Assessment of MLC tracking performance during hypofractionated prostate radiotherapy using real-time dose reconstruction
Author(s)
Type
Journal Article
Abstract
By adapting to the actual patient anatomy during treatment, tracked multi-leaf collimator (MLC) treatment deliveries offer an opportunity for margin reduction and healthy tissue sparing. This is assumed to be especially relevant for hypofractionated protocols in which intrafractional motion does not easily average out. In order to confidently deliver tracked treatments with potentially reduced margins, it is necessary to monitor not only the patient anatomy but also the actually delivered dose during irradiation. In this study, we present a novel real-time online dose reconstruction tool which calculates actually delivered dose based on pre-calculated dose influence data in less than 10 ms at a rate of 25 Hz. Using this tool we investigate the impact of clinical target volume (CTV) to planning target volume (PTV) margins on CTV coverage and organ-at-risk dose. On our research linear accelerator, a set of four different CTV-to-PTV margins were tested for three patient cases subject to four different motion conditions. Based on this data, we can conclude that tracking eliminates dose cold spots which can occur in the CTV during conventional deliveries even for the smallest CTV-to-PTV margin of 1 mm. Changes of organ-at-risk dose do occur frequently during MLC tracking and are not negligible in some cases. Intrafractional dose reconstruction is expected to become an important element in any attempt of re-planning the treatment plan during the delivery based on the observed anatomy of the day.
Date Issued
2016-02-21
Date Acceptance
2015-12-16
Citation
PHYSICS IN MEDICINE AND BIOLOGY, 2016, 61 (4), pp.1546-1562
ISSN
0031-9155
Publisher
IOP PUBLISHING LTD
Start Page
1546
End Page
1562
Journal / Book Title
PHYSICS IN MEDICINE AND BIOLOGY
Volume
61
Issue
4
Copyright Statement
© 2016 Institute of Physics and Engineering in Medicine. Original content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence (http://creativecommons.org/licenses/by/3.0). Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000370452500010&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Technology
Life Sciences & Biomedicine
Engineering, Biomedical
Radiology, Nuclear Medicine & Medical Imaging
Engineering
MLC tracking
dose reconstruction
dose accumulation
prostate cancer
hypofractionation
INTENSITY-MODULATED RADIOTHERAPY
SIEMENS 160 MLC
MULTILEAF COLLIMATOR
RADIATION-THERAPY
ORGAN MOTION
ARC THERAPY
CANCER
DELIVERY
SYSTEM
ONLINE
Publication Status
Published
Date Publish Online
2016-01-27