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VERIQA RT EPID 3D

Pre-Treatment and In Vivo 3D EPID Dosimetry with Monte Carlo Calculations: VERIQA RT EPID 3D is part of the VERIQA platform for integrated, independent patient QA.

It combines phantomless pre-treatment and in vivo EPID dosimetry in a fully automated solution, enabling true 3D patient dose reconstruction in the patient anatomy for all treatment sites. 

Safer treatments, faster.

What makes VERIQA RT EPID 3D so powerful? Watch the video.

10 Reasons Why You Should Use VERIQA RT EPID 3D for Treatment Plan and Delivery Verification

Some EPID algorithms have difficulties in predicting the correct dose in inhomogeneous patient anatomies. VERIQA RT EPID 3D enhances the advanced back-projection algorithm developed by the Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital (NKI-AVL) with a unique, patent-pending Monte Carlo-based inhomogeneity correction. This combination allows for a highly accurate patient dose reconstruction for all treatment sites, including those with significant tissue heterogeneities.

Unlike other commercial EPID dosimetry solutions, VERIQA RT EPID 3D enables true 3D patient dosimetry by using only the acquired EPID image and the patient anatomy from the patient CT scan for 3D dose reconstruction. As a combined solution, VERIQA RT EPID 3D compares EPID reconstructed dose directly with planned patient dose and enables 3D gamma comparisons as well as the calculation of patient dose-volume histograms (DVHs) for both pre-treatment and in vivo dosimetry.

VERIQA RT EPID 3D uses the same algorithm for pre-treatment and in vivo EPID dosimetry, making it easy for you to directly compare in vivo with pre-treatment patient dose distributions. By combining pre-treatment and in vivo EPID dosimetry into a single solution, VERIQA RT EPID 3D allows you to identify and estimate the extent of patient-related errors for each delivered fraction.

VERIQA RT EPID 3D reconstructs a 3D patient dose distribution from EPID images acquired “in air”. This eliminates the need for phantom setup or re-planning, making pre-treatment QA much faster and more efficient without compromising accuracy.

Studies have shown that most errors occur during the first and subsequent treatment fractions and remain unnoticed during pre-treatment verification. In vivo EPID dosimetry is a highly effective tool for detecting clinically relevant errors originating from different error sources (e.g., changes in the patient position or anatomy). Ensure safer treatments by taking corrective action at an early stage in the treatment course.

VERIQA RT EPID 3D provides a fully automated workflow from image acquisition and calculation to evaluation and documentation. All steps are automatically initiated upon receipt of a treatment plan based on a user-defined, plan-specific task, requiring no input from you. QA results can be quickly accessed via web browser from any device and from anywhere in your network.

VERIQA RT EPID 3D reduces commissioning time to a minimum. Unlike other solutions, the VERIQA RT EPID 3D software uses a generic EPID model template, requiring only a few measurements to create an accurate and machine-specific EPID model.

The back-projection algorithm of VERIQA RT EPID 3D is a clinically proven and well-established method, which has been successfully used at the Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital (NKI-AVL) in more than 75,000 patient treatments since 2005. VERIQA RT EPID 3D users benefit from a transparent and independent solution which has been extensively validated in numerous peer-reviewed publications.

VERIQA RT EPID 3D seamlessly integrates into the modular VERIQA patient QA platform, giving you the flexibility to select and combine different measurement- and calculation-based verification methods to achieve the best result. Use VERIQA RT EPID 3D as a complete solution for patient treatment plan and delivery verification. Combine the new EPID in vivo dosimetry module with other VERIQA plan QA tools, e.g., Monte Carlo-based 3D dose calculations, to increase error detection capabilities and add an extra safety net for radiotherapy treatments.

As a vendor-independent 3D dose calculation software, VERIQA RT EPID 3D supports major linacs equipped with modern EPID imaging panels. The new EPID software can be efficiently used with all treatment planning systems capable of DICOM-RT export, and with all major treatment modes, such as 3D, IMRT, Arcs & VMAT, SBRT and SRS.

Advanced 3D Back-Projection Approach

With a unique, patent-pending Monte Carlo-based inhomogeneity correction

VERIQA RT EPID 3D builds on the well-established back-projection algorithm developed by the NKI-AVL, and adds a unique, patent-pending Monte Carlo-based inhomogeneity correction. It allows accurate patient dose reconstruction for all treatment sites, including those with significant tissue heterogeneities.

DICOM Export and Image Acquisition

VERIQA receives DICOM RT data from TPS and EPID images acquired before ('in air') or during patient treatment ('in vivo').

EPID images are automatically assigned to treatment plan.

Calculation

VERIQA RT EPID 3D automatically reconstructs 3D patient dose for all treatment sites both pre-treatment and in vivo.

It compares calculated patient dose against TPS patient dose using 3D Gamma, GVH and DHV metrics.

Results

An automatic email notification is sent upon task completion.

Dose results can be directly accessed via web browser.

Approval

Results can be approved or rejected by an authorized user.

Comments can be added at each important step in the verification process, ensuring full traceability of the results.

Documentation

Multiple options are available to document the results: PDF report, DICOM export to PACS, Track-it export for trending.

Featured article: Reimaging patient QA with Monte Carlo calculations

VERIQA RT EPID 3D ensures true 3D dose verification for both pre-treatment and in vivo EPID dosimetry. Check out the featured article published on Physicsworld to learn more about the algorithm and the clinical benefits of using automated 3D EPID dosimetry as an efficient tool for patient-specific QA. Find out how Monte Carlo comes into play and why you should use VERIQA RT EPID 3D to ensure safer treatments.

Read on

In vivo 3D EPID dosimetry

Identify patient-related errors, which occur over the course of treatment

Click to enlarge

RT EPID 3D uses the same algorithm for both pre-treatment and in vivo verification, allowing you to compare in vivo dose with pre-treatment dose for each delivered fraction. This makes it much easier for you to detect patient-related errors, such as anatomical changes and/or setup issues, which are specific to each fraction, and to better estimate their dosimetric impact.

In the figure on the left, it can be seen how the difference between in vivo and pre-treatment (virtual) patient results becomes larger as the changes in lung density increase. After the result of the 3rd in vivo verification the radiation oncologist was consulted.

Source: Olaciregui-Ruiz et al, Phys Med. 2017 May;37:49-57, doi: 10.1016/j.ejmp.2017.04.016

VERIQA RT EPID 3D in Clinical Use

How does it work? What are the benefits of the back-projection method? Listen to what two clinical experts on EPID dosimetry have to say.

True 3D patient dosimetry – safer treatments, more efficiency in patient QA

Discover what VERIQA RT EPID 3D is, how it works in clinical practice, and which advantages it offers.

Back-projection versus forward-projection – which method is the best?

Learn why an EPID back-projection algorithm makes all the difference in 3D dose verification.

Tips: What you should consider when implementing 3D EPID dosimetry

Hear tips and advice from two experts and experienced users of 3D EPID dosimetry for patient-specific QA.

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