MO-FG-202-06: Improving the Performance of Gamma Analysis QA with Radiomics- Based Image Analysis.

PURPOSE: The use of gamma analysis for IMRT quality assurance has well-known limitations. Traditionally, a simple thresholding technique is used to evaluated passing criteria. However, like any image the gamma distribution is rich in information which thresholding mostly discards. We therefore propose a novel method of analyzing gamma images that uses quantitative image features borrowed from radiomics, with the goal of improving error detection.

METHODS: 368 gamma images were generated from 184 clinical IMRT beams. For each beam the dose to a phantom was measured with EPID dosimetry and compared to the TPS dose calculated with and without normally distributed (2mm sigma) errors in MLC positions. The magnitude of 17 intensity histogram and size-zone radiomic features were derived from each image. The features that differed most significantly between image sets were determined with ROC analysis. A linear machine-learning model was trained on these features to classify images as with or without errors on 180 gamma images.The model was then applied to an independent validation set of 188 additional gamma distributions, half with and half without errors.

RESULTS: The most significant features for detecting errors were histogram kurtosis (p=0.007) and three size-zone metrics (p<1e-6 for each). The sizezone metrics detected clusters of high gamma-value pixels under mispositioned MLCs. The model applied to the validation set had an AUC of 0.8, compared to 0.56 for traditional gamma analysis with the decision threshold restricted to 98% or less.

CONCLUSION: A radiomics-based image analysis method was developed that is more effective in detecting error than traditional gamma analysis. Though the pilot study here considers only MLC position errors, radiomics-based methods for other error types are being developed, which may provide better error detection and useful information on the source of detected errors. This work was partially supported by a grant from the Agency for Healthcare Research and Quality, grant number R18 HS022244-01.