Validation of a method for in vivo 3D dose reconstruction in SBRT using a new transmission detector.

Stereotactic body radiation therapy (SBRT) involves the delivery of substantially larger doses over fewer fractions than conventional therapy. Therefore, SBRT treatments will strongly benefit patients using vivo patient dose verification, because the impact of the fraction is large. For in vivo measurements, a commercially available quality assurance (QA) system is the COMPASS system (IBA Dosimetry, Germany). For measurements, the system uses a new transmission detector (Dolphin, IBA Dosimetry). In this study, we evaluated the method for in vivo 3D dose reconstruction for SBRT using this new transmission detector. We confirmed the accuracy of COMPASS with Dolphin for SBRT using multi leaf collimator (MLC) test patterns and clinical SBRT cases. We compared the results between the COMPASS, the treatment planning system, the Kodak EDR2 film, and the Monte Carlo (MC) calculations. MLC test patterns were set up to investigate various aspects of dose reconstruction for SBRT: (a) simple open fields (2 × 2-10 × 10 cm2 ), (b) a square wave chart pattern, and (c) the MLC position detectability test in which the MLCs were changed slightly. In clinical cases, we carried out 6 and 8 static IMRT beams for SBRT in the lung and liver. For MLC test patterns, the differences between COMPASS and MC were around 3%. The COMPASS with the dolphin system showed sufficient resolution in SBRT. For clinical cases, COMPASS can detect small changes for the dose profile and dose-volume histogram. COMPASS also showed good agreement with MC. We can confirm the feasibility of SBRT QA using the COMPASS system with Dolphin. This method was successfully operated using the new transmission detector and verified by measurements and MC.