BACKGROUND: Volumetric Modulated Arc Therapy (VMAT), as an advanced radiotherapy technique places higher demands on quality assurance (QA) during treatment planning. Although multiple verification systems have been widely applied in clinical practice. Comparative studies between ArcherQA and AccuCheck for VMAT plan verification have been relatively scarce. This study provides a comprehensive comparison of dose verification results between ArcherQA and AccuCheck systems for VMAT plans with the aim of providing practical evidence to guide the selection of appropriate quality assurance tools in clinical practice. METHODS: A total of 90 VMAT plans delivered with the EDGE linear accelerator were retrospectively collected from routine clinical practice, including 24 cranial, 23 thoracic, and 42 abdominal cases. All plans had passed institutional clinical dose verification prior to treatment. Independent secondary dose calculations were performed using both ArcherQA and AccuCheck to ensure cross-platform consistency. The gamma passing rate (GPR) (3%/3 mm) was used as the primary metric to evaluate agreement between TPS and secondary-calculated dose distribution, while mean dose differences (MDD) provided complementary information on PTV and OAR dose variations. Receiver operating characteristic (ROC) curves were generated to determine the optimal global GPR threshold under the 3%/3 mm criteria using Youden's index, and the sensitivity and specificity of plan evaluation at this threshold were subsequently analyzed for both systems. RESULTS: The MDDs against TPS for PTV and OARs were within 3% and 4%, respectively. The GPRs (mean ± SD) for cranial, thoracic, and abdominal cases were (97.03 ± 1.84) % vs. (99.79 ± 0.20) %, (99.52 ± 0.21) % vs. (98.21 ± 0.67) %, and (99.63 ± 0.15) % vs. (99.49 ± 0.22) % for ArcherQA and AccuCheck, respectively. Significant statistical differences were observed in cranial, thoracic, and abdominal cases (t = -7.403, p < 0.001; t = 8.549, p < 0.001 and t = 3.309, p = 0.002). The optimal GPR thresholds under the 3%/3 mm criterion were 99.05% and 99.51%, with sensitivity/specificity of 1.000/0.687 and 0.842/0.673, respectively. CONCLUSION: Both ArcherQA and AccuCheck demonstrated excellent dosimetric agreement with TPS satisfied clinical validation requirements, and can be regarded as reliable independent verification tools for VMAT plans. CLINICAL TRIAL NUMBER: Not applicable.
Wang et al. (Tue,) studied this question.