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Title: A clinical database to assess action levels and tolerances for the ongoing use of Mobius3D.
Epworth Authors: Jolly, David
Dunn, Leon
Kenny, John
Keywords: Radiation Therapy
Patient Dose
Tolerance Levels
Action Level
Independent Verification
Verifcation Programs
Clinical Decision Making
Treatment Planning
Epworth Radiation Oncology Research Centre, Epworth HealthCare, Melbourne, VIC, Australia.
Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Jan-2017
Publisher: Wiley
Citation: J Appl Clin Med Phys. 2017 Jan;18(1):59-65
Abstract: In radiation therapy, calculation of dose within the patient contains inherent uncertainties, inaccuracies, limitations, and the potential for random error. Thus, point dose-independent verification of such calculations is a well-established process, with published data to support the setting of both action levels and tolerances. Mobius3D takes this process one step further with a full independent calculation of patient dose and comparisons of clinical parameters such as mean target dose and voxel-by-voxel gamma analysis. There is currently no published data to directly inform tolerance levels for such parameters, and therefore this work presents a database of 1000 Mobius3D results to fill this gap. The data are tested for normality using a normal probability plot and found to fit this distribution for three sub groups of data; Eclipse, iPlan and the treatment site Lung. The mean (μ) and standard deviation (σ) of these sub groups is used to set action levels and tolerances at μ ± 2σ and μ ± 3σ, respectively. A global (3%, 3 mm) gamma tolerance is set at 88.5%. The mean target dose tolerance for Eclipse data is the narrowest at ± 3%, whilst iPlan and Lung have a range of -5.0 to 2.2% and -1.8 to 5.0%, respectively. With these limits in place, future results failing the action level or tolerance will fall within the worst 5% and 1% of historical results and an informed decision can be made regarding remedial action prior to treatment.
DOI: 10.1002/acm2.12009
PubMed URL:
ISSN: 1526-9914
Journal Title: Journal of Applied Clinical Medical Physics
Type: Journal Article
Type of Clinical Study or Trial: Validation Study
Appears in Collections:Cancer Services

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