Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT

Ruurd Visser, David J.L. Wauben, Martijn de Groot, Roel J.H.M. Steenbakkers, Jeremy Godart, Aart A. van 't Veld, Johannes A. Langendijk, Erik W. Korevaar, Hendrik P Bijl

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background and purpose: Treatment plan verification of intensity modulated radiotherapy (IMRT) is generally performed with the gamma index (GI) evaluation method, which is difficult to extrapolate to clinical implications. Incorporating Dose Volume Histogram (DVH) information can compensate for this. The aim of this study was to evaluate DVH-based treatment plan verification in addition to the GI evaluation method for head and neck IMRT.
Materials and methods: Dose verifications of 700 subsequent head and neck cancer IMRT treatment plans were categorised according to gamma and DVH-based action levels. Fractionation dependent absolute dose limits were chosen. The results of the gamma- and DVH-based evaluations were compared to the decision of the medical physicist and/or radiation oncologist for plan acceptance.
Results: Nearly all treatment plans (99.7%) were accepted for treatment according to the GI evaluation combined with DVH-based verification. Two treatment plans were re-planned according to DVH-based verification, which would have been accepted using the evaluation alone. DVH-based verification increased insight into dose delivery to patient specific structures increasing confidence that the treatment plans were clinically acceptable. Moreover, DVH-based action levels clearly distinguished the role of the medical physicist and radiation oncologist within the Quality Assurance (QA) procedure.
Conclusions: DVH-based treatment plan verification complements the GI evaluation method improving head and neck IMRT-QA.
Original languageEnglish
Pages (from-to)389-395
JournalRadiotherapy and oncology
Volume112
Issue number3
DOIs
Publication statusPublished - Sep 2014

Keywords

  • quality assurance
  • dose volume histogram
  • action levels
  • plan verification
  • IMRT
  • quantitative evaluation
  • dose distributions

Cite this

Visser, R., Wauben, D. J. L., de Groot, M., Steenbakkers, R. J. H. M., Godart, J., van 't Veld, A. A., ... Bijl, H. P. (2014). Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT. Radiotherapy and oncology, 112(3), 389-395. https://doi.org/10.1016/j.radonc.2014.08.002
Visser, Ruurd ; Wauben, David J.L. ; de Groot, Martijn ; Steenbakkers, Roel J.H.M. ; Godart, Jeremy ; van 't Veld, Aart A. ; Langendijk, Johannes A. ; Korevaar, Erik W. ; Bijl, Hendrik P. / Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT. In: Radiotherapy and oncology. 2014 ; Vol. 112, No. 3. pp. 389-395.
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title = "Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT",
abstract = "Background and purpose: Treatment plan verification of intensity modulated radiotherapy (IMRT) is generally performed with the gamma index (GI) evaluation method, which is difficult to extrapolate to clinical implications. Incorporating Dose Volume Histogram (DVH) information can compensate for this. The aim of this study was to evaluate DVH-based treatment plan verification in addition to the GI evaluation method for head and neck IMRT.Materials and methods: Dose verifications of 700 subsequent head and neck cancer IMRT treatment plans were categorised according to gamma and DVH-based action levels. Fractionation dependent absolute dose limits were chosen. The results of the gamma- and DVH-based evaluations were compared to the decision of the medical physicist and/or radiation oncologist for plan acceptance.Results: Nearly all treatment plans (99.7{\%}) were accepted for treatment according to the GI evaluation combined with DVH-based verification. Two treatment plans were re-planned according to DVH-based verification, which would have been accepted using the evaluation alone. DVH-based verification increased insight into dose delivery to patient specific structures increasing confidence that the treatment plans were clinically acceptable. Moreover, DVH-based action levels clearly distinguished the role of the medical physicist and radiation oncologist within the Quality Assurance (QA) procedure.Conclusions: DVH-based treatment plan verification complements the GI evaluation method improving head and neck IMRT-QA.",
keywords = "kwaliteitszorg, radiotherapie, quality assurance, dose volume histogram, action levels, plan verification, IMRT, quantitative evaluation, dose distributions",
author = "Ruurd Visser and Wauben, {David J.L.} and {de Groot}, Martijn and Steenbakkers, {Roel J.H.M.} and Jeremy Godart and {van 't Veld}, {Aart A.} and Langendijk, {Johannes A.} and Korevaar, {Erik W.} and Bijl, {Hendrik P}",
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Visser, R, Wauben, DJL, de Groot, M, Steenbakkers, RJHM, Godart, J, van 't Veld, AA, Langendijk, JA, Korevaar, EW & Bijl, HP 2014, 'Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT' Radiotherapy and oncology, vol. 112, no. 3, pp. 389-395. https://doi.org/10.1016/j.radonc.2014.08.002

Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT. / Visser, Ruurd; Wauben, David J.L.; de Groot, Martijn; Steenbakkers, Roel J.H.M.; Godart, Jeremy ; van 't Veld, Aart A.; Langendijk, Johannes A.; Korevaar, Erik W.; Bijl, Hendrik P.

In: Radiotherapy and oncology, Vol. 112, No. 3, 09.2014, p. 389-395.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT

AU - Visser, Ruurd

AU - Wauben, David J.L.

AU - de Groot, Martijn

AU - Steenbakkers, Roel J.H.M.

AU - Godart, Jeremy

AU - van 't Veld, Aart A.

AU - Langendijk, Johannes A.

AU - Korevaar, Erik W.

AU - Bijl, Hendrik P

PY - 2014/9

Y1 - 2014/9

N2 - Background and purpose: Treatment plan verification of intensity modulated radiotherapy (IMRT) is generally performed with the gamma index (GI) evaluation method, which is difficult to extrapolate to clinical implications. Incorporating Dose Volume Histogram (DVH) information can compensate for this. The aim of this study was to evaluate DVH-based treatment plan verification in addition to the GI evaluation method for head and neck IMRT.Materials and methods: Dose verifications of 700 subsequent head and neck cancer IMRT treatment plans were categorised according to gamma and DVH-based action levels. Fractionation dependent absolute dose limits were chosen. The results of the gamma- and DVH-based evaluations were compared to the decision of the medical physicist and/or radiation oncologist for plan acceptance.Results: Nearly all treatment plans (99.7%) were accepted for treatment according to the GI evaluation combined with DVH-based verification. Two treatment plans were re-planned according to DVH-based verification, which would have been accepted using the evaluation alone. DVH-based verification increased insight into dose delivery to patient specific structures increasing confidence that the treatment plans were clinically acceptable. Moreover, DVH-based action levels clearly distinguished the role of the medical physicist and radiation oncologist within the Quality Assurance (QA) procedure.Conclusions: DVH-based treatment plan verification complements the GI evaluation method improving head and neck IMRT-QA.

AB - Background and purpose: Treatment plan verification of intensity modulated radiotherapy (IMRT) is generally performed with the gamma index (GI) evaluation method, which is difficult to extrapolate to clinical implications. Incorporating Dose Volume Histogram (DVH) information can compensate for this. The aim of this study was to evaluate DVH-based treatment plan verification in addition to the GI evaluation method for head and neck IMRT.Materials and methods: Dose verifications of 700 subsequent head and neck cancer IMRT treatment plans were categorised according to gamma and DVH-based action levels. Fractionation dependent absolute dose limits were chosen. The results of the gamma- and DVH-based evaluations were compared to the decision of the medical physicist and/or radiation oncologist for plan acceptance.Results: Nearly all treatment plans (99.7%) were accepted for treatment according to the GI evaluation combined with DVH-based verification. Two treatment plans were re-planned according to DVH-based verification, which would have been accepted using the evaluation alone. DVH-based verification increased insight into dose delivery to patient specific structures increasing confidence that the treatment plans were clinically acceptable. Moreover, DVH-based action levels clearly distinguished the role of the medical physicist and radiation oncologist within the Quality Assurance (QA) procedure.Conclusions: DVH-based treatment plan verification complements the GI evaluation method improving head and neck IMRT-QA.

KW - kwaliteitszorg

KW - radiotherapie

KW - quality assurance

KW - dose volume histogram

KW - action levels

KW - plan verification

KW - IMRT

KW - quantitative evaluation

KW - dose distributions

U2 - 10.1016/j.radonc.2014.08.002

DO - 10.1016/j.radonc.2014.08.002

M3 - Article

VL - 112

SP - 389

EP - 395

JO - Radiotherapy and oncology

JF - Radiotherapy and oncology

SN - 1879-0887

IS - 3

ER -