Fifty-sixth annual meeting of the American association of physicists in medicine
SU-E-T-12: A Feasibility Study of Patient Specific QA Using Gafchromic Film of Dynamic Feathering in Junctions of Craniospinal Irradiation
Cranio-spinal irradiation is the most complicated format of the conventional external beam radiation therapy because it involves matches of non-coplanar beams which are susceptible to daily setup errors. This study explores the efficacy of Gafchromic film dosimetry to quantitatively verify the junctions for cranio-spinal radiation feathered with field in field technique.
15cm in thickness of solid water phantom was scanned vertically and exported to the Pinnacle TPS as primary phantom data set. A patient cranio-spinal plan, consisted of two bilateral whole brain beams dynamically matched with a posterior spinal beam using field in field technique, was transferred to the phantom and recalculated for one fraction with set monitor units identical to the original plan. Next, planar dose distribution on the phantom was exported to the FilmQA Pro 2013 software (Ashland, Inc.) in binary format for comparison with the measured dose distribution. An EBT2 film was sandwiched in the middle of the phantom and the phantom was set up according to the QA plan based on the room laser system. The shifts instructions associated with the patient original plan were made and the beams from the patient original plan delivered to the solid water phantom via the record and verify system in QA mode. The dose distribution from the measured film was compared with the planned reference distribution using gamma analysis and profile comparison.
Gamma passing rate of 91 % with DTA 3mm and 5% dose difference was obtained within the junction region, significantly greater passing rate above 95 % was obtained in the homogeneous region of the brain field.
This study confirms that Gafchromic film dosimetry can be used to validate the efficacy of FIF feathering technique for cranio-spinal treatment. FIF technique with Gafchromic dosimetry may now be the new standard for delivering efficient and accurate cranio-spinal radiation with confidence.