A commissioning protocol for portal imaging-based radiotherapy in vivo dosimetry systems

Background and Purpose: With the availability of commercial electronic portal imaging detector-based in vivo dosimetry (EPID-based IVD) solutions, many radiotherapy departments are adopting this technology. However, comprehensive commissioning guidance is lacking. This study aims to provide a protoc...

Full description

Saved in:
Bibliographic Details
Main Authors: Marco Esposito, Riccardo Baldoni, Evy Bossuyt, Sara Bresciani, Catharine H Clark, Matthew Jones, Stephen Kry, Joseph Perry, Jeroen van de Kamer, Dirk Verellen, Nuria Jornet
Format: Article
Language:English
Published: Elsevier 2024-10-01
Series:Physics and Imaging in Radiation Oncology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405631624001362
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background and Purpose: With the availability of commercial electronic portal imaging detector-based in vivo dosimetry (EPID-based IVD) solutions, many radiotherapy departments are adopting this technology. However, comprehensive commissioning guidance is lacking. This study aims to provide a protocol for testing the accuracy and sensitivity of EPID-based IVD systems. Material and methods: The protocol was tested across four institutions using two different systems. Accuracy was evaluated with homogeneous slab phantoms using different square regular fields, and clinical plans in a CIRS lung phantom. Multiple forward and back-projected algorithm implementations were assessed for different energies. Sensitivity analysis in the lung phantom examined responses to setup errors, anatomical variations, and delivery errors. Results: In homogeneous phantoms, over 85 % of pixels passed the 5 %/2mm gamma criteria, except for the 2x2 cm2 field. In the lung phantom, all systems and implementations achieved over 95 %-pixel pass rates at the 2 %/2mm criterion for volumetric modulated arc therapy (VMAT) plans. For conformal radiation therapy (3DCRT) plans, one system implementation showed poor accuracy, with over 90 % agreement only at the 5 %/2mm criterion. Considering all systems and implementations, average sensitivity and specificity for CRT plans ranged from 0.92 and 0.42 (at 2 %/2mm) to 0.71 and 0.52 (at 5 %/2mm), while for VMAT plans ranged from 0.41 and 0.81 (at 2 %2mm) to 0.37 and 0.81 (at 5 %/2mm). Conclusion: We successfully developed a protocol to commission EPID IDV systems. It was found that not all systems and implementations achieved satisfactory accuracy and sensitivity, emphasising the need for thorough commissioning and benchmarking.
ISSN:2405-6316