Fifty-eighth annual meeting of the american association of physicists in medicine
SU-F-T-304: Complex Multi-PTV Treatment Evaluation Using a Remotely Processed 3D Gel Dosimeter
A new 3D gel dosimeter (ClearView™, Modus Medical Systems) was investigated for use as a QA tool for stereotactic radiosurgery (SRS) plans exhibiting high dose gradients and spatially separated treatment targets. The unique feature of this gel dosimeter is the remote processing service provided by Modus Medical Systems.
The gel dosimeters were filled in either 10 cm diameter or 15 cm diameter clear plastic jars. The jars were then shipped in ice-cooled containers to our department for irradiation. Clinical SRS plans for treatment of multiple metastases and plans with simulated concave structures were applied to a CT scan of the gel dosimeter. The gel was irradiated in treatment position using modulated arcs and then returned in the cooled container for processing. The 3D gel dose was compared to the DICOM-RT dose from the treatment plan to assess dosimetric and geometric agreement.
There was no discernible difference between the planned and measured dose for dose gradients as high as 10%/mm, which was the highest gradient we evaluated. Geometric agreement for distant metastases separated by 6 cm was within 1.5 mm. Among three identically irradiated gels using a plan intended for nine metastases, the 3%/3mm gamma passing rate was 84.5% with a range of 14.7%, measured over the entire volume of the dosimeter. Regions of larger gamma values correlated with geometric offsets between the planned and measured data.
The gel dosimeter exhibits the dosimetric and geometric characteristics necessary for 3D evaluation of treatment plan deliverability. The range of observed gamma passing rates suggests a high sensitivity to geometric registration. With proper management of geometric registration between planned and measured data, this service should enable a radiation oncology department to use 3D dosimetry in end-to-end testing or patient plan delivery QA without the expense of an in-house processing system.