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• W4231853619 abstract "Stereotactic radiosurgery based on dynamic conformal arcs and intensity-modulated beams using multileaf collimator (MLC) has been widely used in clinical practice. However, knowledge about dosimetric differences between different leaf-width MLCs is limited. The purpose of this study is to investigate the quantitative dosimetric differences between three different MLC leaf-widths for the radiosurgical treatment planning based on dynamic conformal arcs and intensity-modulated beams. Thirty-four cranial cases treated with dynamic conformal arcs and 24 intracranial and extracranial cases treated with intensity-modulated radiosurgery /radiotherapy (IMRS/IMRT) were investigated. A micro MLC with minimal of 3 mm leaf width in a Novalis Radiosurgery Unit, a MLC with 5 mm leaf-width in a Varian CL21EX, and a MLC with 10 mm leaf width in a Varian CL2100C/D accelerator were used for this study. Beam data were acquired and commissioned for the same planning system. For each clinical case, either intracranial or extracranial, three treatment plans were generated with different leaf-width MLCs but with exactly the same planning parameters. The conformity index as well as its ratio between two plans, percentage target coverage at prescription dose, and dose-volume histogram (DVH) for planning target volume (PTV) and organs-at-risk (OAR) were calculated and used for dosimetric analysis and comparison for different treatment techniques and treatment sites. For the plans generated using dynamic conformal arcs technique, there were statistically significant differences of the conformity indices among plans generated with different leaf widths. The ratio of the conformity indices between two different MLCs was dependent on the target volume. The average conformity index ratios between the 5 mm MLC and the 3 mm MLC were 1.37 ± 0.09, 1.12 ± 0.04, 1.08 ± 0.02 and 1.04 ± 0.01 respectively for patients with the target volume (V) in groups: (1) V < 1 CC, (2) 1 CC < V < 8 CC, (3) 8 CC < V < 27 CC, and (4) V > 27 CC. The average conformity index ratios between the 10 mm MLC and the 3 mm MLC were 2.00 ± 0.33, 1.45 ± 0.09, 1.28 ± 0.09 and 1.18 ± 0.05 respectively for patients in the 4 volume groups. No statistically significant difference was found for the target coverage among different MLCs. For the plans generated using the IMRS/IMRT technique with OAR in the proximity of the target, there was no significant difference of conformity indexes between two different MLCs. The average conformity index ratio and the target coverage ratio between the 5 mm MLC and the 3 mm MLC were 1.01 ± 0.05 and 1.00 ± 0.02 respectively. The average conformity index ratio and the target coverage ratio between the 10 mm MLC and the 3 mm MLC were 1.04 ± 0.07 and 0.97 ± 0.02 respectively. The difference of DVH parameters between different MLCs tended to be disease-site related. For dynamic conformal arcs technique, there are significant dosimetric differences of the conformity indices between different MLCs. These differences decrease as target volume increases. However, its clinical impact needs further investigation. For IMRS/IMRT technique, there was no significant difference of conformity indexes between different MLCs. However, the narrower leaf-width MLC shows slight advantage over wider leaf-width MLC in terms of sparing small OARs" @default.
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• W4231853619 date "2004-09-01" @default.
• W4231853619 modified "2023-09-30" @default.
• W4231853619 title "Quantitative dosimetric study using different leaf-width multileaf collimators for treatment planning of dynamic conformal and intensity-modulated radiosurgery" @default.
• W4231853619 doi "https://doi.org/10.1016/s0360-3016(04)01967-4" @default.
• W4231853619 hasPublicationYear "2004" @default.
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