On the dose to a moving target while employing different IMRT delivery mechanisms

• Published in: Radiotherapy and oncology Vol. 83; no. 1; pp. 49 - 56
• Main Authors: Ehler, Eric D, Nelms, Benjamin E, Tomé, Wolfgang A
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.04.2007
• Subjects: 4D IMRT; Computer Simulation; Gated IMRT delivery; Gating; Hematology, Oncology and Palliative Medicine; Humans; Intrafraction motion; Lung Neoplasms - radiotherapy; Movement; Radiotherapy Dosage; Radiotherapy, Intensity-Modulated - methods; Respiration; Temporal dose uniformity; Gated IMRT delivery; 4D IMRT; Temporal dose uniformity; Gating; Intrafraction motion
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2007.02.007

Abstract Background and purposes To compare the temporal uniformity in dose delivered to a moving target for various intensity modulation radiotherapy (IMRT) modalities: solid intensity modulator (SIM), segmented multi-leaf collimator (SMLC), and dynamic multi-leaf collimator (DMLC). Materials and methods Two separate four-dimensional computed tomography data sets were obtained. Tumor motion kernels and motion envelopes were determined from composite positions of the tumor in various phases of the breathing cycle. Treatment plans were created for an unmodulated open field, SIM, SMLC, and DMLC. The motion envelope was treated as a static target volume. A robotic apparatus equipped with a diode array simulated the tumor motion in the plane of the beam’s eye view (BEV). Radiation was delivered to the moving target over ten trials for each modality. The average coefficient of variation (CV) was determined for each beam angle. Results The CV ranged from 0.09% to 0.15%, 0.23% to 3.14%, 1.14% to 5.51%, and 3.83% to 8.25% for the unmodulated open field, SIM, SMLC, and DMLC modalities, respectively. With gating, the CV was 0.23% to 2.31%, 0.31% to 2.97%, and 0.7% to 4.67% for SIM, SMLC, and DMLC, respectively. Conclusion SIM consistently provided the most temporally uniform dose to the moving target while DMLC provided the least. The SMLC and DMLC CV improved with gated delivery.