Skip to main content
SpringerLink
Log in

Clinical pilot study for EPID-based in vivo dosimetry using EPIgray™ for head and neck VMAT

  • Note
  • Published:
Physical and Engineering Sciences in Medicine Aims and scope Submit manuscript

Abstract

This work details the clinical pilot study methodology used at Wellington Blood and Cancer Centre (WBCC) before the clinical release of in vivo dosimetry (IVD) system EPIgray™ for head and neck (H&N) volumetric modulated arc therapy (VMAT) treatments. Clinical pilot studies make it possible to select appropriate, department-specific tolerance ranges for the treatment type and site under investigation. An IVD clinical pilot study of H&N VMAT treatments was conducted over 3 months at WBCC using EPIgray™ dose reconstruction software and included 12 patients and 32 individual treatment fractions. Statistical analysis of the dose deviations between the treatment planning system (TPS) dose and EPIgray™ reconstructed dose confirmed that a deviation tolerance range of ± 7.0% was an appropriate choice for H&N VMAT at WBCC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Abbreviations

aSi:

Amorphous silicon

EPID:

Electronic portal imaging device

H&N:

Head and neck

IVD:

In-vivo dosimetry

Linac:

Linear accelerator

MV:

Megavoltage

QC:

Quality control

SD:

Standard deviation

TPS:

Treatment planning system

VMAT:

Volumetric modulated arc therapy

WBCC:

Wellington Blood and Cancer Centre

\(\Delta {\mathrm{D}}_{\mathrm{auto},\mathrm{mean}}\) :

Mean autopoint dose deviation of in vivo dosimetry system compared to treatment planning system for a single fraction of treatment

\(\overline{\Delta {\mathrm{D}}_{\mathrm{auto},\mathrm{mean}}}\) :

Mean autopoint dose deviation of in vivo dosimetry system compared to treatment planning system averaged over all fractions included in the clinical pilot study

ΔDref :

Reference point dose deviation of in vivo dosimetry system compared to treatment planning system for a single fraction of treatment

\(\overline{\Delta {\mathrm{D} }_{\mathrm{ref}}}\) :

Reference point dose deviation of in vivo dosimetry system compared to treatment planning system averaged over all fractions included in the clinical pilot study

References

  1. The Royal College of Radiologists (2008) Society and college of radiographers, institute of physics and engineering in medicine, national patient safety agency, british institute of radiology, “towards safer radiotherapy.” The Royal College of Radiologists, London

    Google Scholar 

  2. Francois P, Boissard P, Berger L, Mazal A (2011) In vivo dose verification from back projection of a transit dose measurement on the central axis of photon beams. Phys Med 27:1–10

    Article  Google Scholar 

  3. MacDougall N, Graveling M, Hansen V, Brownsword K, Morgan A (2017) In vivo dosimetry in UK external beam therapy: current and future usage. British J Radiol 90:20160915

    Article  Google Scholar 

  4. van Elmpt W, McDermott L, Nijsten S, Wendling M, Lambin P, Mijnheer B (2008) A literature review of electronic portal imaging for radiotherapy dosimetry. Radiother Oncol 88(3):289–309

    Article  Google Scholar 

  5. Louwe RJ, McDermott LN, Sonke JJ, Tielenburg R, Wendling M, Van Herk MB, Mijnheer BJ (2004) The long-term stability of amorphous silicon flat panel imaging devices for dosimetry purposes: stability of EPID response. Med Phys 31(11):2989–2995

    Article  CAS  Google Scholar 

  6. Louwe RJ, Tielenburg R, Van Ingen KM, Mijnheer BJ, Van Herk MB (2004) The stability of liquid-filled matrix ionization chamber electronic portal imaging devices for dosimetry purposes. Med Phys 31(4):819–827

    Article  CAS  Google Scholar 

  7. Greer PB, Vial P, Oliver L, Baldock C (2007) Experimental investigation of the response of an amorphous silicon EPID to intensity modulated radiotherapy beams. Med Phys 34(11):4389–4398

    Article  CAS  Google Scholar 

  8. Wendling M, Louwe RJ, McDermott LN, Sonke JJ, van Herk M, Mijnheer BJ (2006) Accurate two-dimensional IMRT verification using a back-projection EPID dosimetry method. Med Phys 33(2):259–273

    Article  Google Scholar 

  9. Pasma KL, Dirkx ML, Kroonwijk M, Visser AG, Heijmen BJ (1999) Dosimetric verification of intensity modulated beams produced with dynamic multileaf collimation using an electronic portal imaging device. Med Phys 26(11):2373–2423

    Article  CAS  Google Scholar 

  10. Camilleri J, Mazurier J, Franck D, Gallocher O, Chevelle C, Latorzeff I, Jimenez G, Ducassou M, Marre D, Mathy N, Navarro P (2014) 2D/3D EPID-based in-vivo dose reconstruction for dynamic IMRT treatments. Phys Med 30:e141–e142

    Article  Google Scholar 

  11. Van Teijlingen E, Hundley V (2002) The importance of pilot studies. Nurs Stand 16(40):22

    Article  Google Scholar 

  12. Thabane L, Ma J, Chu R, Ismaila A, Rios LP, Thabane M, Giangregorio L, Goldsmith CH (2010) A tutorial on pilot studies: the what, why and how. BMC Med Res Methodol 10(1):1–10

    Article  Google Scholar 

  13. Lowther NJ, Marsh SH, Louwe RJ (2020) Dose accumulation to assess the validity of treatment plans with reduced margins in radiotherapy of head and neck cancer. Phys Imaging Radiat Oncol 14:53–60

    Article  Google Scholar 

  14. Dosisoft (2016) EPIgray Practical Guide, 2.0.5. Dosisoft, Paris

    Google Scholar 

  15. Held M, Cheung J, Perez Andujar A, Husson F, Morin O (2018) Commissioning and evaluation of an electronic portal imaging device-based in-vivo dosimetry software. Cureus. https://doi.org/10.7759/cureus.2139

    Article  Google Scholar 

  16. Ricketts K, Navarro C, Lane K, Moran M, Blowfield C, Kaur U, Cotten G, Tomala D, Loed C, Jones J, Adeyemi A (2015) Implementation and evaluation of a transit dosimetry system for treatment verification. Physica Med 23:671–680

    Google Scholar 

  17. Boissard P, Francois P, Rousseau V, Mazal A (2013) Evaluation and implementation of in vivo transit dosimetry with an electronic portal imaging device. Cancer Radiother 17(7):656–663

    Article  CAS  Google Scholar 

  18. Zaiontz G, “Real Statistics Using Excel. Kruskal-Wallis Test,” Real Stastics, 2020. [Online]. Available: http://www.real-statistics.com/one-way-analysis-of-variance-anova/kruskal-wallis-test/.

  19. Rozendaal R, Mijnheer B, Hammingh-Vrieze O, Mans A, van Herk M (2015) Impact of daily anatomical changes on EPID-based in vivo dosimetry of VMAT treatments of head-and-neck cancer. Radiat Oncol 116(1):70–74

    Article  Google Scholar 

  20. Cilla S, Meluccio D, Fidanzio A, Azario L, Ianiro A, Macchia G, Digesù C, Deodato F, Valentini V, Morganti AG, Piermattei A (2016) Initial clinical experience with Epid-based in-vivo dosimetry for VMAT treatment of head-and-neck tumors. Physica Med 32:52–58

    Article  Google Scholar 

  21. Dosisoft (2018) EPIgray data preperation v3.4, 2.0.6. Dosisoft, Cachan

    Google Scholar 

Download references

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Wellington Blood and Cancer Centre, Wellington Regional Hospital, 49 Riddiford Street, Wellington, New Zealand

    Sophie D. Halliday, Rebecca A. Day & Lynne Greig

  2. Holland Proton Therapy Center, Huismansingel 4, 2629 JH, Delft, The Netherlands

    Robert J. W. Louwe

Authors
  1. Sophie D. Halliday
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rebecca A. Day
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lynne Greig
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert J. W. Louwe
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SH: corresponding author, contributed to the collection and analysis of data, interpretation of data, and writing of the paper. RD: contributed to the conception of the work, collection and analysis of data, interpretation of data, and writing of the paper. LG: contributed to the conception of the work, and writing of the paper. RL: contributed to the conception of the work, interpretation of data and writing of the paper. All authors approved the submitted manuscript.

Corresponding author

Correspondence to Sophie D. Halliday.

Ethics declarations

Competing interests

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Halliday, S.D., Day, R.A., Greig, L. et al. Clinical pilot study for EPID-based in vivo dosimetry using EPIgray™ for head and neck VMAT. Phys Eng Sci Med 45, 1335–1340 (2022). https://doi.org/10.1007/s13246-022-01184-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13246-022-01184-6

Keywords

Search

Navigation