Baylor University Medical Center Proceedings July 2017 - 278

physical measurement. Several
solutions have been proposed,
such as the use of ion chamber
measurement during the delivery to ensure the output of the
machine and the daily verification of the output and MLC
positioning through EPID,
that could complement the use
of machine log files.
Dose verification based on
the daily delivery of the treatment in radiation oncology has
become a novel aspect of the
daily checks in medical physics. Until recently, this information was not available to
physicists through log files or
other means. The information
provided through new technologies can provide a way to
evaluate day-to-day delivery
and to approach IMRT QA in
general. Monitoring of daily log
files can provide a route to identify problems with treatment
delivery and any deviation of
MLC positioning so that issues
can be detected and corrected
before the machine mechanism
can detect MLC failure by analyzing the RMS deviations from
the planned and previous treatment deliveries.

a

b

c

Acknowledgments
The authors wish to thank
the Baylor Scott & White
McClinton Cancer Center for
the use of the facilities and
equipment for this investigation.
Buonamici FB, Compagnucci A,
Marrazzo L, Russo S, Bucciolini
M. An intercomparison between
film dosimetry and diode matrix
for IMRT quality assurance. Med
Phys 2007;34(4):1372-1379.
2.
Chandraraj V, Stathakis S,
Manickam R, Esquivel C, Supe SS, Papanikolaou N. Comparison of
four commercial devices for RapidArc and sliding window IMRT QA. J
Appl Clin Med Phys 2011;12(2):3367.
Li JG, Yan G, Liu C. Comparison of two commercial detector arrays for
IMRT quality assurance. J Appl Clin Med Phys 2009;10(2):2942.
Yan G, Liu C, Simon TA, Peng LC, Fox C, Li JG. On the sensitivity of
patient-specific IMRT QA to MLC positioning errors. J Appl Clin Med
Phys 2009;10(1):2915.

Figure 3. Gamma and profile analysis comparisons for a prostate volumetric-modulated arc therapy plan: (a) comparison
of Mobius FX with ArcCheck measurement with a gamma passing rate of 96.1% for 3%-3 mm criterion; (b) comparison of
ArcCheck with treatment planning system dose calculation with a gamma passing rate of 99.8% for 3%-3 mm criterion;
and (c) comparison of Mobius FX with treatment planning system dose calculation with a gamma passing rate of 99.8%
for 3%-3 mm criterion.

approaches of these IMRT QA methods, as the Mobius FX
uses the multileaf collimator (MLC) log file to estimate dose
delivered while the ArcCheck measures delivered dose through
a diode array. Profile analysis showed comparable results when
using the Mobius FX method or traditional QA methods.
One of the main critiques from the community to move
towards IMRT QA based on machine log files is the lack of
278

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