Tolerances on MLC leaf position accuracy for IMRT delivery with a dynamic MLC
- Department of Medical Physics, Tom Baker Cancer Centre, 1331-29 Street NW, Calgary, Alberta T2N 4N2 (Canada) and Department of Physics and Astronomy, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4 (Canada)
The objective determination of performance standards for radiation therapy equipment requires, ideally, establishing the quantitative relationship between performance deviations and clinical outcome or some acceptable surrogate. In this simulation study the authors analyzed the dosimetric impact of random (leaf by leaf) and systematic (entire leaf bank) errors in the position of the MLC leaves on seven clinical prostate and seven clinical head and neck IMRT plans delivered using a dynamic MLC. In-house software was developed to incorporate normally distributed errors of up to {+-}2 mm in individual leaf position or systematic errors ({+-}1 and {+-}0.5 mm in all leaves of both leaf banks or +1 mm in one bank only) into the 14 plans, thus simulating treatment delivery using a suboptimally performing MLC. The dosimetric consequences of suboptimal MLC performance were quantified using the equivalent uniform doses (EUDs) of the clinical target volumes and important organs at risk (OARs). The deviation of the EUDs of the selected structures as the performance of the MLC deteriorated was used as the objective surrogate of clinical outcome. Random errors of 2 mm resulted in negligible changes for all structures of interest in both sites. In contrast, systematic errors can lead to potentially significant dosimetric changes that may compromise clinical outcome. If a 2% change in EUD of the target and 2 Gy for the OARs were adopted as acceptable levels of deviation in dose due to MLC effects alone, then systematic errors in leaf position will need to be limited to 0.3 mm. This study provides guidance, based on a dosimetric surrogate of clinical outcome, for the development of one component, leaf position accuracy of performance standards for multileaf collimators.
- OSTI ID:
- 22100572
- Journal Information:
- Medical Physics, Vol. 36, Issue 7; Other Information: (c) 2009 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA); ISSN 0094-2405
- Country of Publication:
- United States
- Language:
- English
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