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Clinical implementation of dynamic multileaf collimation for compensated bladder treatments
G J Budgell1, J H Mott, J P Logue
1North Western Medical Physics, Christie Hospital NHS Trust, Wilmslow Road, Withington, M20 4BX, Manchester, UK.
Summary
Dynamic multileaf collimation (DMLC) offers improved dose homogeneity for bladder cancer radiotherapy. This intensity-modulated radiotherapy technique was successfully implemented and tested in a clinical setting.
Area of Science:
- Radiation Oncology
- Medical Physics
Background:
- Intensity-modulated radiotherapy (IMRT) is an advanced cancer treatment technique.
- Dynamic multileaf collimation (DMLC) is a method for delivering IMRT.
- Bladder cancer treatment provides a suitable model for testing new radiotherapy techniques.
Purpose of the Study:
- To describe the clinical implementation of dynamic multileaf collimation (DMLC).
- To evaluate DMLC for custom compensated four-field treatments of bladder carcinoma.
- To assess DMLC as a test site for intensity-modulated radiotherapy introduction.
Main Methods:
- Intensity modulations calculated from CT data, including scatter and primary radiation.
- Conversion of modulations to multileaf collimator (MLC) settings for dynamic delivery on a linear accelerator.
- Dose calculation accounting for dynamic leaf/jaw motion and transmission; pre-treatment verification with phantom measurements; in vivo diode and electronic portal imaging for treatment verification.
Main Results:
- Seven patients treated with DMLC.
- Improved dose homogeneity within the target volume.
- Reduced high-dose areas and compensation for scatter loss at beam edges.
- Typical total treatment time of 20 minutes.
Conclusions:
- Compensated bladder cancer treatments effectively tested DMLC implementation.
- DMLC is a viable technique for intensity-modulated radiotherapy in a clinical setting.
- The technique demonstrated efficiency in a busy clinical environment.