Use of a multileaf collimator to increase the field width achievable with a dynamic wedge

A method is proposed for generating dynamic wedges spanning the entire field width, defined as the collimator opening in the wedged direction, without changes to existing hardware. The technique approximates the fluence pattern of a dynamic wedge by sequentially closing the leaves of a 120-leaf multileaf collimator (MLC). Closure times for the individual leaves were derived by extending the segmented treatment table of the dynamic wedge provided by the manufacturer of the linear accelerator. Using film dosimetry, beam properties of MLC wedges were compared to those of conventional dynamic and mechanical wedges. Profiles and isodose lines of the MLC wedge were almost identical to those of the dynamic wedge, and differed only modestly from the mechanical counterparts. Dose inhomogeneity due to the individually closing leaves was not significant. The high-dose region at the junction between opposing MLC leaves, unavoidable when the field length (i.e., the opening of the collimator in the nonwedged direction) exceeds the maximum leaf extension of 15 cm, was feathered by moving leaf pairs after their closure for the remainder of the irradiation time. Combining the MLC wedge with a regular dynamic wedge to reduce the line of high dose under the leaf junction is under consideration.