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Junctioning longitudinally adjacent PTVs with Helical TomoTherapy.

Lourdes M Garcia¹, Lee H Gerig, Peter Raaphorst

¹Department of Physics, Carleton University, Ottawa, ON K1S5B6, Canada. logarcia@ottawahospital.on.ca

Journal of Applied Clinical Medical Physics

|July 2, 2010

Summary

Treating adjacent planning target volumes (PTVs) with Helical TomoTherapy (HT) requires careful parameter selection. Optimizing field width and using sub-PTVs improves dose uniformity in the junction region for better clinical outcomes.

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Area of Science:

Medical Physics
Radiation Oncology

Background:

Helical TomoTherapy (HT) allows for precise radiation delivery.
Treating longitudinally adjacent planning target volumes (PTVs) presents challenges in dose distribution, particularly in the junction region.

Purpose of the Study:

To investigate parameters influencing dose distribution when treating longitudinally adjacent PTVs with HT.
To evaluate methods for achieving optimal dose homogeneity in the junction area between adjacent PTVs.

Main Methods:

Calculated in-phantom dose distributions for various on- and off-axis cylindrical PTVs using different HT field widths and pitches.
Verified dose distributions with ion chamber and film measurements.
Analyzed 3D dose distributions in the junction region of two adjacent PTVs.

Main Results:

Equal field widths provided the best junction uniformity; larger fields enhanced intra-PTV dose homogeneity.
Using different field widths created significant dose inhomogeneity, improved by dividing the smaller field's PTV into feathered sub-PTVs.
The sub-PTV technique achieved dose homogeneity comparable to equal field widths, with 95% PTV coverage and dose variations from -19% to +13%.

Conclusions:

Junctioning adjacent PTVs with HT is feasible.
Treating adjacent PTVs of different widths is challenging but manageable by segmenting the PTV into feathered sub-PTVs to broaden the junction region and improve dose uniformity.