Abstract
Purpose:
The Elekta beam modulator linac employs a 4‐mm micro multileaf collimator (MLC) backed by a fixed jaw. Out‐of‐field dose discrepancies between treatment planning system (TPS) calculations and output water phantom measurements are caused by the 1‐mm leaf gap required for all moving MLCs in a VMAT arc. In this study, MLC parameters are optimized to improve TPS out‐of‐field dose approximations.
Methods:
Static 2.4 cm square fields were created with a 1‐mm leaf gap for MLCs that would normally park behind the jaw. Doses in the open field and leaf gap were measured with an A16 micro ion chamber and EDR2 film for comparison with corresponding point doses in the Pinnacle TPS. The MLC offset table and tip radius were adjusted until TPS point doses agreed with photon measurements. Improvements to the beam models were tested using static arcs consisting of square fields ranging from 1.6 to 14.0 cm, with 45° collimator rotation, and 1‐mm leaf gap to replicate VMAT conditions. Gamma values for the 3‐mm distance, 3% dose difference criteria were evaluated using standard QA procedures with a cylindrical detector array.
Results:
The best agreement in point doses within the leaf gap and open field was achieved by offsetting the default rounded leaf end table by 0.1 cm and adjusting the leaf tip radius to 13 cm. Improvements in TPS models for 6 and 10 MV photon beams were more significant for smaller field sizes 3.6 cm or less where the initial gamma factors progressively increased as field size decreased, i.e. for a 1.6cm field size, the Gamma increased from 56.1% to 98.8%.
Conclusion:
The MLC optimization techniques developed will achieve greater dosimetric accuracy in small field VMAT treatment plans for fixed jaw linear accelerators. Accurate predictions of dose to organs at risk may reduce adverse effects of radiotherapy.
