PMID- 31605456 OWN - NLM STAT- MEDLINE DCOM- 20200413 LR - 20200413 IS - 1526-9914 (Electronic) IS - 1526-9914 (Linking) VI - 20 IP - 11 DP - 2019 Nov TI - DVH analysis using a transmission detector and model-based dose verification system as a comprehensive pretreatment QA tool for VMAT plans: Clinical experience and results. PG - 80-87 LID - 10.1002/acm2.12743 [doi] AB - PURPOSE: Dose volume histogram (DVH)-based analysis is utilized as a pretreatment quality assurance tool to determine clinical relevance from measured dose which is difficult in conventional gamma-based analysis. In this study, we report our clinical experience with an ionization-based transmission detector and model-based verification system, using DVH analysis, as a comprehensive pretreatment QA tool for complex volumetric modulated arc therapy plans. METHODS AND MATERIALS: Seventy-three subsequent treatment plans categorized into four clinical sites (Head and Neck, Thorax, Abdomen, and Pelvis) were evaluated. The average dose (D(mean) ) and dose received by 1% (D(1) ) of the planning target volumes (PTVs) and organs at risks (OARs) calculated using the treatment planning system (TPS) were compared to a computed (model-based) and reconstructed dose, from the measured fluence, using DVH analysis. The correlation between gamma (3% 3 mm) and DVH-based analysis for targets was evaluated. Furthermore, confidence and action limits for detector and verification systems were established. RESULTS: Linear regression confirmed an excellent correlation between TPS planned and computed dose using a model-based verification system (r(2) = 1). The average percentage difference between TPS calculated and reconstructed dose for PTVs achieved using DVH analysis for each site is as follows: Head and Neck - 0.57 +/- 2.8% (D(mean) ) and 2.6 +/- 2.7% (D(1) ), Abdomen - 0.19 +/- 2.8% and 1.64 +/- 2.2%, Thorax - 0.24 +/- 2.1% and 3.12 +/- 2.8%, Pelvis 0.37 +/- 2.4% and 1.16 +/- 2.3%, respectively. The average percentage of passed gamma values achieved was above 95% for all cases. However, no correlation was observed between gamma passing rates and DVH difference (%) for PTVs (r(2) = 0.11). The results demonstrate a confidence limit of 5% (D(mean) and D(1) ) for PTVs using DVH analysis for both computed and reconstructed dose distribution. CONCLUSION: DVH analysis of treatment plan using a model-based verification system and transmission detector provided useful information on clinical relevance for all cases and could be used as a comprehensive pretreatment patient-specific QA tool. CI - (c) 2019 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine. FAU - Mohamed Yoosuf, Ahamed B AU - Mohamed Yoosuf AB AD - Department of Oncology, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. AD - King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. FAU - AlShehri, Salem AU - AlShehri S AD - Department of Oncology, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. FAU - Alhadab, Abdulrahman AU - Alhadab A AD - Department of Oncology, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. FAU - Alqathami, Mamdooh AU - Alqathami M AD - Department of Oncology, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. AD - King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. LA - eng PT - Journal Article DEP - 20191011 PL - United States TA - J Appl Clin Med Phys JT - Journal of applied clinical medical physics JID - 101089176 SB - IM MH - Abdominal Neoplasms/*radiotherapy MH - Algorithms MH - Head and Neck Neoplasms/*radiotherapy MH - Humans MH - Organs at Risk/radiation effects MH - Pelvic Neoplasms/*radiotherapy MH - Quality Assurance, Health Care/*standards MH - Radiotherapy Dosage MH - Radiotherapy Planning, Computer-Assisted/*methods MH - Radiotherapy, Intensity-Modulated/*instrumentation/methods/*standards MH - Software MH - Thoracic Neoplasms/*radiotherapy PMC - PMC6839390 OTO - NOTNLM OT - dose volume histogram analysis OT - ionization-based transmission detector OT - model-based verification system OT - volumetric modulated arc therapy COIS- The authors declare that there is no conflict of interest regarding the publication of this article. EDAT- 2019/10/13 06:00 MHDA- 2020/04/14 06:00 PMCR- 2019/10/11 CRDT- 2019/10/13 06:00 PHST- 2019/07/04 00:00 [received] PHST- 2019/08/31 00:00 [revised] PHST- 2019/09/15 00:00 [accepted] PHST- 2019/10/13 06:00 [pubmed] PHST- 2020/04/14 06:00 [medline] PHST- 2019/10/13 06:00 [entrez] PHST- 2019/10/11 00:00 [pmc-release] AID - ACM212743 [pii] AID - 10.1002/acm2.12743 [doi] PST - ppublish SO - J Appl Clin Med Phys. 2019 Nov;20(11):80-87. doi: 10.1002/acm2.12743. Epub 2019 Oct 11.