Commissioning, evaluation, quality assurance and clinical application of a virtual micro MLC technique

Multileaf collimators (MLCs) are a valuable tool in modern radiation therapy, offering flexible and convenient field shaping. One disadvantage, however, is the undulation of the dose distribution at the edge shaped by the leaves due to the finite leaf width. An attempt to reduce the effect of this undulation is the objective of the commercial linear accelerator package HD270, which incorporates three-dimensional couch translation together with leaf adjustment to emulate finer leaf widths. In this paper we report on the commissioning and evaluation of this feature, together with the development of a process for quality assurance, as well as description of a clinical application of this technique. It is concluded that this technique could be applied reliably to situations currently utilizing MLC for shielding, with little added cost in treatment time, provided that a comprehensive quality assurance program is in place to monitor the performance of this complicated procedure.