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RapidArc treatment planning quality assurance using electronic portal imaging device for cervical cancer

  • Hafiz Muhibb ullah Zulkafal (a1) (a2), Allah Ditta Khalid (a3), Sajid Anees Minhas (a2), Umair Zafar (a2), Rizwan Hameed (a2), Muhammad Afzal Khan (a1) and Khalid Iqbal (a1) (a2)...



The main objective of this study is to assure the quality of cervical cancer treatment plans using an electronic portal imaging device (EPID) in RapidArc techniques.

Materials and Methods:

Fifteen cases of cervical cancer patients undergoing RapidArc technique were selected to evaluate the quality assurance (QA) of their treatment. The computed tomography (CT) of each patient was obtained with 3-mm-slice thickness and transferred to the Eclipse treatment planning system. The prescribed dose (PD) of 50·4 Gy with 1·8 Gy per fraction to planning target volume (PTV) was used for each patient. The aim of treatment planning was to achieve 95% of PD to cover 97%, and dose to the PTV should not receive 105% of the PD. All RapidArc plans were created using the AAA algorithm and treated on Varian DHX using 6 MV photon beam, with two full arcs. Gamma analysis was used to evaluate the quality of the treatment plans with accepting criteria of 95% at 3%/3 mm.


In this study, maximum and average gamma values were 2·53 ± 0·409 and 0·195 ± 0·059 showing very small deviation and indicating the smaller difference between both predicted and portal doses. Gamma Area changes from > 0·8 to > 1·2. SD increased to 5·4% and mean standard error increased to 4·67%.


On the basis of these outcomes, we can summarise that the EPID is a useful tool for QA in standardising and evaluating RapidArc treatment plans of cervical cancer in routine clinical practice.


Corresponding author

Author for correspondence: Hafiz Muhibb ullah Zulkafal, Department of Physics, Baghdad Al Jadeed Campus, The Islamia University of Bahawalpur, Punjab, Pakistan. Tel: +92-3024388245. E-mail:


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RapidArc treatment planning quality assurance using electronic portal imaging device for cervical cancer

  • Hafiz Muhibb ullah Zulkafal (a1) (a2), Allah Ditta Khalid (a3), Sajid Anees Minhas (a2), Umair Zafar (a2), Rizwan Hameed (a2), Muhammad Afzal Khan (a1) and Khalid Iqbal (a1) (a2)...


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