SU-E-T-152: Error Sensitivity and Superiority of a Protocol for 3D IMRT Quality Assurance




To test if the parameters included in our 3D QA protocol with current tolerance levels are able to detect certain errors and show the superiority of 3D QA method over single ion chamber measurements and 2D gamma test by detecting most of the introduced errors. The 3D QA protocol parameters are: TPS and measured average dose difference, 3D gamma test with 3mmDTA/3% test parameters, and structure volume for which the TPS predicted and measured absolute dose difference is greater than 6%.


Two prostate and two thoracic step-and-shoot IMRT patients were investigated. The following errors were introduced to each original treatment plan: energy switched from 6MV to 10MV, linac jaws retracted to 15cmx15cm, 1,2,3 central MLC leaf pairs retracted behind the jaws, single central MLC leaf put in or out of the treatment field, Monitor Units (MU) increased and decreased by 1 and 3%, collimator off by 5 and 15 degrees, detector shifted by 5mm to the left and right, gantry treatment angle off by 5 and 15 degrees. QA was performed on each plan using single ion chamber, 2D ion chamber array for 2D gamma analysis and using IBA's COMPASS system for 3D QA.


Out of the three tested QA methods single ion chamber performs the worst not detecting subtle errors. 3D QA proves to be the superior out of the three methods detecting all of introduced errors, except 10MV and 1% MU change, and MLC rotated (those errors were not detected by any QA methods tested).


As the way radiation is delivered evolves, so must the QA. We believe a diverse set of 3D statistical parameters applied both to OAR and target plan structures provides the highest level of QA.