella Journal: Med Phys Date: 1993 Nov-Dec Impact factor: 4.071
Authors: Michael J Zelefsky; Zvi Fuks; Margie Hunt; Yoshiya Yamada; Christine Marion; C Clifton Ling; Howard Amols; E S Venkatraman; Steven A Leibel Journal: Int J Radiat Oncol Biol Phys Date: 2002-08-01 Impact factor: 7.038
Authors: Rufus A Scrimger; Wolfgang A Tomé; Gustavo H Olivera; Paul J Reckwerdt; Minesh P Mehta; Jack F Fowler Journal: Am J Clin Oncol Date: 2003-02 Impact factor: 2.339
Authors: J D Fenwick; W A Tomé; H A Jaradat; S K Hui; J A James; J P Balog; C N DeSouza; D B Lucas; G H Olivera; T R Mackie; B R Paliwal Journal: Phys Med Biol Date: 2004-07-07 Impact factor: 3.609
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