A clinically relevant IMRT QA workflow: Design and validation

Medical Physics
Cassandra Stambaugh, Gary Ezzell

Abstract

The purpose of this study was to determine clinically relevant pass/question/fail criteria for gamma analysis of intensity-modulated radiation therapy quality assurance (IMRT QA) plans, identify which plans should be further analyzed with dose-volume histogram (DVH) metrics, and create a workflow for performing that DVH-based analysis. A total of 11 plans, 5 prostate and 6 head/neck, were selected to represent known good plans based on their high-passing rate using conventional IMRT QA criteria. These were modified by moving the programmed MLC positions to underdose the target or overdose important structures by varying amounts. Commercially available hardware/software was used to measure and analyze all plans (76 total) using 4%/3 mm, 3%/3 mm, 3%/2 mm, and 2%/2 mm gamma criteria. Two receiver operator characteristic (ROC) curves per criterion were created to assess effective passing rates. One ROC curve was to find a higher threshold that determined a clear pass and the second to find a lower threshold to determine a clear failure. Plans between these two thresholds need DVH-based analysis to assess the clinical consequence of the dose difference. The modified plans were analyzed in the planning system and reconstructed in com...Continue Reading

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Citations

Jan 2, 2019·Journal of Applied Clinical Medical Physics·Cassandra StambaughGary Ezzell
May 1, 2020·Journal of Applied Clinical Medical Physics·Hunter MehrensStephen F Kry
Jul 10, 2019·Journal of Applied Clinical Medical Physics·Liting YuScott B Crowe

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