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Evaluation of a Commercial EPID-Based in Vivo Dosimetric System in the Presence of Lung Tissue Heterogeneity

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J Gimeno-Olmos

J Gimeno-Olmos1*, R Palomo-Llinares1 , C Candela-Juan1 , T Garcia-Martinez2 , V Carmona Meseguer1 , F Lliso-Valverde1 , J Richart-Sancho3 , F Ballester4 , J Perez-Calatayud1,3, (1) Hospital Universitari i Politecnic La Fe, Valencia, Valencia, (2) Hospital de la Ribera, Alzira, Valencia, (3) Clinica Benidorm, Benidorm, Alicante, (4) University of Valencia, Burjassot


SU-E-J-64 Sunday 3:00PM - 6:00PM Room: Exhibit Hall


To study the performance of Dosimetry Check (DC), an EPID-based dosimetry software, which allows performing transit dosimetry, in low density medium, by comparing calculations in-phantom, and analysing results for 15 lung patients.


DC software (v.3.8, pencil beam-based algorithm) has been tested, for plans (Eclipse v.10.0 TPS) delivered in two Varian Clinac iX equipped with aS1000 EPIDs.
In the CIRS lung phantom, comparisons between DC and Eclipse (Acuros) were performed for several plans: (1) four field box; (2) square field delivered in arc mode; (3) RapidArc lung patient plan medially centred; (4) RapidArc lung patient plan centred in one lung. Reference points analysed: P1 (medial point, plans 1-3) and P2 (located inside one lung, plan 4).
For fifteen lung patients treated with RapidArc, the isocentre and 9 additional points inside the PTV as well as the gamma passing rate (3%/3mm) for the PTV and at the main planes were studied.


Per-field differences in plan 1: good agreement for AP-PA fields; discrepancy of 7% for the lateral fields.
Global differences (plans 1-3): about 4%, showing a compensating effect of the individual differences.
Global difference (plan 4): 15 %. This represents the worst case situation as it is a point surrounded by lung tissue, where the DC pencil beam algorithm is expected to give the greater difference against Acuros.

Lung patients:
Mean point difference inside the PTV:(5.4±4.2) %.
Gamma passing rate inside the PTV:(45±12) %.


The performance of DC in heterogeneous lung medium was studied with a special phantom and the results for 15 patients were analysed.
The found deviations show that even though DC is a highly promising in vivo dosimetry tool, there is a need of incorporating a more accurate algorithm mainly for plans with low density regions involved.

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