Skip to main content
SpringerLink
Log in

Treatment plan complexity metrics for predicting IMRT pre-treatment quality assurance results

  • Scientific Paper
  • Published:
Australasian Physical & Engineering Sciences in Medicine Aims and scope Submit manuscript

Abstract

The planning of IMRT treatments requires a compromise between dose conformity (complexity) and deliverability. This study investigates established and novel treatment complexity metrics for 122 IMRT beams from prostate treatment plans. The Treatment and Dose Assessor software was used to extract the necessary data from exported treatment plan files and calculate the metrics. For most of the metrics, there was strong overlap between the calculated values for plans that passed and failed their quality assurance (QA) tests. However, statistically significant variation between plans that passed and failed QA measurements was found for the established modulation index and for a novel metric describing the proportion of small apertures in each beam. The ‘small aperture score’ provided threshold values which successfully distinguished deliverable treatment plans from plans that did not pass QA, with a low false negative rate.

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
Fig. 3

Similar content being viewed by others

References

  1. Purdy JA, Boyer AL, Butler EB, Dipetrillo TA, Engler MJ, Fraass B, Grant W III, Ling CC, Low DA, Mackie TR, Mohan R, Roach M, Rosenman JG, Verhey LJ, Wong JW, Cumberlin RL, Stone H, Palta JR (2001) Intensity-modulated radiotherapy: current status and issues of interest. Int J Radiat Oncol Biol Phys 51(4):880–914

    Article  Google Scholar 

  2. Lee MT, Purdie TG, Eccles CL, Sharpe MB, Dawson LA (2010) Comparison of simple and complex liver intensity modulated radiotherapy. Radiat Oncol 5:115

    Article  PubMed  PubMed Central  Google Scholar 

  3. Nauta M, Villarreal-Barajas JE, Tambasco M (2011) Fractal analysis for assessing the level of modulation of IMRT fields. Med Phys 38(10):5385–5393

    Article  PubMed  Google Scholar 

  4. Fenoglietto P, Laliberé B, Aillères N, Riou O, Dubois JB, Azria D (2011) Eight years of IMRT quality assurance with ionization chambers and film dosimetry: experience of the Montpellier Comprehensive Cancer Center. Radiat Oncol 6:85

    Article  PubMed  PubMed Central  Google Scholar 

  5. McNiven AL, Sharpe MB, Purdie TG (2010) A new metric for assessing IMRT modulation complexity and plan deliverability. Med Phys 37(2):505–515

    Article  PubMed  Google Scholar 

  6. Webb S (2003) Use of a quantitative index of beam modulation to characterize dose conformality: illustration by a comparison of full beamlet IMRT, few-segment IMRT (fsIMRT) and conformal unmodulated radiotherapy. Phys Med Biol 48(14):2051–2062

    Article  PubMed  CAS  Google Scholar 

  7. Spirou SV, Chui CS (1998) A gradient inverse planning algorithm with dose-volume constraints. Med Phys 25(3):321–333

    Article  PubMed  CAS  Google Scholar 

  8. Bortfeld T, Bürkelbach J, Boesecke R, Schlegel W (1990) Methods of image reconstruction from projections applied to conformation radiotherapy. Phys Med Biol 35(10):1423–1434

    Article  PubMed  CAS  Google Scholar 

  9. Llacer J, Solberg TD, Promberger C (2001) Comparative behaviour of the dynamically penalized likelihood algorithm in inverse radiation therapy planning. Phys Med Biol 46(10):2637–2663

    Article  PubMed  CAS  Google Scholar 

  10. McGarry CK, Chinneck CD, O’Toole MM, O’Sullivan JM, Prise KM, Hounsell AR (2011) Assessing software upgrades, plan properties and patient geometry using intensity modulated radiation therapy (IMRT) complexity metrics. Med Phys 38(4):2027–2034

    Article  PubMed  Google Scholar 

  11. Nicolini G, Fogliata A, Vanetti E, Clivio A, Ammazzalorso F, Cozzi L (2007) What is an acceptably smoothed fluence? Dosimetric and delivery considerations for dynamic sliding window IMRT. Radiat Oncol 2:42

    Article  Google Scholar 

  12. Kim T, Zhu L, Suh T-S, Geneser S, Meng B, Xing L (2011) Inverse planning for IMRT with nonuniform beam profiles using total-variation regularization (TVR). Med Phys 38(1):57–66

    Article  PubMed  PubMed Central  Google Scholar 

  13. Tonigan J, Kry S, Dong L, Purdie T, White R, Ibbott G, Followill D (2011) Does IMRT treatment plan complexity or mismatched dosimetry data contribute to dose delivery errors detected using an IMRT H&N quality assurance phantom? Med Phys 38(6):3804

    Article  Google Scholar 

  14. Tonigan JR (2011) Evaluation of intensity modulated radiation therapy (IMRT) delivery error due to IMRT treatment plan complexity and improperly matched dosimetry data. Master’s Thesis, University of Texas

  15. Kairn T, Hardcastle N, Kenny J, Meldrum R, Tomé WA, Aland T (2011) EBT2 radiochromic film for quality assurance of complex IMRT treatments of the prostate: micro-collimated IMRT, RapidArc, and TomoTherapy. Australas Phys Eng Sci Med 34(3):333–343

    Article  PubMed  CAS  Google Scholar 

  16. Kairn T, Crowe S, Kenny J, Trapp JV (2011) Investigation of stereotactic radiotherapy dose using dosimetry film and Monte Carlo simulations. Radiat Meas 46(12):1985–1988

    Article  CAS  Google Scholar 

  17. Ahnesjö A, Aspradakis MM (1999) Dose calculations for external photon beams in radiotherapy. Phys Med Biol 44(11):R99–R155

    Article  PubMed  Google Scholar 

  18. Brainlab AG (2010) Brainlab physics technical reference guide. Revision 1:2

    Google Scholar 

  19. Crowe S, Kairn T, Fielding AL (2009) The development of a Monte Carlo system to verify radiotherapy treatment dose calculations. Radiother Oncol 92(Supp 1):S71

    Article  Google Scholar 

  20. Crowe SB, Kairn T, Trapp JV, Fielding AL (2013) Experimental evaluation of MCDTK, the Monte Carlo DICOM ToolKit. IFMBE Proc 39:1807–1810

    Article  Google Scholar 

  21. Crowe SB, Kairn T, Middlebrook N, Bill B, Christie DRH, Knight RT, Kenny J, Langton CM, Trapp JV (2013) Retrospective evaluation of dosimetric quality for prostate carcinomas treated with 3D conformal, intensity-modulated and volumetric-modulated arc radiotherapy. J Med Radiat Sci 60(4):131–138

    Article  Google Scholar 

  22. Arnfield MR, Siebers JV, Kim JO, Wu Q, Keall PJ, Mohan R (2000) A method for determining multileaf collimator transmission and scatter for dynamic intensity modulated radiotherapy. Med Phys 27(10):2231–2241

    Article  PubMed  CAS  Google Scholar 

  23. Cosgrove VP, Jahn U, Pfaender M, Bauer S, Budach V, Wurm RE (1999) Commissioning of a micro multi-leaf collimator and planning system for stereotactic radiosurgery. Radiother Oncol 50(3):325–336

    Article  PubMed  CAS  Google Scholar 

  24. Nicolini G, Vanetti E, Clivio A, Fogliata A, Korreman S, Bocanek J, Cozzi L (2008) The GLAaS algorithm for portal dosimetry and quality assurance of RapidArc, an intensity modulated rotational therapy. Radiat Oncol 3:24

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Science and Engineering Faculty, Queensland University of Technology, Brisbane, QLD, Australia

    S. B. Crowe, T. Kairn, C. M. Langton & J. V. Trapp

  2. Genesis Cancer Care Queensland, Brisbane, QLD, Australia

    T. Kairn, R. T. Knight & B. Hill

  3. Epworth Radiation Oncology, Melbourne, VIC, Australia

    J. Kenny

Authors
  1. S. B. Crowe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Kairn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Kenny
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. T. Knight
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Hill
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C. M. Langton
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. V. Trapp
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. B. Crowe.

Additional information

This study was supported by the Australian Research Council, the Wesley Research Institute, Premion and the Queensland University of Technology (QUT), through linkage grant number LP110100401.

Appendix: Summary of initialisms

Appendix: Summary of initialisms

  • AAV: Aperture area variability

  • CAS: Cross axis score

  • CLS: Closed leaf score

  • FMC: Fluence map complexity

  • LSV: Leaf sequence variability

  • MAD: Mean aperture displacement

  • MCDTK: Monte Carlo DICOM tool-kit

  • MCS: Modulation complexity score

  • MFA: Mean field area

  • MI: Modulation index

  • SAS: Small aperture score

  • TADA: Treatment and dose assessor

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Crowe, S.B., Kairn, T., Kenny, J. et al. Treatment plan complexity metrics for predicting IMRT pre-treatment quality assurance results. Australas Phys Eng Sci Med 37, 475–482 (2014). https://doi.org/10.1007/s13246-014-0274-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13246-014-0274-9

Keywords

Search

Navigation