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Real-time auto-adaptive margin generation for MLC-tracked radiotherapy.

M Glitzner1, M F Fast, B Denis de Senneville

  • 1Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

Physics in Medicine and Biology
|December 20, 2016
PubMed
Summary

This study introduces a novel method for real-time margin adjustment in radiotherapy, compensating for multileaf collimator (MLC) tracking errors during treatment delivery to ensure target coverage.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Image-Guided Therapy

Background:

  • Motion tracking in radiotherapy is crucial for abdominal and thoracic treatments.
  • Real-time adjustment of multileaf collimator (MLC) position is limited by system delays and electromechanical complexities, leading to residual positioning errors.
  • These errors can cause underdosage and compromise target coverage during treatment delivery.

Purpose of the Study:

  • To develop and validate a patient-specific, on-line method for calculating and applying margins to compensate for MLC tracking errors during radiotherapy.
  • To statistically characterize geometric errors between intended and actual machine positions.
  • To ensure adequate target dose coverage by adapting margins dynamically during treatment.

Main Methods:

  • Utilized kernel density estimators to statistically derive the geometric error distribution between intended and actual MLC positions.
  • Developed an on-line margin calculation based on a selected coverage parameter to quantify acceptable underdosage.
  • Applied the calculated margin to enlarge the treatment segment, accommodating positioning uncertainties.
  • Validated the approach through an on-line tracking experiment with two test cases.

Main Results:

  • The proposed method successfully recovered underdosages in test cases, increasing dose in underdosed areas.
  • A dose model accurately predicted dose loss due to tracking errors and informed margin requirements.
  • The system implementation achieved a running time of 23 ms, compatible with real-time MLC tracking requirements.
  • Demonstrated auto-adaptivity to machine and patient-specific characteristics.

Conclusions:

  • The developed technique provides a statistically robust and auto-adaptive method for on-line margin adjustment in radiotherapy.
  • This approach effectively compensates for underdosages caused by MLC tracking errors, enhancing treatment precision.
  • The method is a generic and intuitive solution for improving target coverage in motion-managed radiotherapy.