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• W2328589644 abstract "Purpose/Objective(s)Respiratory motion during radiation therapy creates dosimetric discrepancies both in target and organ at risk (OAR). This effect may even get magnified in IMRT treatment due to MLC motion which is not synchronized with respiratory motion. A system to study the interplay is developed which is presented in this study.Materials/MethodsSeven IMRT plans, containing 63 fields (chest wall 46 fields and lung 17 fields) were investigated. Measurements were performed on a linear accelerator with multi frame mode (20 frame/sec) at 10 cm depth with gantry angle 0 degrees. Each frame data was interpolated to 1 mm grid by bilinear method and shifted the distance calculated according to respiratory motion using in-house software. The motion was modeled as sine function, varying the combination of peak to peak motion (0.5, 1.0, 1.5 and 2.0 cm) and breathing cycle of 1, 2, 3 and 4 sec The movement of MLC was parallel to the direction of motion for chest wall cases and perpendicular for lung cases. Motion data was calculated by accumulating all frame data. Interplay effect was evaluated by comparing motion data with static data within CTV projected to the detector plane using gamma analysis with 3 mm/3% criteria. To decrease the effect of starting points in the respiration cycle, the pass rate was averaged with 8 evenly divided initial phase. To assess multi fraction case, dose distribution was averaged 20 times with changing initial phase using random number for combination of 1.5 cm peak to peak motion, and 1 and 3 sec cycle. The paired t-test was used for statistical analysis.ResultsThe pass rates for 0.5, 1.0, 1.5 and 2.0 cm peak to peak motion were 99.7 ± 0.6, 92.6 ± 6.0, 79.2 ± 9.0 and 64.7 ± 10.0%, respectively. For 1.0, 1.5 and 2.0 cm peak to peak motion cases, the pass rate for 1 sec cycle was higher than other cycles with same peak to peak motion by an average of 3.9% (p < 0.01). For multi fraction case, the pass rates were 88.5 ± 6.9 and 88.3 ± 6.9% for 1 and 3 sec cycle, respectively. The difference of pass rate between both cycles is 0.2 ± 0.9% and insignificant. The difference of pass rate between 1 and 20 fraction for 1 sec cycle shows linear relationship with number of fields divided MU (R = 0.82).ConclusionsThe interplay effect is directly related to number of treatment fraction in step and shoot IMRT. For a single fraction case, pass rate decreased, as peak of motion increase. For 20 fraction case, the pass rate increased relative to 1 fraction, and there is no difference of pass rate between 1 and 3 sec cycle. In the case of short cycle, the lower the MU per segment is, the bigger the reduction of interplay effect by multi fraction is. Purpose/Objective(s)Respiratory motion during radiation therapy creates dosimetric discrepancies both in target and organ at risk (OAR). This effect may even get magnified in IMRT treatment due to MLC motion which is not synchronized with respiratory motion. A system to study the interplay is developed which is presented in this study. Respiratory motion during radiation therapy creates dosimetric discrepancies both in target and organ at risk (OAR). This effect may even get magnified in IMRT treatment due to MLC motion which is not synchronized with respiratory motion. A system to study the interplay is developed which is presented in this study. Materials/MethodsSeven IMRT plans, containing 63 fields (chest wall 46 fields and lung 17 fields) were investigated. Measurements were performed on a linear accelerator with multi frame mode (20 frame/sec) at 10 cm depth with gantry angle 0 degrees. Each frame data was interpolated to 1 mm grid by bilinear method and shifted the distance calculated according to respiratory motion using in-house software. The motion was modeled as sine function, varying the combination of peak to peak motion (0.5, 1.0, 1.5 and 2.0 cm) and breathing cycle of 1, 2, 3 and 4 sec The movement of MLC was parallel to the direction of motion for chest wall cases and perpendicular for lung cases. Motion data was calculated by accumulating all frame data. Interplay effect was evaluated by comparing motion data with static data within CTV projected to the detector plane using gamma analysis with 3 mm/3% criteria. To decrease the effect of starting points in the respiration cycle, the pass rate was averaged with 8 evenly divided initial phase. To assess multi fraction case, dose distribution was averaged 20 times with changing initial phase using random number for combination of 1.5 cm peak to peak motion, and 1 and 3 sec cycle. The paired t-test was used for statistical analysis. Seven IMRT plans, containing 63 fields (chest wall 46 fields and lung 17 fields) were investigated. Measurements were performed on a linear accelerator with multi frame mode (20 frame/sec) at 10 cm depth with gantry angle 0 degrees. Each frame data was interpolated to 1 mm grid by bilinear method and shifted the distance calculated according to respiratory motion using in-house software. The motion was modeled as sine function, varying the combination of peak to peak motion (0.5, 1.0, 1.5 and 2.0 cm) and breathing cycle of 1, 2, 3 and 4 sec The movement of MLC was parallel to the direction of motion for chest wall cases and perpendicular for lung cases. Motion data was calculated by accumulating all frame data. Interplay effect was evaluated by comparing motion data with static data within CTV projected to the detector plane using gamma analysis with 3 mm/3% criteria. To decrease the effect of starting points in the respiration cycle, the pass rate was averaged with 8 evenly divided initial phase. To assess multi fraction case, dose distribution was averaged 20 times with changing initial phase using random number for combination of 1.5 cm peak to peak motion, and 1 and 3 sec cycle. The paired t-test was used for statistical analysis. ResultsThe pass rates for 0.5, 1.0, 1.5 and 2.0 cm peak to peak motion were 99.7 ± 0.6, 92.6 ± 6.0, 79.2 ± 9.0 and 64.7 ± 10.0%, respectively. For 1.0, 1.5 and 2.0 cm peak to peak motion cases, the pass rate for 1 sec cycle was higher than other cycles with same peak to peak motion by an average of 3.9% (p < 0.01). For multi fraction case, the pass rates were 88.5 ± 6.9 and 88.3 ± 6.9% for 1 and 3 sec cycle, respectively. The difference of pass rate between both cycles is 0.2 ± 0.9% and insignificant. The difference of pass rate between 1 and 20 fraction for 1 sec cycle shows linear relationship with number of fields divided MU (R = 0.82). The pass rates for 0.5, 1.0, 1.5 and 2.0 cm peak to peak motion were 99.7 ± 0.6, 92.6 ± 6.0, 79.2 ± 9.0 and 64.7 ± 10.0%, respectively. For 1.0, 1.5 and 2.0 cm peak to peak motion cases, the pass rate for 1 sec cycle was higher than other cycles with same peak to peak motion by an average of 3.9% (p < 0.01). For multi fraction case, the pass rates were 88.5 ± 6.9 and 88.3 ± 6.9% for 1 and 3 sec cycle, respectively. The difference of pass rate between both cycles is 0.2 ± 0.9% and insignificant. The difference of pass rate between 1 and 20 fraction for 1 sec cycle shows linear relationship with number of fields divided MU (R = 0.82). ConclusionsThe interplay effect is directly related to number of treatment fraction in step and shoot IMRT. For a single fraction case, pass rate decreased, as peak of motion increase. For 20 fraction case, the pass rate increased relative to 1 fraction, and there is no difference of pass rate between 1 and 3 sec cycle. In the case of short cycle, the lower the MU per segment is, the bigger the reduction of interplay effect by multi fraction is. The interplay effect is directly related to number of treatment fraction in step and shoot IMRT. For a single fraction case, pass rate decreased, as peak of motion increase. For 20 fraction case, the pass rate increased relative to 1 fraction, and there is no difference of pass rate between 1 and 3 sec cycle. In the case of short cycle, the lower the MU per segment is, the bigger the reduction of interplay effect by multi fraction is." @default.
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• W2328589644 date "2013-10-01" @default.
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• W2328589644 title "Impact of Motion Interplay Effect on Step and Shoot IMRT" @default.
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