Teflon cylindrical phantom for delivery quality assurance of SBRT

At our institution the standard delivery quality assurance (DQA) procedure for tomotherapy plans is accomplished with a water equivalent phantom, EDR2 film, and ion chamber point-dose measurements. Most plans deliver at most 5 Gy to the dose plane; however, recently a stereotactic body radiotherapy (SBRT) protocol has produced plans delivering upwards of 12 Gy to the film plane. EDR2 film saturates at a dose of ~ 7 Gy, requiring a modification of our DQA procedure for SBRT plans. To reduce the dose to the film plane and accommodate a possible move to SBRT using Varian RapidArc, a Teflon phantom has been constructed and tested. Our Teflon phantom is cylindrical in shape and of a similar design to the standard phantom. The phantom was MVCT scanned on the TomoTherapy system with images imported into the TomoTherapy and Varian Eclipse planning systems. Phantom images were smoothed to reduce artifacts for treatment planning purposes. Verification SBRT plans were delivered with film and point-dose benchmarked against the standard procedure. Verification tolerance criteria were 3% dose difference for chamber measurements and a gamma pass rate > 90% for film (criteria: 3 mm DTA, 3% dose difference, 10% threshold). The phantom sufficiently reduced dose to the film plane for DQA of SBRT plans. Both planning systems calculated accurate point doses in phantom, with the largest differences being 2.4% and 4.4% for TomoTherapy and Rapid Arc plans. Measured dose distributions correlated well with planning system calculations (γ 95%). These results were comparable to the standard phantom. The Teflon phantom appears to be a potential option for SBRT DQA. Preliminary data show that the planning systems are capable of calculating point doses in the Teflon, and the dose to the film plane is reduced sufficiently to allow for a direct measured DQA without the need for dose rescaling.