Clinical experiment on quality control comparison of complex treatment plans of the VMAT technique using a diode-based cylindrical phantom (ArcCHECK) and an amorphous silicon-based planar detector (A-Si1000)

Abstract Background With increasing application of Volumetric Modulated Arc Therapy (VMAT) and the complexity of treatment plans, necessity of patient-specific quality assurance procedures is raised. Therefore, this study aimed to perform VMAT plan control using the ArcCHECK® (Sun Nuclear) and the EPID (Electronic Portal Imaging Device) A-Si1000 and make a comparison. Methods The study was carried out at AL KAWTAR Oncology Center (Fez-Meknes/Morocco) with the TrueBeamTM accelerator and EclipseTM Treatment Planning System (TPS). GeoGebra 6.0 and Origin 2019 software were applied to statistical analysis and to reconstruct the dose distribution maps for ArcCHECK® Phantom, respectively. Gamma index test with the 3%/3 and 2%/2 mm criteria applied to compare two pretreatment quality control instrumentation. Results Although the EPID A-Si1000 and the ArcCHECK® phantom both were capable of performing VMAT plan control, results of gamma index analysis revealed some differences in the quality of the reviewed plans with the two devices. Conclusion based on the results, a single device to implement patient QA for complex VMAT plans may not be reliable. Therefore, to ensure patient protection against machine or human errors, applying the EPID A-Si1000 and the ArcCHECK® phantom both are proposed to evaluate the quality of complex VMAT plans for different cancer types.