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Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy

An intensity-modulated proton therapy (IMPT) patient-specific quality assurance (PSQA) program based on measurement alone can be very time consuming due to the highly modulated dose distributions of IMPT fields. Incorporating independent dose calculation and treatment log file analysis could reduce...

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Autores principales: Zhu, X. Ronald., Li, Yupeng, Mackin, Dennis, Li, Heng, Poenisch, Falk, Lee, Andrew K., Mahajan, Anita, Frank, Steven J., Gillin, Michael T., Sahoo, Narayan, Zhang, Xiaodong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4491675/
https://www.ncbi.nlm.nih.gov/pubmed/25867000
http://dx.doi.org/10.3390/cancers7020631
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author Zhu, X. Ronald.
Li, Yupeng
Mackin, Dennis
Li, Heng
Poenisch, Falk
Lee, Andrew K.
Mahajan, Anita
Frank, Steven J.
Gillin, Michael T.
Sahoo, Narayan
Zhang, Xiaodong
author_facet Zhu, X. Ronald.
Li, Yupeng
Mackin, Dennis
Li, Heng
Poenisch, Falk
Lee, Andrew K.
Mahajan, Anita
Frank, Steven J.
Gillin, Michael T.
Sahoo, Narayan
Zhang, Xiaodong
author_sort Zhu, X. Ronald.
collection PubMed
description An intensity-modulated proton therapy (IMPT) patient-specific quality assurance (PSQA) program based on measurement alone can be very time consuming due to the highly modulated dose distributions of IMPT fields. Incorporating independent dose calculation and treatment log file analysis could reduce the time required for measurements. In this article, we summarize our effort to develop an efficient and effective PSQA program that consists of three components: measurements, independent dose calculation, and analysis of patient-specific treatment delivery log files. Measurements included two-dimensional (2D) measurements using an ionization chamber array detector for each field delivered at the planned gantry angles with the electronic medical record (EMR) system in the QA mode and the accelerator control system (ACS) in the treatment mode, and additional measurements at depths for each field with the ACS in physics mode and without the EMR system. Dose distributions for each field in a water phantom were calculated independently using a recently developed in-house pencil beam algorithm and compared with those obtained using the treatment planning system (TPS). The treatment log file for each field was analyzed in terms of deviations in delivered spot positions from their planned positions using various statistical methods. Using this improved PSQA program, we were able to verify the integrity of the data transfer from the TPS to the EMR to the ACS, the dose calculation of the TPS, and the treatment delivery, including the dose delivered and spot positions. On the basis of this experience, we estimate that the in-room measurement time required for each complex IMPT case (e.g., a patient receiving bilateral IMPT for head and neck cancer) is less than 1 h using the improved PSQA program. Our experience demonstrates that it is possible to develop an efficient and effective PSQA program for IMPT with the equipment and resources available in the clinic.
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spelling pubmed-44916752015-07-06 Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy Zhu, X. Ronald. Li, Yupeng Mackin, Dennis Li, Heng Poenisch, Falk Lee, Andrew K. Mahajan, Anita Frank, Steven J. Gillin, Michael T. Sahoo, Narayan Zhang, Xiaodong Cancers (Basel) Review An intensity-modulated proton therapy (IMPT) patient-specific quality assurance (PSQA) program based on measurement alone can be very time consuming due to the highly modulated dose distributions of IMPT fields. Incorporating independent dose calculation and treatment log file analysis could reduce the time required for measurements. In this article, we summarize our effort to develop an efficient and effective PSQA program that consists of three components: measurements, independent dose calculation, and analysis of patient-specific treatment delivery log files. Measurements included two-dimensional (2D) measurements using an ionization chamber array detector for each field delivered at the planned gantry angles with the electronic medical record (EMR) system in the QA mode and the accelerator control system (ACS) in the treatment mode, and additional measurements at depths for each field with the ACS in physics mode and without the EMR system. Dose distributions for each field in a water phantom were calculated independently using a recently developed in-house pencil beam algorithm and compared with those obtained using the treatment planning system (TPS). The treatment log file for each field was analyzed in terms of deviations in delivered spot positions from their planned positions using various statistical methods. Using this improved PSQA program, we were able to verify the integrity of the data transfer from the TPS to the EMR to the ACS, the dose calculation of the TPS, and the treatment delivery, including the dose delivered and spot positions. On the basis of this experience, we estimate that the in-room measurement time required for each complex IMPT case (e.g., a patient receiving bilateral IMPT for head and neck cancer) is less than 1 h using the improved PSQA program. Our experience demonstrates that it is possible to develop an efficient and effective PSQA program for IMPT with the equipment and resources available in the clinic. MDPI 2015-04-13 /pmc/articles/PMC4491675/ /pubmed/25867000 http://dx.doi.org/10.3390/cancers7020631 Text en © 2015 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Zhu, X. Ronald.
Li, Yupeng
Mackin, Dennis
Li, Heng
Poenisch, Falk
Lee, Andrew K.
Mahajan, Anita
Frank, Steven J.
Gillin, Michael T.
Sahoo, Narayan
Zhang, Xiaodong
Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy
title Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy
title_full Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy
title_fullStr Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy
title_full_unstemmed Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy
title_short Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy
title_sort towards effective and efficient patient-specific quality assurance for spot scanning proton therapy
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4491675/
https://www.ncbi.nlm.nih.gov/pubmed/25867000
http://dx.doi.org/10.3390/cancers7020631
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