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Estimation of the Delivered Fractional and Accumulative Patient Dose in IMRT and VMAT

Y Graves

Y Graves1*, X Zhen1,2, G Kim1, Q Gautier1, Z Tian1, L Cervino1, M Lambrecht1, X Jia1, S Jiang1, (1) University of California, San Diego, La Jolla, CA, (2) Southern Medical University, Guangzhou, Guangdong, China

SU-E-T-340 Sunday 3:00:00 PM - 6:00:00 PM Room: Exhibit Hall

Purpose: To estimate the delivered dose after each fraction of treatment as well as the delivered accumulative dose distribution. The goal of this project is to develop an automatic verification system using daily images and machine log files.

Methods: First, we perform deformable registration from CT to CBCT and correct CBCT artifacts and CT numbers. Due to the limitation of the current scanning protocol, CBCT may not cover the whole treatment region needed for dose reconstruction. In that case, we use deformed CT for dose calculation which has correct CT number as well as daily patient geometry within whole treatment region. With machine log files, we generate actually delivered fluence maps at all delivery angles for that fraction. Then a GPU-based Monte Carlo dose calculation package, gDPM, is employed to get delivered fractional dose on deformed CT or corrected CBCT. To compare the planned dose with the delivered dose, the delivered dose on new daily image is transferred back to the original CT geometry using the deformation vector fields obtained in the first step. This procedure is employed for each fraction to get the accumulative dose on original CT.

Results: We demonstrate this treatment verification system on VMAT patients. We plot the DVHs for delivered and planned dose distributions and summarize the absolute errors in dose matrix report.

Conclusions: We have proposed a procedure to estimate the delivered fractional and accumulative patient doses in IMRT and VMAT. If big errors are observed in the dose matrix report, then a warning should be sent out to responsible personnel, so the error can be indentified and corrected promptly.

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