Clinical implementation of a secondary dose calculation system for patient-specific quality assurance of complex VMAT and SBRT treatments

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics Pub Date : 2025-06-12 DOI:10.1016/j.ejmp.2025.105025

Edoardo Mastella , Klarisa E. Szilagyi , Sara Fabbri , Eleonora De Guglielmo , Luigi Manco , Eleonora Farina , Melchiore Giganti , Antonio Stefanelli , Alessandro Turra

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引用次数: 0

Abstract

Purpose

Advanced radiotherapy techniques require robust patient-specific quality assurance (PSQA). This study validated a secondary calculation software for plan dose verification, evaluating accuracy across different treatment sites, beam qualities, and plan complexities.

Methods

Data from two beam-matched VersaHD linacs were used to commission RadCalc-V7.3.2.0. 33 end-to-end tests in homogeneous and anthropomorphic phantoms compared RadCalc Monte Carlo (RC-MC) and Collapsed Cone Convolution Superposition (RC-CCCS) algorithms with Pinnacle³ TPS, using gamma analysis (1.5 %/2mm) and ionization chamber measurements. 140 clinical VMAT plans of varying complexities, including 35 head and neck (H&N) and 65 SBRT treatments, were evaluated using gamma analysis (3 %/2mm) and relevant DVH metrics for PTV (D98%, D2%). RadCalc calculations were compared with pre-treatment Octavius 4D measurements.

Results

Phantom studies showed excellent RadCalc-TPS agreement for homogeneous plans and lung SBRT with flattened beams (mean passing rates > 98 %, mean measured dose differences < 1 %). Larger discrepancies were observed in the anthropomorphic thorax phantom for FFF SBRT. For clinical plans, mean passing rates exceeded 98.5 %. Site-specific differences emerged: RC-MC performed better for H&N, RC-CCCS for other sites. RadCalc calculated slightly less homogeneous dose distributions than Pinnacle³, but averaging RC-MC and RC-CCCS results in reduced DVH discrepancies (mean ΔD98% −1.1 ± 1.1 %, mean ΔD2% +1.1 ± 1.5 %). Octavius measurements may underestimate calculation discrepancies due to tissue inhomogeneities.

Conclusions

RadCalc produced very consistent results with Pinnacle³ and can be integrated into our PSQA program for efficient 3D dose verification, reducing measurement workload while maintaining high standards of dosimetric accuracy. Using both RadCalc algorithms effectively reduced calculation uncertainties.

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为复杂VMAT和SBRT治疗患者特异性质量保证的二次剂量计算系统的临床实施

目的：先进的放疗技术需要强有力的患者特异性质量保证（PSQA）。本研究验证了用于计划剂量验证的二次计算软件，评估了不同治疗部位、光束质量和计划复杂性的准确性。方法利用两台波束匹配的VersaHD直线机的数据，对RadCalc-V7.3.2.0进行调试。在同质和拟人模型中进行了33个端到端测试，使用伽马分析（1.5% /2mm）和电离室测量，将RadCalc蒙特卡罗（RC-MC）和塌锥卷积叠加（RC-CCCS）算法与Pinnacle3 TPS进行了比较。140个不同复杂性的临床VMAT计划，包括35个头颈部（H&；N）和65个SBRT治疗，使用伽马分析（3% /2mm）和PTV的相关DVH指标（D98%, D2%）进行评估。RadCalc计算结果与预处理Octavius 4D测量结果进行比较。结果形态学研究显示，均匀平面和扁平梁肺SBRT的RadCalc-TPS一致性良好(平均通过率>；98%，平均测量剂量差<；1%)。在FFF SBRT的拟人化胸幻影中观察到更大的差异。临床计划平均通过率超过98.5%。位点特异性差异出现：RC-MC对H&；N表现较好，RC-CCCS对其他位点表现较好。RadCalc计算的均匀剂量分布略低于Pinnacle3，但RC-MC和RC-CCCS的平均结果减少了DVH差异（平均值ΔD98%−1.1±1.1%，平均值ΔD2% +1.1±1.5%）。屋大维的测量可能低估了由于组织不均匀性造成的计算差异。结论radcalc与Pinnacle3的结果非常一致，可以集成到我们的PSQA程序中进行有效的3D剂量验证，减少测量工作量，同时保持高标准的剂量测定精度。RadCalc算法的使用有效地降低了计算的不确定性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physica Medica-European Journal of Medical Physics 生物-生物物理

CiteScore

6.80

自引率

14.70%

发文量

493

审稿时长

78 days

期刊介绍： Physica Medica, European Journal of Medical Physics, publishing with Elsevier from 2007, provides an international forum for research and reviews on the following main topics: Medical Imaging Radiation Therapy Radiation Protection Measuring Systems and Signal Processing Education and training in Medical Physics Professional issues in Medical Physics.