Optimizing the accuracy of a helical diode array dosimeter: a comprehensive calibration methodology coupled with a novel virtual inclinometer.

PURPOSE The goal of any dosimeter is to be as accurate as possible when measuring absolute dose to compare with calculated dose. This limits the uncertainties associated with the dosimeter itself and allows the task of dose QA to focus on detecting errors in the treatment planning (TPS) and/or delivery systems. This work introduces enhancements to the measurement accuracy of a 3D dosimeter comprised of a helical plane of diodes in a volumetric phantom. METHODS We describe the methods and derivations of new corrections that account for repetition rate dependence, intrinsic relative sensitivity per diode, field size dependence based on the dynamic field size determination, and positional correction. Required and described is an accurate "virtual inclinometer" algorithm. The system allows for calibrating the array directly against an ion chamber signal collected with high angular resolution. These enhancements are quantitatively validated using several strategies including ion chamber measurements taken using a "blank" plastic shell mimicking the actual phantom, and comparison to high resolution dose calculations for a variety of fields: static, simple arcs, and VMAT. A number of sophisticated treatment planning algorithms were benchmarked against ion chamber measurements for their ability to handle a large air cavity in the phantom. RESULTS Each calibration correction is quantified and presented vs its independent variable(s). The virtual inclinometer is validated by direct comparison to the gantry angle vs time data from machine log files. The effects of the calibration are quantified and improvements are seen in the dose agreement with the ion chamber reference measurements and with the TPS calculations. These improved agreements are a result of removing prior limitations and assumptions in the calibration methodology. Average gamma analysis passing rates for VMAT plans based on the AAPM TG-119 report are 98.4 and 93.3% for the 3%/3 mm and 2%/2 mm dose-error/distance to agreement threshold criteria, respectively, with the global dose-error normalization. With the local dose-error normalization, the average passing rates are reduced to 94.6 and 85.7% for the 3%/3 mm and 2%/2 mm criteria, respectively. Some algorithms in the convolution/superposition family are not sufficiently accurate in predicting the exit dose in the presence of a 15 cm diameter air cavity. CONCLUSIONS Introduction of the improved calibration methodology, enabled by a robust virtual inclinometer algorithm, improves the accuracy of the dosimeter's absolute dose measurements. With our treatment planning and delivery chain, gamma analysis passing rates for the VMAT plans based on the AAPM TG-119 report are expected to be above 91% and average at about 95% level for γ(3%/3 mm) with the local dose-error normalization. This stringent comparison methodology is more indicative of the true VMAT system commissioning accuracy compared to the often quoted dose-error normalization to a single high value.