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Aim To present practical examples of our new algorithm for reconstruction of 3D dose distribution, based on the actual MLC leaf movement. Background DynaLog and RTplan files were used by DDcon software to prepare a new RTplan file for dose distribution reconstruction. Materials and methods Four different clinically relevant scenarios were used to assess the feasibility of the proposed new approach: (1) Reconstruction of whole treatment sessions for prostate cancer; (2) Reconstruction of IMRT verification treatment plan; (3) Dose reconstruction in breast cancer; (4) Reconstruction of interrupted arc and complementary plan for an interrupted VMAT treatment session of prostate cancer. The applied reconstruction method was validated by comparing reconstructed and measured fluence maps. For all statistical analysis, the U Mann–Whitney test was used. Results In the first two and the fourth cases, there were no statistically significant differences between the planned and reconstructed dose distribution ( p = 0.910, p = 0.975, p = 0.893, respectively). In the third case the differences were statistically significant ( p = 0.015). Treatment plan had to be reconstructed. Conclusion Developed dose distribution reconstruction algorithm presents a very useful QA tool. It provides means for 3D dose distribution verification in patient volume and allows to evaluate the influence of actual MLC leaf motion on the dose distribution. [ABSTRACT FROM AUTHOR]

Abstract: Aim: The aim was to provide a dosimetric comparison between IMRT and RapidArc treatment plans with RPI index with simultaneous comparison of the treatment delivery time. Background: IMRT and RapidArc provide highly conformal dose distribution with good sparing of normal tissues. However, a complex spatial dosimetry of IMRT and RapidArc plans hampers the evaluation and comparison between plans calculated for the two modalities. RPI was used in this paper for treatment plan comparisons. The duration of the therapeutic session in RapidArc is reported to be shorter in comparison to therapeutic time of the other dynamic techniques. For this reasons, total treatment delivery time in both techniques was compared and discussed. Materials and methods: 15 patients with prostate carcinoma were randomly selected for the analysis. Two competitive treatment plans using respectively the IMRT and RapidArc techniques were computed for each patient in Eclipse planning system v. 8.6.15. RPIwin® application was used for RPI calculations for each treatment plan. Additionally, total treatment time was compared between IMRT and RapidArc plans. Total treatment time was a sum of monitor units (MU) for each treated field. Results: The mean values of the RPI indices were insignificantly higher for IMRT plans in comparison to rotational therapy. Comparison of the mean numbers of monitor units confirmed that the use of rotational technique instead of conventional static field IMRT can significantly reduce the treatment time. Conclusion: Analysis presented in this paper, demonstrated that RapidArc can compete with the IMRT technique in the field of treatment plan dosimetry reducing the time required for dose delivery. [Copyright &y& Elsevier]

Abstract: Aim: The aim of the study was to estimate the dose at the reference point applying an aSi-EPID device in the course of patient treatment. Materials and methods: The method assumes direct proportionality between EPID signal and dose delivered to the patient reference point during the treatment session. The procedure consists of treatment plan calculation for the actual patient in the arc technique. The plan was realized with an elliptic water-equivalent phantom. An ionization chamber inside the phantom measured the dose delivered to the reference point. Simultaneously, the EPID matrix measured the CU distribution. EPID signal was also registered during patient irradiation with the same treatment plan. The formula for in vivo dose calculation was based on the CU(g) function, EPID signal registered during therapy and the relation between the dose and EPID signal level measured for the phantom. In vivo dose was compared with dose planned with the treatment planning system. Irradiation was performed with a Clinac accelerator by Varian Medical Systems in the RapidArc technique. The Clinac was equipped with an EPID matrix (electronic portal image device) of aSi-1000. Treatment plans were calculated with the Eclipse/Helios system. The phantom was a Scanditronix/Wellhöfer Slab phantom, and the ionization chamber was a 0.6ccm PTW chamber. Results: In vivo dose calculations were performed for five patients. Planned dose at the reference point was 2Gy for each treatment plan. Mean in vivo dose was in the range of 1.96–2.09. Conclusions: Our method was shown to be appropriate for in vivo dose evaluation in the RapidArc technique. [Copyright &y& Elsevier]