Sci—Sat AM: Stereo — 01: 3D Pre-treatment Dose Verification for Stereotactic Body Radiation Therapy Patients

Radical treatment techniques such as stereotactic body radiation therapy (SBRT) are becoming popular and they involve delivery of large doses in fewer fractions. Due to this feature of SBRT, a high-resolution, pre-treatment dose verification method that makes use of a 3D patient representation would be appropriate. Such a technique will provide additional information about dose delivered to the target volume(s) and organs-at-risk (OARs) in the patient volume compared to 2D verification methods. In this work, we investigate an electronic portal imaging device (EPID) based pre-treatment QA method which provides an accurate reconstruction of the 3D-dose distribution in the patient model. Customized patient plans are delivered ‘in air’ and the portal images are collected using the EPID in cine mode. The images are then analysed to determine an estimate of the incident energy fluence. This is then passed to a collapsed-cone convolution dose algorithm which reconstructs a 3D patient dose estimate on the CT imaging dataset. To date, the method has been applied to 5 SBRT patient plans. Reconstructed doses were compared to those calculated by the TPS. Reconstructed mean doses were mostly within 3% of those in the TPS. DVHs of target volumes and OARs compared well. The Chi pass rates using 3%/3mm in the high dose region are greater than 97% in all cases. These initial results demonstrate clinical feasibility and utility of a robust, efficient, effective and convenient pre-treatment QA method using EPID. Research sponsored in part by Varian Medical Systems.