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To compare the measured dose distributions to calculated ones in dose-to-water (Dw) and dose-to-medium (Dm) reporting modes for simple plans and patient-specific intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans using ArcCHECK with a fixed phantom density. Methods: The recommended density value of 1.18 g/cm3 for Acuros XB and X-ray voxel Monte Carlo was assigned to ArcCHECK on CT images. A total of 45 simple plans, including a 1-field plan, a 3-field plan, a 4-field plan, a half-arc plan from 270° to 90°, and a full-arc plan, were assessed. Subsequently, the patient-specific 96 IMRT and VMAT plans were evaluated. Gamma analysis with a 3% normalized global dose error and a 3 mm distance-to-agreement criteria (γ3%G/3mm) was performed in the Dw and Dm. The change in γ3%G/3mm between Dw and Dm were statistically analyzed using JMPPro11 software. Results: The median values of γ3%G/3mm for all simple plans for Dw and Dm were 98.1% (range, 75.2% - 100%) and 95.5% (range, 23.7% - 100%), respectively (p < 0.01). In the patient-specific IMRT and VMAT plans, the median values of γ3%G/3mm for Dw and Dm were 98.6% (range, 90.1% - 100%) and 90.5% (range, 38.5% - 97.2%), respectively (p < 0.01). Conclusion: Our results showed that the calculated and measured dose distributions were in good agreement for Dw, but were not for Dm. From the viewpoint of the rationale of dosimetry, Dw shows better agreement with measured dose distribution when using the fixedphantom density recommended by the vendor.

international journal of medical physics, clinical engineering and radiation oncology

Comparison of Gamma Pass Rate between the Dose-to-Water and Dose-to-Medium Reporting Modes for Patient-Specific QA Using a Helical Diode Array Dosimeter with a Fixed Phantom Density