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Validation of a new control system for Elekta accelerators facilitating continuously variable dose rate.

Anders Bertelsen¹, Ebbe L Lorenzen, Carsten Brink

¹Institute of Clinical Research, University of Southern Denmark, Odense DK-5000, Denmark. anders.bertelsen@ouh.regionsyddanmark.dk

Medical Physics

|September 21, 2011

Summary

The new Integrity system for Elekta accelerators offers smoother Volumetric Modulated Arc Therapy (VMAT) delivery and significantly reduces treatment time by 35% using continuously variable dose rate (CVDR) without compromising dosimetric accuracy.

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Area of Science:

Medical Physics
Radiation Oncology

Background:

Current Elekta accelerators use Desktop 7.01 (D7) with binned variable dose rate (BVDR) for Volumetric Modulated Arc Therapy (VMAT).
The upcoming Integrity system supports both BVDR and continuously variable dose rate (CVDR).
CVDR may reduce treatment time but potentially impact dosimetric accuracy due to faster accelerator component movement.

Purpose of the Study:

To investigate differences in accelerator control, treatment efficiency, and dosimetric accuracy between D7 and Integrity systems for VMAT.
To evaluate the impact of CVDR versus BVDR on VMAT delivery using the Integrity system.

Main Methods:

Single parameter tests assessed accelerator component control (jaws, MLCs, gantry) and dose rate feedback at 4 Hz.
Clinical VMAT plans (n=15) were tested on Integrity, measuring treatment time and comparing calculated vs. measured doses (DELTA4) using gamma evaluation.
Positional errors and dose rates were recorded during controlled movements.

Main Results:

Integrity demonstrated improved gantry-to-dose rate feedback over D7, with minor trade-offs in MLC control; jaw control was similar.
VMAT delivery was smoother with Integrity (CVDR or BVDR) compared to D7, featuring less abrupt motion.
Gamma evaluation (2%/2mm) showed >97.8% pass rates for D7, Integrity BVDR, and Integrity CVDR.
Integrity with CVDR significantly reduced average treatment time by 35% (55 ± 13 s) without compromising dosimetric accuracy.

Conclusions:

The Integrity system offers smoother VMAT delivery compared to D7 due to improved feedback loops and CVDR.
CVDR in the Integrity system significantly reduces VMAT treatment time by an average of 35%.
This reduction in treatment time is achieved without any compromise in dosimetric accuracy.