Feasibility of Estimating Patient-Specific Dose Verification Results Directly from Linear Accelerator Log Files in Volumetric Modulated Arc Therapy

The feasibility of estimating patient-specific dose verification results directly from linear accelerator (linac) log files has been investigated for prostate cancer patients who undergo volumetric modulated arc therapy (VMAT). Twenty-six patients who underwent VMAT in our facility were consecutively selected. VMAT plans were created using Monaco treatment planning system and were transferred to an Elekta linac. During the beam delivery, dynamic machine parameters such as positions of the multi-leaf collimator and the gantry were recorded in the log files; subsequently, root mean square (rms) values of control errors, speeds and accelerations of the above machine parameters were calculated for each delivery. Dose verification was performed for all the plans using a cylindrical phantom with diodes placed in a spiral array. The gamma index pass rates were evaluated under 3%/3 mm and 2%/2 mm criteria with a dose threshold of 10%. Subsequently, the correlation coefficients between the gamma index pass rates and each of the above rms values were calculated. Under the 2%/2 mm criteria, significant negative correlations were found between the gamma index pass rates and the rms gantry angle errors (r = 0.64, p < 0.001) as well as the pass rates and the rms gantry accelerations (r = 0.68, p < 0.001). On the other hand, the rms values of the other dynamic machine parameters did not significantly correlate with the gamma index pass rates. We suggest that the VMAT quality assurance (QA) results can be directly estimated from the log file thereby providing potential to simplify patient-specific prostate VMAT QA procedure.