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Cancers 2015, 7(2), 631-647; doi:10.3390/cancers7020631

Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy

1
Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
2
Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Robert Weiss
Received: 3 February 2015 / Revised: 21 March 2015 / Accepted: 25 March 2015 / Published: 10 April 2015
(This article belongs to the Special Issue Proton Therapy for Cancer)
View Full-Text   |   Download PDF [1114 KB, uploaded 10 April 2015]   |  

Abstract

An intensity-modulated proton therapy (IMPT) patient-specific quality assurance (PSQA) program based on measurement alone can be very time consuming due to the highly modulated dose distributions of IMPT fields. Incorporating independent dose calculation and treatment log file analysis could reduce the time required for measurements. In this article, we summarize our effort to develop an efficient and effective PSQA program that consists of three components: measurements, independent dose calculation, and analysis of patient-specific treatment delivery log files. Measurements included two-dimensional (2D) measurements using an ionization chamber array detector for each field delivered at the planned gantry angles with the electronic medical record (EMR) system in the QA mode and the accelerator control system (ACS) in the treatment mode, and additional measurements at depths for each field with the ACS in physics mode and without the EMR system. Dose distributions for each field in a water phantom were calculated independently using a recently developed in-house pencil beam algorithm and compared with those obtained using the treatment planning system (TPS). The treatment log file for each field was analyzed in terms of deviations in delivered spot positions from their planned positions using various statistical methods. Using this improved PSQA program, we were able to verify the integrity of the data transfer from the TPS to the EMR to the ACS, the dose calculation of the TPS, and the treatment delivery, including the dose delivered and spot positions. On the basis of this experience, we estimate that the in-room measurement time required for each complex IMPT case (e.g., a patient receiving bilateral IMPT for head and neck cancer) is less than 1 h using the improved PSQA program. Our experience demonstrates that it is possible to develop an efficient and effective PSQA program for IMPT with the equipment and resources available in the clinic. View Full-Text
Keywords: spot scanning proton therapy; IMPT; SFO; SFIB; patient specific QA spot scanning proton therapy; IMPT; SFO; SFIB; patient specific QA
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Zhu, X.R.; Li, Y.; Mackin, D.; Li, H.; Poenisch, F.; Lee, A.K.; Mahajan, A.; Frank, S.J.; Gillin, M.T.; Sahoo, N.; Zhang, X. Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy. Cancers 2015, 7, 631-647.

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