The Professional Doctorate in Medical Physics (DMP) was originally conceived as a solution to the shortage of medical physics residency training positions. While this shortage has now been largely satisfied through conventional residency training positions, the DMP has expanded to multiple institutions and grown into an educational pathway that provides specialized clinical training and extends well beyond the creation of additional training spots. As such, it is important to reevaluate the purpose and the value of the DMP. Additionally, it is important to outline the defining characteristics of the DMP to assure that all existing and future programs provide this anticipated value. Since the formation and subsequent accreditation of the first DMP program in 2009-2010, four additional programs have been created and accredited. However, no guidelines have yet been recommended by the American Association of Physicists in Medicine. CAMPEP accreditation of these programs has thus far been based only on the respective graduate and residency program standards. This allows the development and operation of DMP programs which contain only the requisite Master of Science (MS) coursework and a 2-year clinical training program. Since the MS plus 2-year residency pathway already exists, this form of DMP does not provide added value, and one may question why this existing pathway should be considered a doctorate. Not only do we, as a profession, need to outline the defining characteristics of the DMP, we need to carefully evaluate the potential advantages and disadvantages of this pathway within our education and training infrastructure. The aims of this report from the Working Group on the Professional Doctorate Degree for Medical Physicists (WGPDMP) are to (1) describe the current state of the DMP within the profession, (2) make recommendations on the structure and content of the DMP for existing and new DMP programs, and (3) evaluate the value of the DMP to the profession of medical physics.

INTRODUCTION Francisella tularensis is an aerobic Gram-negative coccobacillus, which causes acute febrile illness of humans and other mammals, most commonly rabbits. Exposure may occur through direct contact with infected animals, arthropod bites including ticks, deer flies, and mosquitoes, contaminated soil, or ingestion of contaminated meats or water, and, in some cases, via inhalation of aerosolized organisms. Based on a retrospective study, arthropod bite was identified in 77% of cases, which was consistent with the mode of transmission in our current case.1 Manifestation of tularemia infection varies. Of the seven forms of tularemia, the classic clinical presentation is ulcero-glandular.1 Of note, each form is associated with symptoms consistent with an influenza-like illness, consisting of fevers, chills, headache, and myalgia. “Typhoidal” symptoms were reported in 47% of cases, double the proportion of the more classic manifestation of lymphadenopathy, which was contrary to the expectations. Fever is defined as a core temperature of at least 38.0°C (100.4°F). Febrile illness in the pediatric population has a broad differential diagnosis. Fever can be due to infections (bacterial, viral, fungal, or tickborne), autoimmune disorders, or malignancy. A detailed history and physical examination are needed to narrow the differential diagnosis. The following was a case of an 8-month-old presenting with fever which was found later to be due to a tick-borne illness although initial serologies for tick-borne illness were negative.

The American Association of Physicists in Medicine (AAPM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) recognized the need for a review of the current state of nuclear medicine physics training and the need to explore pathways for improving nuclear medicine physics training opportunities. For these reasons, the two organizations formed a joint AAPM/SNMMI Ad Hoc Task Force on Nuclear Medicine Physics Training. The mission of this task force was to assemble a representative group of stakeholders to: Estimate the demand for board‐certified nuclear medicine physicists in the next 5–10 years, Identify the critical issues related to supplying an adequate number of physicists who have received the appropriate level of training in nuclear medicine physics, and Identify approaches that may be considered to facilitate the training of nuclear medicine physicists.As a result, a task force was appointed and chaired by an active member of both organizations that included representation from the AAPM, SNMMI, the American Board of Radiology (ABR), the American Board of Science in Nuclear Medicine (ABSNM), and the Commission for the Accreditation of Medical Physics Educational Programs (CAMPEP). The Task Force first met at the AAPM Annual Meeting in Charlotte in July 2012 and has met regularly face‐to‐face, online, and by conference calls. This manuscript reports the findings of the Task Force, as well as recommendations to achieve the stated mission.PACS number: 01.40.G‐

Purpose: The MatriXX array detector array has been shown to provide inadequate sampling and absolute dose measurements for small, highly modulated fields. These devices generally fail due to spatial frequency contributions exceeding the sampling rate as defined by the Nyquist criteria and maximum point doses falling between chamber locations. This study attempts to demonstrate the feasibility of using an extended source detector distance (ESDD) measurement combined with array shifting to maximize MatriXX resolution for the quality assurance of radiosurgery fields. Methods: Measurements were taken using a Novalis TX with HD-MLCs at an extended 202 cm SDD with 3.8 mm shifts in the radial and transverse directions. A VBA code was developed to sum the four shifted images into a single dose plane. A line pair pattern with decreasing MLC openings from 1.25 to 0.25 cm was used to quantify the MatriXX resolution using conventional and shifted ESDD techniques. Next, the quality assurance of an intensity modulated radiosurgery (IMRS) plan was measured conventionally with the MatriXX and portal imaging device, and then compared to the shifted ESDD technique using a 3%, 3 mm gamma analysis and point dose comparison. Results: The ESDD technique increased the effective sampling frequency from 1.3 to 5.6 cm−1 allowing for the accurate representation of frequency contributions up to 2 cm−1 corresponding to dose fluctuations from single HD-MLC openings. The gamma passing rate of the ESDD measured IMRS fields averaged 95.4% compared to 86.4% for conventional SDD and 99.5% for portal dosimetry. Absolute point doses differences improved on average from 4.3% and 3.3%, for conventional SDD and portal respectively, to 2.7% for the ESSD technique. Conclusion: This study demonstrates that the resolution of the MatriXX can be improved by a factor of four with extended SDD and array shifting techniques allowing for improved QA of radiosurgery plans.

Purpose: Two-dimensional ion chamber arrays are widely used in the clinical setting for the verification of MLC dose planes for IMRT treatment plans. However, the sampling resolution of these arrays has been shown to break down during the measurement of small, highly-modulated fluences as seen with IMRS. These fields generally fail due to spatial frequency contributions exceeding the necessary sampling rate as defined by the Nyquist criteria. A study was performed to examine the effects of an extended SSD measurement technique on chamber array resolution. Methods: HD-MLC line pair patterns with decreasing slit openings from 1.25 to 0.25 cm at isocenter, corresponding to line pairs of increasing frequency (0.4 to 2 cm−1), were used to examine an I'mRT MatriXX phantom at various SSDs. A Varian TX accelerator was used to apply 200 MU of 6X photons on the array set at 89, 119, and 208 cm SSD. Additionally, an IMRS patient plan with a poor gamma passing rate (90% of pixels passing 3%, 3mm) at conventional SSD was re-measured with the MatriXX placed at 208 cm SSD. Results: At 208 cm SSD, this technique increased the number of sampling points per field a factor of 4.8 while improving the spatial resolution by a factor of 2.2 in any direction. Frequency contributions up to 2 cm−1 at isocenter were resolved by an effective chamber sampling rate of 3 cm−1 at extended SSD. This technique was able to increase the gamma passing rates of all ten IMRS fields to above 95%. Conclusions: This study demonstrates that an extended SSD measurement can improve the sampling resolution of the MatriXX device with little alteration to existing IMRT QA calculations or procedures. This method allows for the successful measurement of highly modulated fields without using EPID, film or array-shifting QA techniques for improved resolution.

Purpose: A retrospective study was performed to determine any dosimetric or delivery benefits for treatment planning with intensity-modulated radiotherapy (IMRT) versus volumetric-modulated arc therapy (VMAT) for the treatment of brain neoplasms. Methods: Eighteen patients treated with modulated brain radiotherapy treatments were included in this study (primary treatment volumes of 15.3 to 374.9 cc). IMRT and VMAT plans were generated for each patient using the same criteria for prescription coverage and normal tissue sparing. IMRT optimizations ranged from five to seven fields and VMAT from two to four arcs. Plans were generated with Varian Eclipse treatment planning system utilizing AAA-8615 dose calculation algorithm. Results: VMAT optimizations provided limited dosimetric advantages versus IMRT. VMAT provided superior treatment volume coverage (volumes receiving 95%, 100% of prescription dose (V95%, V100%)) over IMRT, but differences were not statistically significant (paired t-test p > 0.05). Relative maximum dose values, conformity and homogeneity indices also exhibited no statistical differences. IMRT plans resulted in similar mean brain minus treatment volume (Brain- TV) dose (mean = 1460.1 vs. 1506.3 cGy; p = 0.056). The volume of Brain- TV receiving 40Gy was lower for VMAT than IMRT (average = 38.96 vs. 44.97 cc; p = 0.050). Maximum skin dose was lower for VMAT (mean = 4568.8 vs. 5063.3cGy; p = 0.006), as well as skin V20Gy (6.56% vs 7.69%; p = 0.027) and V40Gy (0.56% vs. 0.35%; p = 0.017). VMAT plans required fewer fields along with fewer MU than IMRT (mean = 388.2 vs. 721.1 MU, respectively), allowing for approximately 20% faster delivery times. Conclusions: VMAT treatments significantly reduced treatment time due to reduced MU and fewer fields. Certain skin and Brain-TV high dose spread parameters were superior for VMAT as compared to IMRT plans. All other dosimetric parameters tested were statistically equivalent for VMAT and IMRT techniques.

The education of medical physicists has historically been quite varied and medical physicists have entered the field through several pathways including specialized educational programs, postdoctoral fellowships, and on-the-job training. It is argued that the contributions of viewpoints from different branches of physics has contributed to the development of novel solutions and advances in radiation oncology. However, there also has been an effort recently to make graduate education of medical physicists more consistent and uniform, particularly for the preparation of clinically oriented therapy physicists. The trend towards a more systematic approach has been guided in part by the requirements for graduate program accreditation developed by CAMPEP and by the requirements for medical physicist certification by the ABR. At the same time, there has been criticism of this approach as being too confining and guiding graduates toward a career as technicians rather than independent thinkers. Educational programs have had to balance the requirements of accreditation and certification against the goal of preparing students for careers as independent researchers. Three speakers will describe the approaches taken by their graduate educational programs to meet the requirements of CAMPEP and adequately prepare graduates for certification by the ABR, while maintaining a commitment to providing a comprehensive education in medical physics.LEARNING OBJECTIVES:1. Understand the requirements for graduate program accreditation 2. Understand the education and experience requirements for certification 3. Learn the approaches taken by several graduate programs to meet the requirements for accreditation and certification while providing a comprehensive education in medical physics.

PURPOSEEpiscleral eye plaque brachytherapy has been utilized in the treatment of intra-ocular malignancies, delivering large prescription doses to the apex of the tumor. Advances in dose calculation and image guidance, via calibrated fundus images, enable localization of the tumor and determination of dose to the macula, optic disc, and lens. A two-year post-implant study aims to correlate dosimetry with local tumor control and changes in visual acuity, as well as assess the need for plaque optimization with respect to critical structures.METHODSA retrospective, two-year follow-up study of 21 patients who have received episcleral eye plaque brachytherapy at our institution was used to correlate dosimetry with clinical outcomes and evaluate the need for eye plaque optimization. BEBIG Plaque Simulator wasused in treatment planning; fundus photographs were registered for tumor localization and the TG43-U1 formulism enabled dose calculation of I-125- loaded COMS plaques. Doses to the apex, macula, and optic disc were correlated to changes in apex height and visual acuity. Selected patients were replanned using optimization strategies to reduce dose to critical structures.RESULTSA total of seven patients (33%) noted improved eyesight at two years. 11 (52%) patients lost at least two lines of vision at two years. Two patients saw increases in apical height (9%) within two years. Optimized eye plaque plans were able to reduce optic disc and macular doses (average 68Gy and 80Gy, respectively) by 36% and 25% on the average, while maintaining the prescribed dose.CONCLUSIONImage guidance and optimization are important tools that can aid in treatment of intra-ocular malignancies, as these techniques provide physicists with the ability to spare critical structures while delivering the prescription dose, thus increasing the possibility of local control and vision sparing.

PURPOSE:Stereotactic body radiotherapy (SBRT) has been applied in treating early stage small lung lesions, delivering hypofractionated doses in a conformai manner. Studies have shown that SBRT has similar outcomes compared with surgery. Conventionally, SBRT lung treatments rely on utilization of multiple small, conformai, static fields in coplanar and non- coplanar arrangements. With the advent of RapidArc, it is important to evaluate the differences in dosimetry and delivery of conformai SBRT lung treatments for both conventional static field and VMAT techniques.METHODS:A retrospective study of 12 patients at our institution who have received SBRT for primary lung lesions was used to evaluate the application of RapidArc for such cases. Originally treated plans utilized eight to ten conformai static coplanar and non-coplanar fields. RapidArc plans were generated in Eclipse using single and multiple arc setups.RESULTS:As an ntensity-modulated modality, RapidArc provides greater freedom as compared to conventional static field delivery, as one can achieve dose uniformity throughout the PTV or replicate the dosimetry synonymous with conventional SBRT. RapidArc is capable of reproducing the high conformality achieved by conventional SBRT; dual arc plans, delivering uniform dose distributions, yielded an average CI100% of 1.11 and D2cm maximum of 63% of the prescribed dose, compared to 1.33 and 77% (p- values of .002 and .005, respectively) for conventional SBRT. Application of a short, non-coplanar arc, in conjunction with dual coplanar arcs, improved sparing of OARs in direct proximity of the PTV at the expense of treatment time. RapidArc allows for faster treatment delivery; conventional SBRT delivery averages 13.7 minutes at our institution, whereas coplanar dual arcs are estimated to average treatment durations of 4.2 minutes.CONCLUSIONS:RapidArc is capable of generating conformai dose distributions and sparing of OARs, allows greater freedom in plan optimization, and reduces treatment time significantly.

Purpose: The goal of episcleral eye plaque brachytherapy has been to deliver a prescribed dose to the apex of an intra‐ocular malignancy. Advances in dose calculation and image guidance allow for optimal plaque treatment planning. The BEBIG Plaque Simulator™ utilizes calibrated fundus collages to more precisely localize intra‐ocular tumors volumes, thus enabling physicists to plan plaque therapies that deliver the prescribed dose to the tumor while quantifying and limiting dose to critical optical structures, including the macula, optic disc, and lens. Methods and Materials: A retrospective study of 30 patients at our institution who previously received episcleral eye plaque brachytherapy based on conventional treatment planning techniques. For each patient, the originally defined Ultrasoundtumor dimensions, plaque specifications (COMS universal or notched), and treatment times were entered into Plaque Simulator. Fundus collages were calibrated and overlaid on a retinal diagram. The tumor was placed over the delineated tumor on the fundus collage. Doses to the tumor apex, macula, optic disc, and lens were calculated using TG‐43U1 formalism after assuming correct plaque placement. Results: Localization of intra‐ocular tumors allowed for accurate plaque placement and realistic dose calculation for critical structures. Recreated plans validated the original prescriptions while elucidating doses to critical structures. Doses to the macula and optic disc have been correlated to clinical outcomes, including radiation maculopathy and optic neuropathy, in an effort to evaluate dose thresholds that can be enforced in future plaque therapies. Conclusions: The use of image guidance gives radiationoncology‐ophthalmology teams the ability to deliver plaque therapy with the intent to control the tumor and spare critical structures. Dose determination may highlight the necessity of proper plaque placement, plaque size, source strength, and carrier angle optimization to deliver the prescribed dose while reducing dose to critical structures below suggested thresholds in order to preserve vision.

Purpose: Patient‐specific Quality Assurance (QA) of dose delivery for intracranial linac‐based Stereotactic Radiosurgery (SRS) is not a common practice. This study describes an efficient patient‐specific measurement using an ion chamber array system to validate the dose at the isocenter plane when High‐Definition Multileaf Collimators (HDMLC) are used for planning dynamic arcs in small fields.Methods: Measurement of dose in typical SRS treatments is a challenge due to the small sizes of the fields. This study focuses in the measurement of dose at one isocenter plane by using the ion chamber array system MatriXX® embedded into the MultiCube® phantom (IBA Dosimetry Inc.) for patients treated with SRS delivered by HDMLC (2.5‐mm leaf thickness) using the Novalis‐TX linear accelerator. The patient plan is mapped into the phantom placing the isocenter of the lesion in the center of the array, and converting the non‐coplanar arcs into coplanar ones. The total dose distribution in the ion‐chamber array plane is calculated using the same Treatment Planning Algorithm (TPA) used for the patient plan. The phantom‐mapped plan is fully delivered on the phantom such that the combined dose distribution at the isocenter plane of the array is measured directly. A statistical analysis using both the gamma‐factor criteria (3% dose difference and 3 mm distance‐to‐agreement) and the absolute dose difference is then performed between the measured and the calculated dose distributions.Results: This patient‐specific QA was applied to 14 lesions (greater than 1.8 cm in the longest extension) in 7 patients. The percent of pixels with gamma factor greater than one were below 3%, and the percent of pixels with absolute dose difference greater than 5% were less than 5% in all cases Conclusions: This patient‐specific QA for HDMLC is feasible and effective to ensure the accuracy of calculations by the TPA.

Purpose: To examine the accuracy of different methods of converting percentage depth dose (PDD) curves to tissue phantom ratios (TPR) for small cones by comparing them with directly measured TPR values.Methods: For a 6 MV beam, a detector remained fixed in water at an SAD of 100 cm. The depth was increased from 1.5 cm to 20 cm to directly measure TPRs for cones of 7.5 to 30 mm and fields of 5×5 and 10×10 cm square. PDD curves were measured at 100 cm SSD. Three methods were used to obtain TPR from PDD: 1.) by correcting inverse-square only; 2.) by correcting for inverse-square and interpolating between PDD curves to correct for the increasing field size with increasing depth; and 3.) by using method 2 in addition to a ratio of field-size corrected peak scatter factors (PSF). Because of the lack of charged particle equilibrium (CPE), PSFs for small fields were obtained by an analytical fit. Results: For fields larger than the 10 mm cone, method 2 corrected errors generated using method 1 and produced TPRs within 1% of the directly measured values for all depths. Method 2 did not significantly reduce the difference for the 7.5 and 10 mm cones. When compared to directly measured TPRs, derived values for the 7.5 mm cone varied from 2.2% low at dmax to 2.4% high at 20 cm. Method 3 reduced the deviations within +/− 1% for all fields and depths. Conclusions: This study shows that TPR values derived using method 2 can reduce deviation from directly measured TPR to less than 1% for field sizes greater than 1 square cm. The deviation of derived TPR values for field sizes less than 1 square cm can be reduced to less than 1% by combining method 2 and empirically fitted PSFs.

Purpose: To report changes of cone beam properties when opened jaw field sizes were incorrectly set larger than the cone beam limiting device and to show the unintended dose to normal tissues resulting from the error in Linac-based non-coplanar arc treatment. Methods: The Monte Carlo code, BEAMnrc, was used to simulate the entire Linac head and circular cone beam limiting device accessory of a 6 MV beam. In addition to the correct jaw size of 5cm×5cm, two incorrect jaw sizes, 10cm×10cm and 20cm×20cm are simulated. The simulated beams were stored in phase-space files and were analyzed to obtain the beam properties. The beams were then used to calculate dose to patient based on CT images resulting from non-coplanar arcs. For the same circular cones, the dose to both target and the normal tissues were compared between using correct jaw settings and incorrect ones. Results: When the jaw sizes are larger than the cone beam limiting device, significant photon fluence at off-axis distances greater than 5cm was confirmed using film measurements. Monte Carlo dose calculations for a representative patient using a 10 mm BrainLab cone arc plan resulted in a small dose increase within the regions of less than 5cm radius and a large dose increase (20% of dose to the target) for the regions at distance greater than 5cm up to the field size of 20cm×20cm set by jaws. For 20 Gy tumor dose, this jaw size error may result in 4 Gy of unintended dose to normal tissues at distance greater than 5 cm away from the isocenter. Conclusions: The unintended doses to normal tissues are significant due to jaw setting errors. The point dose QA measurement performed at isocenter may not detect the error in jaw setting. A more robust QA protocol is warranted.

This study presents beam characteristics of five recently available x-ray beams produced by an on-board imager (OBI 1.4) for acquiring kilovoltage cone-beam computed tomography (kV-CBCT) and investigates suitable methods for the beam radiation output determination resulting from an image acquisition. Both are essential for commissioning an x-ray beam in a radiotherapy treatment planning system. The BEAM/DOSXYZnrc Monte Carlo codes were used in the investigation. The simulated beam data were benchmarked against measurements. Three different commercially available plastic phantom materials are investigated as liquid water substitutes in the beam radiation output determination. Ionization chambers are used for the measurements. Five kV-CBCT beam characteristics including photon fluence, average beam energy and photon spectra are generated from Monte Carlo simulations. The Monte Carlo calculated dose profiles are validated by measurements. The fluence of kV-CBCT beams is strongly dependent on the geometry of added filters as well as X and Y beam collimations. The potential errors of determining the beam output of a kV-CBCT beam in Solid Water and PMMA phantoms may approach 8% and 20%, respectively, for use in a conventional treatment planning system, whereas using the Plastic Water low-energy range (PW-LR) phantom results in errors within 2%. The Monte Carlo simulation is essential in providing the parameters of an x-ray beam which are needed for the commissioning of a kV-CBCT beam in a radiotherapy treatment planning system. The PW-LR phantom is a suitable liquid water substitute in the beam output determination resulting from a kV-CBCT acquisition.

Purpose: The additional radiation dose delivered to radiotherapy patients from repeated image guidance procedures is a growing concern. This study presents a new approach to model‐based dose calculation that overcomes the deficiencies of currently available model‐based algorithms in the kilovoltage regime. Method and Materials: Monte Carlo techniques were used to calculate the dose to patients resulting from kV‐CBCT scans for multiple scan sites including the head‐and‐neck, chest, and pelvis. Both dose‐to‐medium and dose‐to‐water were calculated using realistic simulated kV‐CBCT beams to find a correlation between the effective thickness of bone (dEB) traversed by an x‐ray beam to reach a voxel and the correction factor needed to correct the model‐based dose calculation. A program was written to facilitate the calculation of dEB in which the incident beam profiles and isocenter relative to a scanned patient were taken into account. Results: A strong correlation between dose correction factor and dEB was observed. A unique correction factor calibration curve as a function of dEB was derived and used to predict patient dose. Compared to gold standard Monte Carlo calculated dose distributions, the resulting mean dose error for each patient was less than 3% for bone and 2% for soft‐tissue. This was in contrast to model‐based calculations, which resulted in mean errors of up to −103% for bone and 8% for soft‐tissue. Conclusion: The derived correction factor as a function of effective bone thickness is capable of accurately calculating the dose to bone and soft‐tissue by making use of patient CT data and the incident kV‐CBCT beam information. The accuracy of this new approach is patient and scan site independent because it takes into account the spectral changes of the x‐ray beam. With the addition of a commissioned kV‐CBCT beam this new approach can facilitate inclusion of imaging dose in radiotherapy treatment planning.

Purpose: The purpose of this work was to commission, validate, and implement the COMPASS (IBA, Inc) system into a clinical intensity‐modulated‐radiotherapy (IMRT) quality‐assurance (QA) program. Method and Materials: The COMPASS system is comprised of an array of ionization detectors (MatriXX) mounted to the gantry using a custom holder and a software package for the analysis and visualization of quality assurance results. Commissioning of the COMPASS required reformatting 6‐MV photon data from a Varian‐Novalis‐TX linac into a software acceptable beam model. Validating COMPASS was a multi‐step process including the qualification of our Varian‐Eclipse‐treatment‐planning system (TPS) and the COMPASS computation, prediction, and reconstruction algorithms. Prior validation of our TPS included comparisons of measured dose in a pelvic phantom to calculated dose and correlation of predicted IMRT fluence with measured fluence using the MatriXX and OmniPro software. Validation of the computation algorithm involved direct comparison of TPS calculated dose to COMPASS calculated dose. The prediction algorithm was validated by comparing the predicted response to measured response on the MatriXX. Finally, the validation of the reconstruction algorithm included fluence measurements taken using COMPASS for actual patients undergoing IMRT treatment at our facility and comparing the reconstructed dose to the TPS calculated dose. Results: Validation of our TPS using point dose measurements was found to be within less than 1% from our TPS calculated dose. The COMPASS fluence prediction algorithm was evaluated using difference histograms; analyses indicated that ∼96% of the pixels were within ±1.5% difference. Conclusion: This work shows clinical potential for a new visualization display of IMRT QA; 2D fluence measurements in conjunction with a valid beam model and patient CT information can be utilized to reconstruct measured dose onto a patient 3D data set. Conflict of Interest: This study was sponsored by IBA, Inc., Bartlett, Tennessee.

to TPS, (2) an independent MU calculation system (RadCalc, LifeLine Software Inc.) for secondary MU check, and (3) a record and verify (R&V) system (Lantis, Siemens, or Mosaiq, Elekta) by retrieving the imported and stored plan data with an open database connectivity (ODBC) connection.The ODBC connection to the R&V system database was created to be read only and password protected.The data from aforementioned three sources were compared to verify the consistency between the data in the TPS and those stored in the R&V system and to search for any discrepancy between the MU numbers calculated by the TPS and by the secondary MU check program.The comparison results were output by the software tool.Results: The verification software tool was tested with real IMRT plans from regular treatments and from the online adaptive radiotherapy.The tool was capable of automatically detecting any inconsistency between the beam data from the TPS and the data transferred and stored in the R&V system and identifying any discrepancy between the MU numbers calculated from the TPS and from the secondary MU check program.The execution of the tool lasted only a few seconds.The tool is being integrated into our clinical online adaptive re-planning process as a necessary QA step to be performed prior to the delivery of the adaptive plan.The use of this tool speeded the online adaptive process by eliminating the manual and tedious visual inspection.The tool was also found to be useful for regular plan check and verification.Conclusions: A QA software tool has been developed to automatically verify the plan data transfer from the planning system to the R&V system and to identify discrepancy in MU calculations between the planning system and the secondary MU check.This tool speeds up the online adaptive re-planning process and improves QA and safety.

Purpose: To evaluate the dosimetric accuracy and reproducibility of an implantable DVS‐HFT dosimeter for hypo‐fractionated radiation treatment in stereotactic radiotherapy. Method and Materials: The dosimeters are factory calibrated to read within the range of 340–950 cGy per fraction. Communication from the detector to the reading device is achieved telemetrically. Two sets of dosimeters were studied in a phantom and one set is implanted in a prostate cancer patient treated with five fractions. The planned doses to detectors were calculated based on CT images. The calculated doses were validated with ionization chamber measurements in the phantom. Both static and IMRT beams were studied. The uncertainty of dosimeter reading was estimated by Results: In the phantom studies, the uncertainty of daily readings were found to be from −0.1 to −4.9% (with a mean value of −1.6%) and from +1.4 to +4.8% (with a mean value of +2.5%) for five daily doses of 700 cGy delivered by static and IMRT beams respectively. For the dosimeters implanted in the prostate cancer patient, the daily discrepancies between dosimeter‐1 readings and calculated doses of 767 cGy range from −8.2% to +4.0% (with a mean value of +2.0%) during five fractions. However, the discrepancies of dosimeter‐2 implanted in a region with high dose gradients (calculated dose of 180 cGy) range from −4.3% to +35.0% (with a mean value of +3.4%). Conclusion: The accuracy of the DVS‐HFT dosimeter is shown to be within the manufacture stated uncertainties of < 5.5%. The study demonstrates that the dosimeter may be an effective tool to determine the actual dose delivered to treatment targets as well as organ at risk. The information obtained can be utilized to study actual dose fluctuations of daily treatment.Conflict of Interest: Two sets of dosimeters used in phantom study were provided by Sicel.