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WE‐D‐BRA‐06: IMRT QA with ArcCHECK: The MD Anderson Experience
Author(s) -
Aristophanous M,
Suh Y,
Chi P,
LaNeave S,
Whittlesey L,
Martel M
Publication year - 2015
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.4925933
Subject(s) - medicine , quality assurance , nuclear medicine , significant difference , radiology , pathology , external quality assessment
Purpose: The objective of this project was to report our initial IMRT QA results and experience with the SunNuclear ArcCHECK. Methods: Three thousand one‐hundred and sixteen cases were treated with IMRT or VMAT at our institution between October 2013 and September 2014. All IMRT/VMAT treatment plans underwent Quality Assurance (QA) using ArcCHECK prior to therapy. For clinical evaluation, a Gamma analysis is performed following QA delivery using the SNC Patient software (Sun Nuclear Corp) at the 3%/3mm level. QA Gamma pass rates were analyzed based on categories of treatment site, technique, and type of MLCs. Our current clinical threshold for passing a QA (Tclin) is set at a Gamma pass rate greater than 90%. We recorded the percent of failures for each category, as well as the Gamma pass rate threshold that would Result in 95% of QAs to pass (T95). Results: Using Tclin a failure rate of 5.9% over all QAs was observed. The highest failure rate was observed for gynecological (22%) and the lowest for CNS (0.9%) treatments. T95 was 91% over all QAs and ranged from 73% (gynecological) to 96.5% (CNS) for individual treatments sites. T95 was lower for IMRT and non‐HD (high definition) MLCs at 88.5% and 94.5%, respectively, compared to 92.4% and 97.1% for VMAT and HD MLC treatments, respectively. There was a statistically significant difference between the passing rates for IMRT vs. VMAT and for HD MLCs vs. non‐HD MLCs (p‐values << 0.01). Gynecological, IMRT, and HD MLC treatments typically include more plans with larger field sizes. Conclusion: On average, Tclin with ArcCHECK was consistent with T95, as well as the 90% action level reported in TG‐119. However, significant variations between the examined categories suggest a link between field size and QA passing rates and may warrant field size‐specific passing rate thresholds.

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