Independent Three-dimensional Dose Calculation from Log Files for Breast VMAT: A Measurement-free Quality Assurance Approach
Abstract
Purpose: The purpose of this study was to evaluate and validate a measurement-free patient-specific quality assurance (PSQA) approach for volumetric modulated arc therapy (VMAT) breast cancer treatments based on independent three-dimensional (3D) dose calculation from Digital Imaging and Communications in Medicine (DICOM) plans and linear accelerator log files. Materials and Methods: Seventy clinical breast VMAT plans (36 left-sided and 34 right-sided) were retrospectively analyzed. Independent 3D dose calculations were performed using RadCalc v7.3 based on the DICOM treatment plan (independent dose calculation [IDC] RTPlan) and on delivery log files acquired during the first treatment fraction (IDC LOGs). Results were compared with portal dosimetry (two-dimensional [2D]) and fluence-based analysis. Gamma passing rates (GPRs) were evaluated using 3%/2 mm and 2%/2 mm criteria under action (90%) and tolerance (95%) limits. Receiver operating characteristic (ROC) analysis was performed to evaluate the discriminatory capability. Sensitivity to delivery errors was investigated by introducing controlled multileaf collimator (MLC) shifts (0.5–2.0 mm) and collimator rotation errors (1°–3°). Results: All PSQA methods met the TG-218 action limit (GPR ≥ 90%) at 3%/2 mm. Under the stricter 2%/2 mm criterion, statistically significant differences among quality assurance methods were observed (P < 0.001). ROC analysis demonstrated superior discriminatory performance for 3D dose-based methods, with area under the curve values of 0.9 for both IDC RTPlan and IDC LOGs, compared with 0.7 for portal dosimetry and 0.5 for fluence-based analysis. Error sensitivity analysis showed that stringent gamma criteria (1%/2 mm and 1%/1 mm) improved detection of subtle MLC and collimator deviations, with log file-based 3D reconstruction outperforming 2D approaches. Conclusions: Independent 3D dose calculation is a reliable PSQA approach for breast VMAT, showing higher sensitivity than conventional 2D methods.
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BibTeX
@article{sevilla2026independent,
title = {{Independent Three-dimensional Dose Calculation from Log Files for Breast VMAT: A Measurement-free Quality Assurance Approach}},
author = {Rosa Angelica Petit Sevilla and Oscar Abel Apaza Blanco and Nayron Medeiros Soares and Maximiliano Musso and Ezequiel Agustín Cabrera Lacey and Luis C Bohorquez and Lucy Wolfsberger and Maria José Almada and Carlos Daniel Venencia},
journal = {Journal of Medical Physics},
year = {2026},
month = jul,
doi = {10.4103/jmp.jmp_38_26},
url = {https://doi.org/10.4103/jmp.jmp_38_26},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Independent Three-dimensional Dose Calculation from Log Files for Breast VMAT: A Measurement-free Quality Assurance Approach
AU - Rosa Angelica Petit Sevilla
AU - Oscar Abel Apaza Blanco
AU - Nayron Medeiros Soares
AU - Maximiliano Musso
AU - Ezequiel Agustín Cabrera Lacey
AU - Luis C Bohorquez
AU - Lucy Wolfsberger
AU - Maria José Almada
AU - Carlos Daniel Venencia
PY - 2026
DA - 2026/07/01
JO - Journal of Medical Physics
DO - 10.4103/jmp.jmp_38_26
UR - https://doi.org/10.4103/jmp.jmp_38_26
AB - Purpose: The purpose of this study was to evaluate and validate a measurement-free patient-specific quality assurance (PSQA) approach for volumetric modulated arc therapy (VMAT) breast cancer treatments based on independent three-dimensional (3D) dose calculation from Digital Imaging and Communications in Medicine (DICOM) plans and linear accelerator log files. Materials and Methods: Seventy clinical breast VMAT plans (36 left-sided and 34 right-sided) were retrospectively analyzed. Independent 3D dose calculations were performed using RadCalc v7.3 based on the DICOM treatment plan (independent dose calculation [IDC] RTPlan) and on delivery log files acquired during the first treatment fraction (IDC LOGs). Results were compared with portal dosimetry (two-dimensional [2D]) and fluence-based analysis. Gamma passing rates (GPRs) were evaluated using 3%/2 mm and 2%/2 mm criteria under action (90%) and tolerance (95%) limits. Receiver operating characteristic (ROC) analysis was performed to evaluate the discriminatory capability. Sensitivity to delivery errors was investigated by introducing controlled multileaf collimator (MLC) shifts (0.5–2.0 mm) and collimator rotation errors (1°–3°). Results: All PSQA methods met the TG-218 action limit (GPR ≥ 90%) at 3%/2 mm. Under the stricter 2%/2 mm criterion, statistically significant differences among quality assurance methods were observed (P < 0.001). ROC analysis demonstrated superior discriminatory performance for 3D dose-based methods, with area under the curve values of 0.9 for both IDC RTPlan and IDC LOGs, compared with 0.7 for portal dosimetry and 0.5 for fluence-based analysis. Error sensitivity analysis showed that stringent gamma criteria (1%/2 mm and 1%/1 mm) improved detection of subtle MLC and collimator deviations, with log file-based 3D reconstruction outperforming 2D approaches. Conclusions: Independent 3D dose calculation is a reliable PSQA approach for breast VMAT, showing higher sensitivity than conventional 2D methods.
SN - 0971-6203
SN - 1998-3913
ER -