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Comparison of Error Range of Delivery Quality Assurance by Type of Intensity Modulated Radiation Therapy

Journal of Magnetics, Volume 23, Number 4, 31 Dec 2018, Pages 587-595
Jeong Ho Kim (Department of Radiation Oncology, Konyang University Hospital), Se Jong Yoo * (Department of Radiology, Daejeon Health Institute of Technology)
Abstract
Delivery Quality Assurance (DQA) is performed to evaluate the intensity modulated radiotherapy (IMRT). However, differences in the DQA results may be caused by factors such as the IMRT technique, treatment volume, etc. In this study, we compared five types of gamma index and four types of dose differences as IMRT technique, Treatment site, Volume of Planning Target Volume (PTV), Regularity Shape Index (RSI), indices of treatment planning evaluation. From January 1, 2016 to December 31, 2017, 32 patients who underwent IMRT plan were used to perform Step and Shoot (SNS) technique, Sliding Window (SW) technique, and Volumetric Modulated Arc radio-Therapy (VMAT) technique. After obtaining the Treatment Site, Volume of PTV, RSI, CI, HI, QOC according to each planning technique, nine factors of DQA were compared. As a result of the comparison, it was not possible to confirm the tendency of the items except the IMRT technique. The results of the IMRT technique showed the highest values for area gamma (< 1.0) and area dose difference (> 0.8) for SNS technique, and the lowest values for the other seven factors. For VMAT technique, the lowest value was obtained for area gamma (< 1.0) and area dose difference (> 0.8), and the highest value was obtained for the other seven factors. This study is limited to Electronic Portal Image Device(EPID). Therefore, it is necessary to study various equipment and program version in order to evaluate various DQA tools. In addition, there are limitations on the Treatment Site, Volume of PTV, and etc. necessary for evaluation. Therefore, it is considered that evaluation using various cases will be needed in the future. Nine factors, results of DQA, were a tendency by the IMRT techniques. The tolerance range of gamma index should be tightly in 80 % and 60 %, and the tolerance range of dose difference index should be tightly in 75 % and 25 %. Therefore, it can be concluded that accurate electromagnetic radiation therapy can be performed by applying the appropriate tolerance according to the IMRT technique in the future.
 
Keywords: radiotherapy; intensity modulated radiation therapy; delivery quality assurance
DOI: https://doi.org/10.4283/JMAG.2018.23.4.587
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