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http://dx.doi.org/10.14316/pmp.2015.26.3.127

Dosimetric Evaluation of Amplitude-based Respiratory Gating for Delivery of Volumetric Modulated Arc Therapy  

Lee, Chang Yeol (Department of Radiation Oncology, College of Medicine, Inha University)
Kim, Woo Chul (Department of Radiation Oncology, College of Medicine, Inha University)
Kim, Hun Jeong (Department of Radiation Oncology, College of Medicine, Inha University)
Park, Jeong Hoon (Department of Radiation Oncology, College of Medicine, Inha University)
Min, Chul Kee (Department of Radiation Oncology, College of Medicine, Soonchunhyang University)
Shin, Dong Oh (Department of Radiation Oncology, College of Medicine, KyungHee University)
Choi, Sang Hyoun (Research Institute of Radiological and Medical Sciences, Korea Institute of Radiological and Medical Sciences)
Park, Seungwoo (Research Institute of Radiological and Medical Sciences, Korea Institute of Radiological and Medical Sciences)
Huh, Hyun Do (Department of Radiation Oncology, College of Medicine, Inha University)
Publication Information
Progress in Medical Physics / v.26, no.3, 2015 , pp. 127-136 More about this Journal
Abstract
The purpose of this study is to perform a dosimetric evaluation of amplitude-based respiratory gating for the delivery of volumetric modulated arc therapy (VMAT). We selected two types of breathing patterns, subjectively among patients with respiratory-gated treatment log files. For patients that showed consistent breathing patterns (CBP) relative to the 4D CT respiration patterns, the variability of the breath-holding position during treatment was observed within the thresholds. However, patients with inconsistent breathing patterns (IBP) show differences relative to those with CBP. The relative isodose distribution was evaluated using an EBT3 film by comparing gated delivery to static delivery, and an absolute dose measurement was performed with a $0.6cm^3$ Farmer-type ion chamber. The passing rate percentages under the 3%/3 mm gamma analysis for Patients 1, 2 and 3 were respectively 93.18%, 91.16%, and 95.46% for CBP, and 66.77%, 48.79%, and 40.36% for IBP. Under the more stringent criteria of 2%/2 mm, passing rates for Patients 1, 2 and 3 were respectively 73.05%, 67.14%, and 86.85% for CBP, and 46.53%, 32.73%, and 36.51% for IBP. The ion chamber measurements were within 3.5%, on average, of those calculated by the TPS and within 2.0%, on average, when compared to the static-point dose measurements for all cases of CBP. Inconsistent breathing patterns between 4D CT simulation and treatment may cause considerable dosimetric differences. Therefore, patient training is important to maintain consistent breathing amplitude during CT scan acquisition and treatment delivery.
Keywords
Amplitude-based respiratory gating; Respiratory motion; Volumetric Modulated Arc Therapy (VMAT);
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