A Patient Quality Assurance System for Intensity Modulated Proton Therapy with Automated GPU-Accelerated Log File-Based Dose Reconstruction and Analysis In Under 10 Seconds
Abstract
Purpose
To develop and validate a log file-based patient quality assurance (LFQA) system for intensity modulated proton therapy (IMPT) using a GPU-accelerated pencil beam algorithm for dose reconstruction, permitting rapid log file upload, dose reconstruction, automated Gamma analysis, and report generation, all from a web interface accessible from the treatment machine console, and compare resultant Gamma pass rates and end-to-end workflow times to clinically standard measurement-based QA (MQA).
Methods
We developed a custom LFQA system based on our in-house GPU-accelerated pencil beam algorithm for our Hitachi Probeat system, including a custom DICOM listener that receives plans and reference dose distributions from our clinical treatment planning system (TPS), RayStation 2023B, and a web interface allowing log file upload from the treatment console immediately after beam delivery. File upload triggers dose reconstruction, 3D Gamma analysis, and report generation, which can then be downloaded and entered into our oncology information system (Mosaiq v2.86) immediately. The LFQA approach was tested in 10 IMPT patients who had previously been treated at various sites and verified using MQA with an ion chamber array. Workflow times and Gamma pass rates were recorded and compared between approaches.
Results
The mean±standard deviation (SD) time requirement for MQA was 36.6±12.7 min, including 12.6±10.9 min for beam delivery and 24.0±6.7 min for calculations and analysis. LFQA required 6.3±5.1 min, including 6.2±5.1 min for beam delivery and only 3.2±1.7 s for recalculation and analysis. Both approaches provided Gamma pass rates >95% for all plans at 3%/3 mm criteria.
Conclusion
The GPU-accelerated LFQA approach was developed and validated, significantly reducing the time required for patient QA relative to the clinical standard by accelerating dose calculation, automating steps, and eliminating the need to switch between computers. The LFQA approach holds promise for streamlining clinical operations and enabling faster treatment initiation with adaptive IMPT.