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Title: Quantification of the impact of MLC modeling and tissue heterogeneities on dynamic IMRT dose calculations

Abstract

This study quantifies the dose prediction errors (DPEs) in dynamic IMRT dose calculations resulting from (a) use of an intensity matrix to estimate the multi-leaf collimator (MLC) modulated photon fluence (DPE{sub IGfluence}) instead of an explicit MLC particle transport, and (b) handling of tissue heterogeneities (DPE{sub hetero}) by superposition/convolution (SC) and pencil beam (PB) dose calculation algorithms. Monte Carlo (MC) computed doses are used as reference standards. Eighteen head-and-neck dynamic MLC IMRT treatment plans are investigated. DPEs are evaluated via comparing the dose received by 98% of the GTV (GTV D{sub 98%}), the CTV D{sub 95%}, the nodal D{sub 90%}, the cord and the brainstem D{sub 02%}, the parotid D{sub 50%}, the parotid mean dose (D{sub Mean}), and generalized equivalent uniform doses (gEUDs) for the above structures. For the MC-generated intensity grids, DPE{sub IGfluence} is within {+-}2.1% for all targets and critical structures. The SC algorithm DPE{sub hetero} is within {+-}3% for 98.3% of the indices tallied, and within {+-}3.4% for all of the tallied indices. The PB algorithm DPE{sub hetero} is within {+-}3% for 92% of the tallied indices. Statistical equivalence tests indicate that PB DPE{sub hetero} requires a {+-}3.6% interval to state equivalence with the MC standard, whilemore » the intervals are <1.5% for SC DPE{sub hetero} and DPE{sub IGfluence}. Overall, these results indicate that SC and MC IMRT dose calculations which use MC-derived intensity matrices for fluence prediction do not introduce significant dose errors compared with full Monte Carlo dose computations; however, PB algorithms may result in clinically significant dose deviations.« less

Authors:
; ; ;  [1];  [2]
  1. Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205 (United States) and Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298 (United States)
  2. (United States)
Publication Date:
OSTI Identifier:
20951145
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 34; Journal Issue: 4; Other Information: DOI: 10.1118/1.2712413; (c) 2007 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; ALGORITHMS; CALIBRATION STANDARDS; COLLIMATORS; ERRORS; FORECASTING; MONTE CARLO METHOD; NECK; RADIATION DOSES; RADIOTHERAPY; SIMULATION

Citation Formats

Mihaylov, I. B., Lerma, F. A., Fatyga, M., Siebers, J. V., and Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298. Quantification of the impact of MLC modeling and tissue heterogeneities on dynamic IMRT dose calculations. United States: N. p., 2007. Web. doi:10.1118/1.2712413.
Mihaylov, I. B., Lerma, F. A., Fatyga, M., Siebers, J. V., & Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298. Quantification of the impact of MLC modeling and tissue heterogeneities on dynamic IMRT dose calculations. United States. doi:10.1118/1.2712413.
Mihaylov, I. B., Lerma, F. A., Fatyga, M., Siebers, J. V., and Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298. Sun . "Quantification of the impact of MLC modeling and tissue heterogeneities on dynamic IMRT dose calculations". United States. doi:10.1118/1.2712413.
@article{osti_20951145,
title = {Quantification of the impact of MLC modeling and tissue heterogeneities on dynamic IMRT dose calculations},
author = {Mihaylov, I. B. and Lerma, F. A. and Fatyga, M. and Siebers, J. V. and Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298},
abstractNote = {This study quantifies the dose prediction errors (DPEs) in dynamic IMRT dose calculations resulting from (a) use of an intensity matrix to estimate the multi-leaf collimator (MLC) modulated photon fluence (DPE{sub IGfluence}) instead of an explicit MLC particle transport, and (b) handling of tissue heterogeneities (DPE{sub hetero}) by superposition/convolution (SC) and pencil beam (PB) dose calculation algorithms. Monte Carlo (MC) computed doses are used as reference standards. Eighteen head-and-neck dynamic MLC IMRT treatment plans are investigated. DPEs are evaluated via comparing the dose received by 98% of the GTV (GTV D{sub 98%}), the CTV D{sub 95%}, the nodal D{sub 90%}, the cord and the brainstem D{sub 02%}, the parotid D{sub 50%}, the parotid mean dose (D{sub Mean}), and generalized equivalent uniform doses (gEUDs) for the above structures. For the MC-generated intensity grids, DPE{sub IGfluence} is within {+-}2.1% for all targets and critical structures. The SC algorithm DPE{sub hetero} is within {+-}3% for 98.3% of the indices tallied, and within {+-}3.4% for all of the tallied indices. The PB algorithm DPE{sub hetero} is within {+-}3% for 92% of the tallied indices. Statistical equivalence tests indicate that PB DPE{sub hetero} requires a {+-}3.6% interval to state equivalence with the MC standard, while the intervals are <1.5% for SC DPE{sub hetero} and DPE{sub IGfluence}. Overall, these results indicate that SC and MC IMRT dose calculations which use MC-derived intensity matrices for fluence prediction do not introduce significant dose errors compared with full Monte Carlo dose computations; however, PB algorithms may result in clinically significant dose deviations.},
doi = {10.1118/1.2712413},
journal = {Medical Physics},
number = 4,
volume = 34,
place = {United States},
year = {Sun Apr 15 00:00:00 EDT 2007},
month = {Sun Apr 15 00:00:00 EDT 2007}
}
  • Effective doses were calculated from the delivery of 6 MV, 15 MV, and 18 MV conventional and intensity-modulated radiation therapy (IMRT) prostate treatment plans. ICRP-60 tissue weighting factors were used for the calculations. Photon doses were measured in phantom for all beam energies. Neutron spectra were measured for 15 MV and 18 MV and ICRP-74 quality conversion factors used to calculate ambient dose equivalents. The ambient dose equivalents were corrected for each tissue using neutron depth dose data from the literature. The depth corrected neutron doses were then used as a measure of the neutron component of the ICRP protectionmore » quantity, organ equivalent dose. IMRT resulted in an increased photon dose to many organs. However, the IMRT treatments resulted in an overall decrease in effective dose compared to conventional radiotherapy. This decrease correlates to the ability of an intensity-modulated field to minimize dose to critical normal structures in close proximity to the treatment volume. In a comparison of the three beam energies used for the IMRT treatments, 6 MV resulted in the lowest effective dose, while 18 MV resulted in the highest effective dose. This is attributed to the large neutron contribution for 18 MV compared to no neutron contribution for 6 MV.« less
  • An algorithm is presented that allows for the control of multileaf collimation (MLC) leaves based entirely on real-time calculations of the intensity delivered over the target. The algorithm is capable of efficiently correcting generalized delivery errors without requiring the interruption of delivery (self-correcting trajectories), where a generalized delivery error represents anything that causes a discrepancy between the delivered and intended intensity profiles. The intensity actually delivered over the target is continually compared to its intended value. For each pair of leaves, these comparisons are used to guide the control of the following leaf and keep this discrepancy below a user-specifiedmore » value. To demonstrate the basic principles of the algorithm, results of corrected delivery are shown for a leading leaf positional error during dynamic-MLC (DMLC) IMRT delivery over a rigid moving target. It is then shown that, with slight modifications, the algorithm can be used to track moving targets in real time. The primary results of this article indicate that the algorithm is capable of accurately delivering DMLC IMRT over a rigid moving target whose motion is (1) completely unknown prior to delivery and (2) not faster than the maximum MLC leaf velocity over extended periods of time. These capabilities are demonstrated for clinically derived intensity profiles and actual tumor motion data, including situations when the target moves in some instances faster than the maximum admissible MLC leaf velocity. The results show that using the algorithm while calculating the delivered intensity every 50 ms will provide a good level of accuracy when delivering IMRT over a rigid moving target translating along the direction of MLC leaf travel. When the maximum velocities of the MLC leaves and target were 4 and 4.2 cm/s, respectively, the resulting error in the two intensity profiles used was 0.1{+-}3.1% and -0.5{+-}2.8% relative to the maximum of the intensity profiles. For the same target motion, the error was shown to increase rapidly as (1) the maximum MLC leaf velocity was reduced below 75% of the maximum target velocity and (2) the system response time was increased.« less
  • A hybrid dose-computation method is designed which accurately accounts for multileaf collimator (MLC)-induced intensity modulation in intensity modulated radiation therapy (IMRT) dose calculations. The method employs Monte Carlo (MC) modeling to determine the fluence modulation caused by the delivery of dynamic or multisegmental (step-and-shoot) MLC fields, and a conventional dose-computation algorithm to estimate the delivered dose to a phantom or a patient. Thus, it determines the IMRT fluence prediction accuracy achievable by analytic methods in the limit that the analytic method includes all details of the MLC leaf transport and scatter. The hybrid method is validated and benchmarked by comparisonmore » with in-phantom film dose measurements, as well as dose calculations from two in-house, and two commercial treatment planning system analytic fluence estimation methods. All computation methods utilize the same dose algorithm to calculate dose to a phantom, varying only in the estimation of the MLC modulation of the incident photon energy fluence. Gamma analysis, with respect to measured two-dimensional (2D) dose planes, is used to benchmark each algorithm's performance. The analyzed fields include static and dynamic test patterns, as well as fields from ten DMLC IMRT treatment plans (79 fields) and five SMLC treatment plans (29 fields). The test fields (fully closed MLC, picket fence, sliding windows of different size, and leaf-tip profiles) cover the extremes of MLC usage during IMRT, while the patient fields represent realistic clinical conditions. Of the methods tested, the hybrid method most accurately reproduces measurements. For the hybrid method, 79 of 79 DMLC field calculations have {gamma}{<=}1 (3%/3 mm) for more than 95% of the points (per field) while for SMLC fields, 27 of 29 pass the same criteria. The analytic energy fluence estimation methods show inferior pass rates, with 76 of 79 DMLC and 24 of 29 SMLC fields having more than 95% of the test points with {gamma}{<=}1 (3%/3 mm). Paired one-way ANOVA tests of the gamma analysis results found that the hybrid method better predicts measurements in terms of both the fraction of points with {gamma}{<=}1 and the average gamma for both 2%/2 mm and 3%/3 mm criteria. These results quantify the enhancement in accuracy in IMRT dose calculations when MC is used to model the MLC field modulation.« less
  • No abstract prepared.
  • 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 ofmore » 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.« less