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Commissioning of An In-Vivo Quality Assurance Method Using the Electronic Portal Imaging Device

O Morin

O Morin*, M Held , J Pouliot , UC San Francisco, San Francisco, CA


SU-E-T-438 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Patient specific pre-treatment quality assurance (QA) using arrays of detectors or film have been the standard approach to assure the correct treatment is delivered to the patient. This QA approach is expensive, labor intensive and does not guarantee or document that all remaining fractions were treated properly. The purpose of this abstract is to commission and evaluate the performance of a commercially available in-vivo QA software using the electronic portal imaging device (EPID) to record the daily treatments.

The platform EPIgray V2.0.2 (Dosisoft), which machine model compares ratios of TMR with EPID signal to predict dose was commissioned for an Artiste (Siemens Oncology Care Systems) and a Truebeam (Varian medical systems) linear accelerator following the given instructions. The systems were then tested on three different phantoms (homogeneous stack of solid water, anthropomorphic head and pelvis) and on a library of patient cases. Simple and complex fields were delivered at different exposures and for different gantry angles. The effects of the table attenuation and the EPID sagging were evaluated. Gamma analysis of the measured dose was compared to the predicted dose for complex clinical IMRT cases.

Commissioning of the EPIgray system for two photon energies took 8 hours. The difference between the dose planned and the dose measured with EPIgray was better than 3% for all phantom scenarios tested. Preliminary results on patients demonstrate an accuracy of 5% is achievable in high dose regions for both 3DCRT and IMRT. Large discrepancies (>5%) were observed due to metallic structures or air cavities and in low dose areas. Flat panel sagging was visible and accounted for in the EPIgray model.

The accuracy achieved by EPIgray is sufficient to document the safe delivery of complex IMRT treatments. Future work will evaluate EPIgray for VMAT and high dose rate deliveries.

Funding Support, Disclosures, and Conflict of Interest: This work is supported by Dosisoft, Cachan, France.

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