Clinical Implementation of a 3D Dosimeter for Accurate IMRT and VMAT Patient Specific QA

Abstract

The Delta4 3D dose verification device was commissioned in the current work for pre-treatment quality assurance (QA) of Intensity Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) plans. The cross cali-bration and relative array calibration were performed to enable absolute dose comparison. The linearity of response with dose and temperature sensitivity tests were also conducted to investigate dosimetric properties of the Delta4 device. The need to modify the original CT image of the Delta4 phantom for accurate dose calculation and comparison is addressed in this work, applying a CT extension algorithm. A number of test plans varying from simple 4—field conformal to IMRT and VMAT plans were measured to evaluate the accuracy of this device. It was found that the Delta4 device measured dose accurately to within ±1%. In order to maintain this level of accuracy the machine output fluctuations need to be corrected prior to each measurement and the relative array calibration needs to be performed every six months.