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In Vivo Dosimetry and Daily Arc Junction Verification Using EBT3 Gafchromic Film for Pediatric Cranio-Spinal Irradiation


H Saleh

H Saleh*, S Ferjani , V Masssey , T Howlin , D Pokhrel , University of Kansas Hospital, Kansas City, KS

Presentations

SU-E-T-815 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall


Purpose: Perform dosimetric comparison between planned and delivered dose in the junction area, measure daily dose variation in the arc junction area for pediatric patients treated for medulloblastoma using Craniospinal axis irradiation(CSI)

Material and methods
Dose comparison in the junction area, daily dose variation in the arc junction area for a Rando Phantom and 5 pediatric patients treated using CSI technique were analyzed. Plans were created using the Eclipse treatment planning system. Two arcs for cranium and 1 arc for spine region were used. Planar dose matrix was created by projecting phantom and patient plan into the ArcCheck phantom. EBT3 film was placed in the middle of ArcCheck plug to measure dose distribution in the junction area
During patient treatment, strip of EBT3 film was placed daily at each junction area for verification. EBT3 films were scanned using a flatbed scanner, Epson Expression 10000 XL. Film QA pro software was used to analyze film. Scanning and analysis was performed according to vendor recommendations and AAPM TG-55 report. Films were scanned and analyzed daily after each treatment and at the end of treatment course. Planar dose distributions from films were compared with planar dose distribution from treatment planning system.

Results: Comparison of planned vs. measured dose distributions for patients have passing rates of 90% - 100% with 3% and 3 mm gamma analysis. In some of the treatment fractions, daily setup film showed variation in dose distribution in the junction area.

Conclusion: It is critical to measure dose distribution in the arc junction area and use additional quality assurance measures to verify daily setup for CSI patient where one or more junctions are present. EBT3 film prove to be a good tool to achieve this task considering flexibility associated with the film such as symmetry, self-developing and ease of use



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