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Radiation Oncology
Published in: Radiation Oncology 1/2018

Open Access 01-12-2018 | Research

To propose adding index of achievement (IOA) to IMRT QA process

Authors: Dong-Su Kim, Siyong Kim, Seong-Hee Kang, Tae-Ho Kim, So-Hyun Park, Kyeong-Hyeon Kim, Min-Seok Cho, Dong-Seok Shin, Yu-Yun Noh, Jin-Beom Chung, Tae Suk Suh

Published in: Radiation Oncology | Issue 1/2018

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Abstract

Background

In intensity modulated radiation therapy (IMRT) quality assurance (QA), evaluation of QA result using a pass/non-pass strategy under an acceptance criterion often suffers from lack of information on how good the plan is in absolute manner. In this study, we suggested adding an index system, previously developed for dose painting technique, to current IMRT QA process for better understanding of QA result.

Methods

The index system consists of three indices, index of achievement (IOA), index of hotness (IOH) and index of coldness (IOC). As indicated by its name, IOA does measure the level of agreement. IOH and IOC, on the other hand, measure the magnitude of overdose and underdose, respectively. A systematic analysis was performed with three 1-dimensional hypothetical dose distributions to investigate the characteristics of the index system. The feasibility of the system was also assessed with clinical volumetric modulated arc therapy (VMAT) QA cases from 8 head & neck and 5 prostate patients. In both simulation studies, certain amount of errors was intentionally induced to each dose distribution. Furthermore, we applied the proposed system to compare calculated with actual measured data for a total of 60 patients (30 head & neck and 30 prostate cases). QA analysis was made using both the index system and gamma method, and results were compared.

Results

While the gamma evaluation showed limited sensitivity in evaluating QA result depending on the level of tolerance criteria used, the proposed indices tended to better distinguish plans in terms of the amount of errors. Hotness and coldness of prescribed dose in the plan could be evaluated quantitatively by the indices.

Conclusions

The proposed index system provides information with which IMRT QA result would be better evaluated, especially when gamma pass rates are identical or similar among multiple plans. In addition, the independency of the index system on acceptance criteria would help making clear communications among readers of published articles and researchers in multi-institutional studies.
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Metadata
Title
To propose adding index of achievement (IOA) to IMRT QA process
Authors
Dong-Su Kim
Siyong Kim
Seong-Hee Kang
Tae-Ho Kim
So-Hyun Park
Kyeong-Hyeon Kim
Min-Seok Cho
Dong-Seok Shin
Yu-Yun Noh
Jin-Beom Chung
Tae Suk Suh
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2018
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-018-1055-5

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