Treatment planning for volumetric modulated arc therapy

Journal Article · Sun Nov 15 04:00:00 EST 2009 · Medical Physics

DOI:https://doi.org/10.1118/1.3240488· OSTI ID:22102146

Bedford, James L. ^[1]

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1. Joint Department of Physics, Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT (United Kingdom)

Purpose: Volumetric modulated arc therapy (VMAT) is a specific type of intensity-modulated radiation therapy (IMRT) in which the gantry speed, multileaf collimator (MLC) leaf position, and dose rate vary continuously during delivery. A treatment planning system for VMAT is presented. Methods: Arc control points are created uniformly throughout one or more arcs. An iterative least-squares algorithm is used to generate a fluence profile at every control point. The control points are then grouped and all of the control points in a given group are used to approximate the fluence profiles. A direct-aperture optimization is then used to improve the solution, taking into account the allowed range of leaf motion of the MLC. Dose is calculated using a fast convolution algorithm and the motion between control points is approximated by 100 interpolated dose calculation points. The method has been applied to five cases, consisting of lung, rectum, prostate and seminal vesicles, prostate and pelvic lymph nodes, and head and neck. The resulting plans have been compared with segmental (step-and-shoot) IMRT and delivered and verified on an Elekta Synergy to ensure practicality. Results: For the lung, prostate and seminal vesicles, and rectum cases, VMAT provides a plan of similar quality to segmental IMRT but with faster delivery by up to a factor of 4. For the prostate and pelvic nodes and head-and-neck cases, the critical structure doses are reduced with VMAT, both of these cases having a longer delivery time than IMRT. The plans in general verify successfully, although the agreement between planned and measured doses is not very close for the more complex cases, particularly the head-and-neck case. Conclusions: Depending upon the emphasis in the treatment planning, VMAT provides treatment plans which are higher in quality and/or faster to deliver than IMRT. The scheme described has been successfully introduced into clinical use.

• OSTI ID: 22102146
• Journal Information: Medical Physics, Journal Name: Medical Physics Journal Issue: 11 Vol. 36; ISSN 0094-2405; ISSN MPHYA6
• Country of Publication: United States
• Language: English

Related Subjects

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND TECHNOLOGY
62 RADIOLOGY AND NUCLEAR MEDICINE
ALGORITHMS
HEAD
ITERATIVE METHODS
LEAST SQUARE FIT
LINEAR ACCELERATORS
LUNGS
NECK
OPTIMIZATION
PROSTATE
RADIATION DOSES
RADIOTHERAPY
RECTUM