SU-E-T-679: Retrospective Analysis of the Sensitivity of Planar Dose Measurements To Gamma Analysis Criteria

Purpose: IMRT QA using planar dose measurements is still a widely used method for checking the accuracy of treatment plans. A pass/fail judgment is made using gamma analysis based on a single endpoint. Using more stringent criteria is a way to increase the sensitivity to planning and delivery errors. Before such implementation, it is necessary to understand how the sensitivity to different gamma criteria settings affects gamma passing rates (GPR). Methods: 752 IMRT QA measurements were re-analyzed with varying distance to agreement (DTA) and dose difference (DD) percentages using a Matlab program. Other quantifying information such as the mean dose difference in the treatment target (defined as points that are greater than 80% of maximal dose) were stored in a relational database for retrospective analysis. Results: The average and standard deviation of GPR (%) fell from 99.84 ± (0.43) to 89.61 ± (6.08) when restricting DD from 5 − 1% respectively, as compared to a drop from 99.15 ± (1.19) to 95.00 ± (4.43), when restricting the DTA from 5 − 1 mm respectively. The mean dose difference (%) in the treatment target between measured and calculated dose was −1.96 ± (0. 83), −0.09 ± (0.98), and 1.44 ± (0. 86) for each of our institution’s three matched linear accelerators (LINAC 1, 2, and 3 respectively). For plans that are approximately 2.7 sigma below the mean GPR, an average of 78.4% of those plans were measured on LINAC 1 or 3, while only 48% of the total plans were run on those machines. Conclusion: The data demonstrates that when restricting gamma criterion, such as the DD, the greatest indicator of reduced GPR in our institution is which matched LINAC the plan was measured on. While small, these differences manifest themselves to levels comparable to other treatment related differences and possibly confound the gamma analysis.