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Dose Verification of Helical

TomoTherapy IMRT Treatment


using ArcCHECK device

Servicio de Radiofsica
Ruth Rodrguez Romero
Patricia Snchez Rubio

International TomoTherapy Conference (Heidelberg 2011)

Introduction
12
absorbed
dose points

>> 2
absorbed
dose points

DQA x 2 ?
< 8 Gy

Material

ArcCHECK (detector)

1386 diodes in a helical grid

21 cm

International TomoTherapy Conference (Heidelberg 2011)

L 21 cm

0.8 x 0.8 mm2


0.000019 cm3
spacing 10mm
spatial resolution ~ 7mm

No warm-up
No dose or acquisition limit
Real time updates (50 ms)

ArcCHECK (software)

BEV display

Unrolled RTDose files

Centre device coordinates


Rescaling by fraction number

Comparison (profiles, histograms, DTA, gamma)

International TomoTherapy Conference (Heidelberg 2011)

Method

ArcCHECK calibration

Absorbed dose calibration (6 MV Tomotherapy)


Default array calibration

12 TomoTherapy IMRT treatments

Clinical cases

Analyze

Sites (brain, head & neck, lung...)


Fractionation (1.8, 2, 3, 5, 18 Gy)
Size (27 2900 cm3)

relative and absolute gamma


calculated shifts

measured

abs(2%, 2mm)
92.0%

Hot points
Cold points

Compare

A1SL ion chamber absorbed dose

EBT2 dose distribution

planned

Breast
(2 Gy x 28)

International TomoTherapy Conference (Heidelberg 2011)

Results
> 92%

> 92%

International TomoTherapy Conference (Heidelberg 2011)

Results
> 97%

International TomoTherapy Conference (Heidelberg 2011)

Results: Comparison
Eye Orbit
(2 Gy x 33)
Absorbed dose
sampling

ArcCHECK (-2.0%, +2.0%)

ArcCHECK

rel(3, 3)
99.3%

A1SL
-3.1%
-3.4%

EBT2
rel(3, 3)
95.8%

International TomoTherapy Conference (Heidelberg 2011)

Results: Comparison
+0.4%

-1.9%

2%

>

International TomoTherapy Conference (Heidelberg 2011)

Conclusions

ArcCHECK vs TPS
abs (3% 3mm) > 92%
rel (3% 3mm) > 97%
Small volumes: abs (3% 3mm)>99%

abs (2% 2mm)>92%

ArcCHECK vs A1SL + EBT2

Ddiodes > Dion chambers

2%

(A1SL vs TPS -1.5%)

Dose diode calibration?

Detector size effect?

array > film

(0.000019 vs 0.051 cm3)

International TomoTherapy Conference (Heidelberg 2011)

Conclusions
ArcCHECK is suitable to measure IMRT TomoTherapy

more absorbed dose measurement points


larger absorbed dose sample region
absolute an relative dose simultaneous
real verifications, without dose rescaling
no multiple DQA plans
on line measurements
no scanning / processing required

Thanks for your attention

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