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Quality assurance of intensity modulated radiation therapy treatment planning using head and neck phantom

  • Zahra (a1), Jalil ur Rehman (a1) (a2), H M Noor ul Huda Khan Asghar (a1), Nisar Ahmad (a1), Zaheer Abbas Gilani (a1), Gulfam Nasar (a3) and Malik M Akhter (a4)...

Abstract

Purpose

The purpose of this study is the verification of intensity modulated radiation therapy (IMRT) head neck treatment planning with one-dimensional and two-dimensional (2D) dosimeters using imaging and radiation oncology core (IROC) Houston head & neck (H&N) phantom.

Method

The image of the H&N phantom was obtained by computed tomography scan which was then transferred to Pinnacle@3 treatment planning system (TPS) for treatment planning. The contouring of the target volumes and critical organ were done manually and dose constraints were set for each organ according to IROC prescription. The plan was optimised by adoptive convolution algorithm to meet the IROC criteria and collapse cone convolution algorithm calculated the delivered doses for treatment. Varian Clinac 2110 was used to deliver the treatment plan to the phantom, the process of irradiation and measurement were repeated three times for reproducibility and reliability. The treatment plan was verified by measuring the doses from thermoluminescent dosimeters (TLDs) and GafChromic external beam therapy 2 films. The agreement between the planned and delivered doses were checked by calculating the percentage dose differences, analysing their isodose line profiles and 2D gamma maps.

Results

The average percent dose difference of 1·8% was obtained between computed doses by TPS and measured doses from TLDs, however these differences were found to be higher for organ at risk. The film dose profile was well in agreement with the planned dose distribution with distance to agreement of 1·5 mm. The gamma analysis of the computed and recorded doses passed the criteria of 3%/3 mm with passing percentages of >96%, which shows successful authentication of delivered doses for IMRT.

Conclusion

IMRT pre-treatment validation can be done with IROC anthropomorphic phantoms, which is essential for the delivery of modulated radiotherapies. It was concluded that films and TLDs can be used as quality assurance tools for IMRT.

Copyright

Corresponding author

Author for correspondence: Jalil ur Rehman, Iqbal Hall, Department of Physics, FABS, BUITEMS, Quetta, Pakistan. E-mail: jalil_khanphy@yahoo.com

Footnotes

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Cite this article: Zahra, Rehman J, Noor ul Huda Khan Asghar HM, Ahmad N, Gilani ZA, Nasar G, Akhter MM. (2019) Quality assurance of intensity modulated radiation therapy treatment planning using head and neck phantom. Journal of Radiotherapy in Practice18: 239–245. doi: 10.1017/S1460396918000729

Footnotes

References

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1. Mendenhall, W M, Amdur, R J, Palta, J R. Intensity-modulated radiotherapy in the standard management of head and neck cancer: promises and pitfalls. J Clin Oncol 2006; 24: 26182623.10.1200/JCO.2005.04.7225
2. Das, I J, Cheng, C-W, Chopra, K L et al. Intensity-modulated radiation therapy dose prescription, recording, and delivery: patterns of variability among institutions and treatment planning systems. J Natl Cancer Inst 2008; 100: 300307.10.1093/jnci/djn020
3. Lee, N, Xia, P, Fischbein, N J et al. Intensity-modulated radiation therapy for head-and-neck cancer: the UCSF experience focusing on target volume delineation. Int J Radiat Oncol Biol Phys 2003; 57: 4960.
4. Nutting, C M, Morden, J P, Harrington, K J 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: 127136.10.1016/S1470-2045(10)70290-4
5. Eisbruch, A, Schwartz, M, Rasch, C et al. Dysphagia and aspiration after chemoradiotherapy for head-and-neck cancer: which anatomic structures are affected and can they be spared by IMRT? Int J Radiat Oncol Biol Phys 2004; 60: 14251439.10.1016/j.ijrobp.2004.05.050
6. Veldeman, L, Madani, I, Hulstaert, F et al. Evidence behind use of intensity-modulated radiotherapy: a systematic review of comparative clinical studies. Lancet Oncol 2008; 9: 367375.10.1016/S1470-2045(08)70098-6
7. Park, H C. Is the use of intensity-modulated radiotherapy beneficial for pancreatic cancer patients? Gut Liver 2016; 10: 164165.10.5009/gnl16014
8. Taylor, A, Powell, M. Intensity-modulated radiotherapy – what is it? Cancer Imaging 2004; 4: 6873.10.1102/1470-7330.2004.0003
9. Sanghani, M, Mignano, J. Intensity modulated radiation therapy: a review of current practice and future directions. Technol Cancer Res Treat 2006; 5: 447450.10.1177/153303460600500501
10. Bortfeld, T. IMRT: a review and preview. Phys Med Biol 2006; 51: R363.10.1088/0031-9155/51/13/R21
11. Zhou, J, Fei, D, Wu, Q. Potential of intensity-modulated radiotherapy to escalate doses to head-and-neck cancers: what is the maximal dose? Int J Radiat Oncol Biol Phys 2003; 57: 673682.10.1016/S0360-3016(03)00626-6
12. de Arruda, F F, Puri, D R, Zhung, J et al. Intensity-modulated radiation therapy for the treatment of oropharyngeal carcinoma: the Memorial Sloan-Kettering Cancer Center experience. Int J Radiat Oncol Biol Phys 2006; 64: 363373.10.1016/j.ijrobp.2005.03.006
13. Kestin, L L, Sharpe, M B, Frazier, R C et al. Intensity modulation to improve dose uniformity with tangential breast radiotherapy: initial clinical experience. Int J Radiat Oncol Biol Phys 2000; 48: 15591568.
14. Ashman, J B, Zelefsky, M J, Hunt, M S et al. Whole pelvic radiotherapy for prostate cancer using 3D conformal and intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 2005; 63: 765771.10.1016/j.ijrobp.2005.02.050
15. Marta, G N, Silva, V, de Andrade Carvalho, H et al. Intensity-modulated radiation therapy for head and neck cancer: systematic review and meta-analysis. Radiother Oncol 2014; 110: 915.10.1016/j.radonc.2013.11.010
16. Lee, N, Terezakis, S. Intensity‐modulated radiation therapy. J Surg Oncol 2008; 97: 691696.10.1002/jso.21014
17. Fitzmaurice, C, Allen, C, Barber, R M et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol 2017; 3: 524548.
18. Partridge, M, Evans, P M, Mosleh‐Shirazi, A, Convery, D. Independent verification using portal imaging of intensity‐modulated beam delivery by the dynamic MLC technique. Med Phys 1998; 25: 18721879.10.1118/1.598376
19. Palta, J R, Deye, J A, Ibbott, G S et al. Credentialing of institutions for IMRT in clinical trials. Int J Radiat Oncol Biol Phys 2004; 59: 12571259.10.1016/j.ijrobp.2004.03.007
20. Group IMRTCW. Intensity-modulated radiotherapy: current status and issues of interest. Int J Radiat Oncol Biol Phys 2001; 51: 880914.10.1016/S0360-3016(01)01749-7
21. Leif, J, Roll, J, Followill, D, Ibbott, G. 2893: the value of credentialing. Int J Radiat Oncol Biol Phys 2006; 66: S716.10.1016/j.ijrobp.2006.07.1312
22. Followill, D S, Evans, D R, Cherry, C et al. Design, development, and implementation of the radiological physics center’s pelvis and thorax anthropomorphic quality assurance phantoms. Med Phys 2007; 34: 20702076.10.1118/1.2737158
23. Ibbott, G, Thwaites, D. Audits for advanced treatment dosimetry. J Phys Conf Ser 2015; doi:10.1088/1742-6596/573/1/012002.
24. 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: 22092219.10.1118/1.1410123
25. Baek, T S, Chung, E J, Son, J, Yoon, M. Detection of IMRT delivery errors based on a simple constancy check of transit dose by using an EPID. J Korean Phys Soc 2015; 67: 18761881.10.3938/jkps.67.1876
26. Han, Z, Ng, S K, Bhagwat, M S et al. Evaluation of MatriXX for IMRT and VMAT dose verifications in peripheral dose regions. Med Phys 2010; 37: 37043714.10.1118/1.3455707
27. Low, D A, Dempsey, J F. Evaluation of the gamma dose distribution comparison method. Med Phys 2003; 30: 24552464.10.1118/1.1598711
28. McVicker, D, Yin, F F, Adamson, J D. On the sensitivity of TG‐119 and IROC credentialing to TPS commissioning errors. J Appl Clin Med Phys 2016; 17: 3448.10.1120/jacmp.v17i1.5452
29. Partridge, M, Trapp, J, Adams, E et al. An investigation of dose calculation accuracy in intensity-modulated radiotherapy of sites in the head & neck. Phys Med 2006; 22: 97104.10.1016/S1120-1797(06)80003-7
30. Hasabelrasoul, H A. Estimation of uncertainty in TLD calibration. Sudan Acad Sci 2013; 1: 445.
31. 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: 20892115.10.1118/1.1591194
32. Hartford, A C, Galvin, J M, Beyer, D C 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: 612617.10.1097/COC.0b013e31826e0515
33. Bogdanich, W. As technology surges, radiation safeguards lag. New York Times 2010; 23: 15.
34. Bogdanich, W. Radiation offers new cures, and ways to do harm. New York Times 2010; 23: A1.

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