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    Development and validation of a comprehensive patient-specific quality assurance program for a novel stereotactic radiation delivery system for breast lesions

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    Author
    Becker, S.J.
    Mutaf, Y.
    Chen, S.
    Poirier, Y.
    Nichols, E.M.
    Yi, B.
    Date
    2019
    Journal
    Journal of Applied Clinical Medical Physics
    Publisher
    John Wiley and Sons Ltd
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1002/acm2.12778
    Abstract
    Purpose: The GammaPod is a dedicated prone breast stereotactic radiosurgery (SRS) machine composed of 25 cobalt‐60 sources which rotate around the breast to create highly conformal dose distributions for boosts, partial‐breast irradiation, or neo‐adjuvant SRS. We describe the development and validation of a patient‐specific quality assurance (PSQA) system for the GammaPod. Methods: We present two PSQA methods: measurement based and calculation based PSQA. The measurements are performed with a combination of absolute and relative dose measurements. Absolute dosimetry is performed in a single point using a 0.053‐cc pinpoint ionization chamber in the center of a polymethylmethacrylate (PMMA) breast phantom and a water‐filled breast cup. Relative dose distributions are verified with EBT3 film in the PMMA phantom. The calculation‐based method verifies point doses with a novel semi‐empirical independent‐calculation software. Results: The average (± standard deviation) breast and target sizes were 1263 ± 335.3 cc and 66.9 ± 29.9 cc, respectively. All ion chamber measurements performed in water and the PMMA phantom agreed with the treatment planning system (TPS) within 2.7%, with average (max) difference of –1.3% (−1.9%) and −1.3% (−2.7%), respectively. Relative dose distributions measured by film showed an average gamma pass rate of 97.0 ± 3.2 when using a 3%/1 mm criteria. The lowest gamma analysis pass rate was 90.0%. The independent calculation software had average agreements (max) with the patient and QA plan calculation of 0.2% (2.2%) and −0.1% (2.0%), respectively. Conclusion: We successfully implemented the first GammaPod PSQA program. These results show that the GammaPod can be used to calculate and deliver the predicted dose precisely and accurately. For routine PSQA performed prior to treatments, the independent calculation is recommended as it verifies the accuracy of the planned dose without increasing the risk of losing vacuum due to prolonged waiting times. Copyright 2019 The Authors.
    Keyword
    breast
    commissioning
    patient specific quality assurance
    stereotactic radiosurgery
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85076363903&doi=10.1002%2facm2.12778&partnerID=40&md5=5a5b4f4b3abf2c7c80e314bbb0f56d5b; http://hdl.handle.net/10713/11542
    ae974a485f413a2113503eed53cd6c53
    10.1002/acm2.12778
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