Skip to main content Accessibility help

Dose verification of volumetric-modulated arc therapy using one-dimensional and two-dimensional dosimeters

  • Jalil ur Rehman (a1) (a2), Zahra Syed (a1), Ghulam Hussain (a1), Nisar Ahmad (a1), H M Noor ul Huda Khan Asghar (a1), Zaheer Abbas Gilani (a1), Gulfam Nasar (a3), Malik M Akhter (a4), Muhammad Isa (a5) and Tahir Iqbal (a5)...



To verify dose delivery and quality assurance of volumetric-modulated arc therapy (VMAT) for head and neck (H&N) cancer.


The Imaging and Radiation Oncology Core Houston (IROC-H) H&N phantom with thermoluminescent dosimeters (TLDs) and films, were imaged with computed tomography scan and the reconstructed image was transferred to pinnacle treatment planning system (TPS). On TPS, the planning target volume (PTV), secondary target volume (STV) and organ at risk (OAR) were delineated manually and a treatment plan was made. The dose constraints were determined for the concerned organs according to IROC-H prescription. The treatment plan was optimised using adoptive convolution algorithm to improve dose homogeneity and conformity. The dose calculation was performed using C.C Convolution algorithm and a Varian True Beam linear accelerator was used to deliver the treatment plan to the H&N phantom. The delivered radiation dose to the phantom was measured through TLDs and GafChromic external beam radiotherapy 2 (EBT2) films. The dosimetric performance of the VMAT delivery was studied by analysing percent dose difference, isodose line profile and gamma analysis of the TPS-computed dose and linac-delivered doses.


The percent dose difference of 3.8% was observed between the planned and measured doses of TLDs and a 1.5-mm distance to agreement (DTA) was observed by comparing isodose line profiles. Passed the gamma criteria of 3%/3 mm was with good percentages.


The dosimetric performance of VMAT delivery for a challenging H&N radiotherapy can be verified using TLDs and films embedded in an anthropomorphic H&N phantom.


Corresponding author

Author for correspondence: Jalil ur Rehman, Iqbal Hall, Department of Physics, FABS, BUITEMS, Quetta, Pakistan. Tel: +92-81-111-717-111 (EXT-641). E-mail:; or Ghulam Hussain,


Hide All

Cite this article: Rehman Ju, Syed Z, Hussain G, Ahmad N, Asghar HMNuHK, Gilani ZA, Nasar G, Akhter MM, Isa M, Iqbal T. (2019) Dose verification of volumetric-modulated arc therapy using one-dimensional and two-dimensional dosimeters. Journal of Radiotherapy in Practice18: 304–308. doi: 10.1017/S1460396918000559



Hide All
1. Jemal, A, Siegel, R, Xu, J et al. Cancer statistics, 2010. Canc J Clin 2010; 60(5): 277300.10.3322/caac.20073
2. Nutting, C M, James, P M, Kevin, J H et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol 2011; 12(2): 127136.10.1016/S1470-2045(10)70290-4
3. Purdy, J A. Dose to normal tissues outside the radiation therapy patient’s treated volume: a review of different radiation therapy techniques. Health Phys 2008; 95(5): 666676.10.1097/01.HP.0000326342.47348.06
4. Hall, E J. Intensity-modulated radiation therapy, protons, and the risk of second cancers. Int J Radiat Oncol Biol Phys 2006; 65(1): 17.10.1016/j.ijrobp.2006.01.027
5. Zhang, P, Happersett, L, Hunt, M et al. Volumetric modulated arc therapy: planning and evaluation for prostate cancer cases. Int J Radiat Oncol Biol Phys 2010; 76(5): 14561462.10.1016/j.ijrobp.2009.03.033
6. Johnston, M, Clifford, S, Bromley, R et al. Volumetric-modulated arc therapy in head and neck radiotherapy: a planning comparison using simultaneous integrated boost for nasopharynx and oropharynx carcinoma. Clin Oncol 2011; 23(8): 503511.10.1016/j.clon.2011.02.002
7. Ong, C L, Verbakel, W F, Cuijpers, J P et al. Stereotactic radiotherapy for peripheral lung tumors: a comparison of volumetric modulated arc therapy with 3 other delivery techniques. Radiother Oncol 2010; 97(3): 437442.10.1016/j.radonc.2010.09.027
8. Lutjeboer, S, Rook, J W A, Stiekema, G et al. PV-0456: Volumetric modulated arc therapy for patients with bilateral breast cancer. Radiother Oncol 2017; 123: S242S243.10.1016/S0167-8140(17)30897-6
9. Studenski, M T, Bar-Ad, V, Siglin, J et al. Clinical experience transitioning from IMRT to VMAT for head and neck cancer. Med Dosimet 2013; 38(2): 171175.10.1016/j.meddos.2012.10.009
10. Zulkafal, H M, Khan, M A, Ahmad, M W et al. Volumetric modulated arc therapy treatment planning assessment for low-risk prostate cancer in radiotherapy. Clin Canc Investigat J 2017; 6(4): 179.
11. Otto, K. Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys 2008; 35(1): 310317.10.1118/1.2818738
12. Ling, C C, Zhang, P, Archambault, Y et al. Commissioning and quality assurance of RapidArc radiotherapy delivery system. Int J Radiat Oncol Biol Phys 2008; 72(2): 575581.10.1016/j.ijrobp.2008.05.060
13. Verbakel, W F, Cuijpers, J P, Hoffmans, D et al. Volumetric intensity-modulated arc therapy vs. conventional IMRT in head-and-neck cancer: a comparative planning and dosimetric study. Int J Radiat Oncol Biol Phys 2009; 74(1): 252259.10.1016/j.ijrobp.2008.12.033
14. Ruben, J D, Davis, S, Evans, C et al. The effect of intensity-modulated radiotherapy on radiation-induced second malignancies. Int J Radiat Oncol Biol Phys 2008; 70(5): 15301536.10.1016/j.ijrobp.2007.08.046
15. Ezzell, G A, Galvin, J M, Low, D et al. Guidance document on delivery, treatment planning, and clinical implementation of IMRT: report of the IMRT Subcommittee of the AAPM Radiation Therapy Committee. Med Phys 2003; 30(8): 20892115.10.1118/1.1591194
16. Hartford, A C, Seung, S K, Larson, D A et al. American College of Radiology (ACR) and American Society for Radiation Oncology (ASTRO) practice guideline for intensity-modulated radiation therapy (IMRT). Am J Clin Oncol 2012; 35(6): 612617.10.1097/COC.0b013e31826e0515
17. Rehman, Ju, Iqbal, T, Tailor, R et al. Dosimetric comparison among different head and neck radiotherapy techniques using PRESAGE dosimeter. Int J Canc Ther Oncol 2015; [S.l.], v. 3, n. 4.10.14319/ijcto.34.9
18. Ur Rehman, J, Isa, M, Ahmad, N et al. Quality assurance of volumetric-modulated arc therapy head and neck cancer treatment using PRESAGE dosimeter. J Radiother Pract 2018; 16.
19. LoSasso, T, Chui, C S, Ling, C C. Comprehensive quality assurance for the delivery of intensity modulated radiotherapy with a multileaf collimator used in the dynamic mode. Med Phys 2001; 28(11): 22092219.10.1118/1.1410123
20. Song, Y, Zhang, Q, Burman, C et al. Investigation of the compounding effect of MLC positioning uncertainty and gantry angular acceleration in VMAT delivery. Int J Radiat Oncol Biol Phys 2011; 81(2): S892.10.1016/j.ijrobp.2011.06.1598
21. Park, J, Wu, H G, Kim, J H et al. The effect of MLC speed and acceleration on the plan delivery accuracy of VMAT. Br J Radiol 2015; 88(1049): 20140698.10.1259/bjr.20140698
22. Lynch, B D, Kozelka, J, Ranade, M K et al. Important considerations for radiochromic film dosimetry with flatbed CCD scanners and EBT GAFCHROMIC film. Med Phys 2006; 33(12): 45514556.10.1118/1.2370505
23. Hasabelrasoul, H A. Estimation of uncertainty in TLD calibration. M.Sc. Thesis. Sudan: Sudan Academy of Science, 2013.


Related content

Powered by UNSILO

Dose verification of volumetric-modulated arc therapy using one-dimensional and two-dimensional dosimeters

  • Jalil ur Rehman (a1) (a2), Zahra Syed (a1), Ghulam Hussain (a1), Nisar Ahmad (a1), H M Noor ul Huda Khan Asghar (a1), Zaheer Abbas Gilani (a1), Gulfam Nasar (a3), Malik M Akhter (a4), Muhammad Isa (a5) and Tahir Iqbal (a5)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.