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IMRT Dosimetry Differences in An Institution with Community and Academic Model

S Srivastava

S Srivastava1,2*, A Andersen2 , C Cheng3 , I Das2 , (1) Indiana University Health Methodist Hospital, Indianapolis, IN, (2) Indiana University School of Medicine, Indianapolis, IN, (3) University Hospitals Medical Center, Cleveland, OH


TU-G-BRD-3 (Tuesday, July 14, 2015) 4:30 PM - 6:00 PM Room: Ballroom D

Purpose: Radiation outcome among institutions can be interpreted meaningfully if the dose delivery and prescription to the target volume is documented accurately and consistently. ICRU-83 recommended specific guidelines in IMRT for target volume definitions and dose reporting. This retrospective study evaluates the pattern of IMRT dose prescription and recording in an academic institution (AI) and a community hospital (CH) models in a single institution with reference to ICRU-83 recommendation.

Materials & Methods: Dosimetric information of 625 (500 from academic and 125 from community) patients treated with IMRT was collected retrospectively from the AI and a CH. The dose-volume histogram (DVH) for the target volume of each patient was extracted. Standard dose parameters such as D2, D50, D95, D98, D100, as well as the homogeneity index (HI) defined as (D2-D98)/D50 and monitor units (MUs) were collected.

Results: Significant dosimetric variations were observed in disease sites and between AI and CH. The variation in the mean value of D95 for AI is 98.48±4.12 and for CH is 96.41±4.13. A similar pattern was noticed for D50 (104.18±6.04 for AI and 101.05±3.49 for CH). Thus, nearly 95% of patients received dosage higher than 100% to the site viewed by D50 and varied between AI and CH models. The average variation of HI is found to be 0.12±0.08 and 0.11±0.08 for AI and CH model, showing better IMRT treatment plans for academic model compared to community.

Conclusion: Even with the implementation of ICRU-83 guidelines, there is a large variation in dose prescription and delivery in IMRT. The variation is institution and site specific. For any meaningful comparison of the IMRT outcome, strict guidelines for dose reporting should be maintained in every institution.

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