Abstract
Purpose To investigate intrinsic sensitivity of an electronic portal imaging device (EPID) and the ArcCHECK detector and to use this in assessing their performance in detecting delivery variations for lung SBRT VMAT. The effect of detector spatial resolution and dose matrix interpolation on the gamma pass rate was also considered.
Materials and methods Fifteen patients' lung SBRT VMAT plans were used. Delivery variations (errors) were introduced by modifying collimator angles, multi-leaf collimator (MLC) field sizes and MLC field shifts by +/- 5, +/- 2, and +/- 1 degrees or mm (investigating 103 plans in total). EPID and ArcCHECK measured signals with introduced variations were compared to measured signals without variations (baseline), using OmniPro-I'mRT software and gamma criteria of 3%/3 mm, 2%/2 mm, 2%/1 mm, and 1%/1 mm, to test each system's basic performance. The measurement sampling resolution for each was also changed to 1 mm and results compared to those with the default detector system resolution.
Results Intrinsic detector sensitivity analysis, that is, comparing measurement to baseline measurement, rather than measurement to plan, demonstrated the intrinsic constraints of each detector and indicated the limiting performance that users might expect. Changes in the gamma pass rates for ArcCHECK, for a given introduced error, were affected only by dose difference (DD %) criteria. However, the EPID showed only slight changes when changing DD%, but greater effects when changing distance-to-agreement criteria. This is pertinent for lung SBRT where the minimum dose to the target will drop dramatically with geometric errors. Detector resolution and dose matrix interpolation have an impact on the gamma results for these SBRT plans and can lead to false positives or negatives in error detection if not understood.
Conclusion The intrinsic sensitivity approach may help in the selection of more meaningful gamma criteria and the choice of optimal QA device for site-specific dose verification.