{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:58:53Z","timestamp":1790330333833,"version":"4.1.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The purpose of this study was to evaluate and validate a measurement-free patient-specific quality assurance (PSQA) approach for volumetric modulated arc therapy (VMAT) breast cancer treatments based on independent three-dimensional (3D) dose calculation from Digital Imaging and Communications in Medicine (DICOM) plans and linear accelerator log files.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Seventy clinical breast VMAT plans (36 left-sided and 34 right-sided) were retrospectively analyzed. Independent 3D dose calculations were performed using RadCalc v7.3 based on the DICOM treatment plan (independent dose calculation [IDC] RTPlan) and on delivery log files acquired during the first treatment fraction (IDC LOGs). Results were compared with portal dosimetry (two-dimensional [2D]) and fluence-based analysis. Gamma passing rates (GPRs) were evaluated using 3%\/2 mm and 2%\/2 mm criteria under action (90%) and tolerance (95%) limits. Receiver operating characteristic (ROC) analysis was performed to evaluate the discriminatory capability. Sensitivity to delivery errors was investigated by introducing controlled multileaf collimator (MLC) shifts (0.5\u20132.0 mm) and collimator rotation errors (1\u00b0\u20133\u00b0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      All PSQA methods met the TG-218 action limit (GPR \u2265 90%) at 3%\/2 mm. Under the stricter 2%\/2 mm criterion, statistically significant differences among quality assurance methods were observed (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). ROC analysis demonstrated superior discriminatory performance for 3D dose-based methods, with area under the curve values of 0.9 for both IDC RTPlan and IDC LOGs, compared with 0.7 for portal dosimetry and 0.5 for fluence-based analysis. Error sensitivity analysis showed that stringent gamma criteria (1%\/2 mm and 1%\/1 mm) improved detection of subtle MLC and collimator deviations, with log file-based 3D reconstruction outperforming 2D approaches.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Independent 3D dose calculation is a reliable PSQA approach for breast VMAT, showing higher sensitivity than conventional 2D methods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmp.jmp_38_26","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:02:19Z","timestamp":1790168539000},"page":"569-577","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Independent Three-dimensional Dose Calculation from Log Files for Breast VMAT: A Measurement-free Quality Assurance Approach"],"prefix":"10.4103","volume":"51","author":[{"given":"Rosa Angelica Petit","family":"Sevilla","sequence":"first","affiliation":[{"name":"Department of Medical Physics, Instituto Zunino, C\u00f3rdoba, Argentina"},{"name":"Marie Curie Foundation, Zunino Institute, C\u00f3rdoba, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar Abel Apaza","family":"Blanco","sequence":"additional","affiliation":[{"name":"Marie Curie Foundation, Zunino Institute, C\u00f3rdoba, Argentina"},{"name":"Faculty of Astronomy, Mathematics, Physics and Computing, Universidad Nacional de C\u00f3rdoba, C\u00f3rdoba, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayron Medeiros","family":"Soares","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Instituto Zunino, C\u00f3rdoba, Argentina"},{"name":"Marie Curie Foundation, Zunino Institute, C\u00f3rdoba, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximiliano","family":"Musso","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Instituto Zunino, C\u00f3rdoba, Argentina"},{"name":"Marie Curie Foundation, Zunino Institute, C\u00f3rdoba, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezequiel Agust\u00edn Cabrera","family":"Lacey","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Instituto Zunino, C\u00f3rdoba, Argentina"},{"name":"Marie Curie Foundation, Zunino Institute, C\u00f3rdoba, Argentina"},{"name":"Faculty of Astronomy, Mathematics, Physics and Computing, Universidad Nacional de C\u00f3rdoba, C\u00f3rdoba, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis C","family":"Bohorquez","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, LAP of America Laser Applications, Boynton Beach, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Wolfsberger","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, LAP of America Laser Applications, Boynton Beach, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jos\u00e9","family":"Almada","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Instituto Zunino, C\u00f3rdoba, Argentina"},{"name":"Marie Curie Foundation, Zunino Institute, C\u00f3rdoba, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Daniel","family":"Venencia","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Instituto Zunino, C\u00f3rdoba, Argentina"},{"name":"Marie Curie Foundation, Zunino Institute, C\u00f3rdoba, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"R1-20260925","doi-asserted-by":"crossref","first-page":"101728","DOI":"10.1016\/j.adro.2025.101728","article-title":"Why is volumetric modulated arc therapy not considered the standard of care for locoregional radiation therapy for breast cancer patients?","volume":"10","author":"Kendall","year":"2025","journal-title":"Adv Radiat Oncol"},{"key":"R2-20260925","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1093\/jrr\/rrv052","article-title":"Volumetric-modulated arc therapy for left-sided breast cancer and all regional nodes improves target volumes coverage and reduces treatment time and doses to the heart and left coronary artery, compared with a field-in-field technique","volume":"56","author":"Tyran","year":"2015","journal-title":"J Radiat 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