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Clinical evaluation of monitor unit software and the application of action levels
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
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2007 (English)In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 85, no 2, 306-315 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of this study was the clinical evaluation of an independent dose and monitor unit verification (MUV) software which is based on sophisticated semi-analytical modelling. The software was developed within the framework of an ESTRO project. Finally, consistent handling of dose calculation deviations applying individual action levels is discussed.

Materials and methods: A Matlab-based software ("MUV") was distributed to five well-established treatment centres in Europe (Vienna, Graz, Basel, Copenhagen, and Umea) and evaluated as a quality assurance (QA) tool. in clinical routine. Results were acquired for 226 individual treatment plans including a total of 815 radiation fields. About 150 beam verification measurements were performed for a portion of the individual treatment plans, mainly with time variable fluence patterns. The deviations between dose calculations performed with a treatment planning system (TPS) and the MUV software were scored with respect to treatment area, treatment technique, geometrical depth, radiological depth, etc.

Results: In general good agreement was found between calculations performed with the different TPSs and MUV, with a mean deviation per field of 0.2 +/- 3.5% (1 SD) and mean deviations of 0.2 +/- 2.2% for composite treatment plans. For pelvic treatments less than 10% of all fields showed deviations larger than 3%. In general, when using the radiological depth for verification calculations the results and the spread in the results improved significantly, especially for head-and-neck and for thorax treatments. For IMRT head-and-neck beams, mean deviations between MUV and the local TPS were -1.0 +/- 7.3% for dynamic, and -1.3 +/- 3.2% for step-and-shoot IMRT delivery. For dynamic IMRT beams in the pelvis good agreement was obtained between MUV and the local TIPS (mean: -1.6 +/- 1.5%). Treatment site and treatment technique dependent action levels between 3% and 5% seem to be clinically realistic if a radiological depth correction is performed, even for dynamic wedges and IMRT.

Conclusion: The software MUV is well suited for patient specific treatment plan QA applications and can handle all currently available treatment techniques that can be applied with standard linear accelerators. The highly sophisticated dose calculation model implemented in MUV allows investigation of systematic TIPS deviations by performing calculations in homogeneous conditions. (c) 2007 Elsevier Ireland Ltd. All rights reserved.

Place, publisher, year, edition, pages
2007. Vol. 85, no 2, 306-315 p.
Keyword [en]
Dose calculation accuracy, action level, independent dose calculation
URN: urn:nbn:se:umu:diva-39900DOI: 10.1016/j.radonc.2007.04.035ISI: 000252201400020OAI: diva2:396840
Available from: 2011-02-11 Created: 2011-02-11 Last updated: 2011-03-25Bibliographically approved

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Nyholm, TufveOlofsson, JörgenKarlsson, Mikael
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