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Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

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Published on: June 7, 2015

Dynamic MLC leaf sequencing for integrated linear accelerator control systems.

Richard A Popple¹, Ivan A Brezovich

¹Department of Radiation Oncology, The University of Alabama, Birmingham, AL, USA.

Medical Physics

|November 4, 2011

Summary

This summary is machine-generated.

New TrueBeam™ linear accelerators maintain accurate radiation delivery by adjusting dose rate, preventing leaf position errors common in older systems. This ensures precise treatment, unlike conventional controllers that can cause significant dosimetric deviations.

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Area of Science:

Medical Physics
Radiation Oncology

Background:

Accurate synchronization of dynamic multileaf collimator (DMLC) leaf positions with monitor unit (MU) delivery is crucial for intensity-modulated radiation therapy.
Conventional MLC controllers (e.g., Varian C3) can introduce dosimetric errors if planned leaf velocities exceed system capabilities, leading to beam holds.

Purpose of the Study:

To evaluate the performance of the TrueBeam™ linear accelerator, which integrates MLC control with prospective dose rate modulation.
To assess if TrueBeam™ can maintain synchronization between leaf position and MU delivery by adjusting dose rate when high leaf velocities are planned.

Main Methods:

DMLC leaf trajectories were tested on TrueBeam™ and a conventional controller using phantom measurements (ionization chamber, film).
Three sets of trajectories were used: single leaf bank closing at various speeds, and two clinical fluence maps (patient plans) delivered at different planned dose rates.

Main Results:

TrueBeam™ successfully reduced dose rate to maintain leaf velocity within limits, achieving <3% deviation for planned trajectories.
Conventional controller showed up to 19% deviation due to leaves falling behind and beam holds.
On TrueBeam™, reducing planned dose rate decreased dose in low-fluence regions (15-24%) and increased delivery time, with no significant impact on high-dose regions or target coverage.

Conclusions:

Integrated MLC control systems should adapt leaf sequencing algorithms to de-emphasize maximum leaf velocity constraints.
TrueBeam™'s dose rate modulation effectively preserves dosimetric accuracy during DMLC delivery.