A method for patient-specific DVH verification using a high-sampling-rate log file in an Elekta linac.

We have proposed a method for patient-specific dose-volume histogram (DVH) verification using a 40-ms high-sampling-rate log file (HLF) available in an Elekta linac. Ten prostate volumetric-modulated arc therapy plans were randomly selected, and systematic leaf position errors of ±0.2, ±0.4, or ±0.8 mm were added to the 10 plans, thereby producing a total of 70 plans. An RTP file was created by interpolating each leaf position in the HLF to obtain values at each control point, which is subsequently exported to a treatment planning system. The isocenter dose calculated by the HLF-based plan to a phantom (Delta4 Phantom+) was compared to that measured by the diode in the phantom in order to evaluate the accuracy of the HLF-based dose calculation. The D95 of the planning target volume (PTV) was also compared between the HLF-based plans and the original plans with the systematic leaf position errors, the latter being referred to as theory-based plans. Sensitivities of the DVH parameters in the target, the rectum, and the bladder were also calculated with the varied systematic leaf position errors. The relative differences in the isocenter doses between the HLF-based calculations and the measurements among the 70 plans were 0.21% ± 0.67% (SD). The maximum relative differences in PTV D95 between the HLF-based and the theory-based plans among the 70 cases were 0.11%. The patient-specific DVH verification method detected a change in the target DVH parameters of less than 1% when the systematic leaf position error was ±0.2 mm. It is therefore suggested that the proposed DVH verification method may simplify patient-specific dose quality assurance procedures without compromising accuracy and sensitivity.