ArticleAdvances in radiation oncology2025
Reporting Clinical Results of EPID-Based Patient-Specific Quality Assurance for Brain Stereotactic Radiosurgery/Radiation Therapy: Demonstrating the Feasibility of Same-Day Stereotactic Radiosurgery via HyperArc Delivery.
Article in Advances in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- A component-wise commissioning and validation framework for non-transit electronic portal imaging device patient-specific quality assurance.Physics and imaging in radiation oncology · 2026Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Patient-specific quality assurance (PSQA) of complex volumetric modulated arc therapy plans via Electronic portal imaging device (EPID)-based portal dosimetry (PD) is widely adopted by the radiation therapy community. We report our EPID-based PSQA results for brain HyperArc stereotactic radiosurgery/radiation therapy (SRS/SRT) patients, justifying its efficiency for the potential of same-day LINAC-based radiosurgery. Methods and Materials: A total of 130 brain SRS/SRT patients were treated via highly conformal HyperArc delivery for 1, 3, and 5 fractions of 18-24 Gy, 24-27 Gy, and 30-35 Gy to each lesion in either single-isocenter/single-lesion (SISL, 60 plans) or single-isocenter/multilesion (SIML, 70 plans) setting following the Alliance brain SRS/SRT clinical trial criteria. Acuros-based dose engine for 6MV-FFF beam (1400 MU/min) was used. For each HyperArc SRS/SRT plan, EPID-based PD PSQA was performed. Independent dose verification of these brain SRS/SRT plans was done via an in-house Monte Carlo (MC) program. The PSQA results, total quality assurance (QA) time, MC agreement, and MLC modulation (MF) were analyzed. Results: The average gamma passing rates were 99.4% (SISL) and 96.9% (SIML) plans with a 2%/2mm clinical gamma criteria. Compared to SISL plans, SIML plans had a higher average MF by a factor of 1.2, maximum of 1.4. We observed a slight correlation between MF and the number of treated lesions. Although SIML plans had relatively lower PSQA pass rates, all plans met the clinical QA criteria for HyperArc delivery. EPID-based PSQA was completed in ∼15 minutes. Moreover, an independent second physics check via in-house MC dose verification was within ±5% compared to AcurosXB calculation and completed within 15 minutes for both treatment schemes including ARIA documentation. Conclusions: These promising PSQA results for complex clinical HyperArc brain SRS/SRT plans delivered in a timely manner via EPID-based PD and independent MC second check demonstrate EPID-based PD is a fast, safe, and efficient QA method for HyperArc treatments. With proper automation of contouring tool and SRS planning via RapidPlan model, this EPID-based PSQA method can be safely implemented for the same-day HyperArc delivery of high-quality brain SRS/SRT treatments in the near future.
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Registered trials
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