Chen Meining,Ding Shouliang,Li Yongbao,et al.Application of ArcherQA for independent dose verification of MR-guided online adaptive radiotherapy plans[J].Chinese Journal of Radiological Medicine and Protection,2024,44(5):379-385
Application of ArcherQA for independent dose verification of MR-guided online adaptive radiotherapy plans
Received:July 24, 2023  
DOI:10.3760/cma.j.cn112271-20230724-00018
KeyWords:Magnetic resonance guided radiotherapy  Online adaptive radiotherapy  Independent dose verification  ArcherQA
FundProject:国家重点研发计划项目(2022YFC2404604);广州市基础与应用基础研究项目(202201011090);广东省基础与应用基础研究基金项目(2021A1515110642);国家自然科学基金项目(12275372);广东省自然科学基金(2023A1515011153);中华国际医学交流基金会肿瘤精准放疗星火计划(2019-N-11-34)
Author NameAffiliationE-mail
Chen Meining State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou 510060, China  
Ding Shouliang State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou 510060, China  
Li Yongbao State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou 510060, China  
Wang Bin State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou 510060, China  
Cheng Bo Institute of Nuclear Medical Physics, University of Science and Technology of China, Hefei 210027, China  
Pei Xi Institute of Nuclear Medical Physics, University of Science and Technology of China, Hefei 210027, China  
Huang Xiaoyan State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou 510060, China  
Liu Hongdong State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou 510060, China liuhd@sysucc.org.cn 
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Abstract::
      Objective To explore the feasibility of applying ArcherQA to independent dose verification of MR-guided online adaptive radiotherapy (ART) plans performed on Elekta Unity 1.5 Tesla (T) magnetic resonance-linear accelerator (MR-Linac). Methods The dose calculation accuracy of ArcherQA under a specific magnetic field was validated using a homogeneous water phantom. A total of 32 patients who received MR-guided online ART on Elekta Unity were randomly selected by lottery, with 32 offline plans and 177 online plans for five treatment sites (brain, mediastinum, liver, kidney, and vertebral body) enrolled. Finally, the γ pass rates (threshold: 10%; criteria: 3 mm/3% and 2 mm/2%) were compared among the result upon independent dose verification of ArcherQA, measurements of ArcCheck, and calculations using the Monaco treatment planning system (TPS) to quantitatively evaluate the accuracy and efficiency of ArcherQA in independent dose verification of online plans on Elekta Unity. Results ArcherQA was proven accurate in calculating the dose distribution of therapeutic photon beams under the specific magnetic field. With the 3 mm/3% criterion, the γ pass rates of verification result exceeded 99% in all square fields of a water phantom. Under the stricter 2 mm/2% criterion, the γ pass rates also surpassed 95% in all square fields except 20 cm × 20 cm field. Regarding the verification of treatment plans, the ArcherQA result were found to be highly consistent with those measured or calculated using ArcCheck and Monaco TPS, with the average γ pass rates exceeding 99% under the 3 mm/3% criterion and above 97% under the 2 mm/2% criterion. ArcherQA was acceptably efficient for independent dose verification of online plans, with 50 to 150 s, (108 s on average) required to complete the independent dose verification of 177 online plans. Conclusions ArcherQA allows for accurately and efficiently calculating the dose distribution of therapeutic photon beams under a specific magnetic field, establishing it as an effective supplementary tool for independent dose calculation of MR-guided offline and online ART plans, thereby ensuring the safety of patient treatment plans.
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