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Title: The dosimetric impact of control point spacing for sliding gap MLC fields
Authors: Zwan, Benjamin ;Hindmarsh, Jonathan ;Seymour, Erin;Kandasamy, Kankean;Sloan, Kirbie;David, Rajesakar;Lee, Christopher 
Affliation: Central Coast Local Health District
Gosford Hospital
Issue Date: Nov-2016
Source: 17(6):204-216
Journal title: Journal of Applied Clinical Medical Physics
Department: Central Coast Cancer Centre
Abstract: Dynamic sliding gap multileaf collimator (MLC) fields are used to model MLC properties within the treatment planning system (TPS) for dynamic treatments. One of the key MLC properties in the Eclipse TPS is the dosimetric leaf gap (DLG) and precise determination of this parameter is paramount to ensuring accurate dose delivery. In this investigation, we report on how the spacing between control points (CPs) for sliding gap fields impacts the dose delivery, MLC positioning accuracy, and measurement of the DLG. The central axis dose was measured for sliding gap MLC fields with gap widths ranging from 2 to 40 mm. It was found that for deliveries containing two CPs, the central axis dose was underestimated by the TPS for all gap widths, with the maximum difference being 8% for a 2 mm gap field. For the same sliding gap fields containing 50 CPs, the measured dose was always within ±2% of the TPS dose. By directly measuring the MLC trajectories we show that this dose difference is due to a systematic MLC gap error for fields containing two CPs, and that the cause of this error is due to the leaf position offset table which is incorrectly applied when the spacing between CPs is too large. This MLC gap error resulted in an increase in the measured DLG of 0.5 mm for both 6 MV and 10 MV, when using fields with 2 CPs compared to 50 CPs. Furthermore, this change in DLG was shown to decrease the mean TPS-calculated dose to the target volume by 2.6% for a clinical IMRT test plan. This work has shown that systematic MLC positioning errors occur for sliding gap MLC fields containing two CPs and that using these fields to model critical TPS parameters, such as the DLG, may result in clinically significant systematic dose calculation errors during subsequent dynamic MLC treatments. PACS number(s): 87.56.nk.
DOI: 10.1120/jacmp.v17i6.6345
ISSN: 1526-9914
Publicaton type: Journal Article
Keywords: Radiotherapy
Appears in Collections:Health Service Research

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