title: Application of enhanced dynamic wedge to stereotactic radiotherapy.
abstract: Stereotactic radiotherapy has developed into a useful treatment technique in which conformal dose distributions can be delivered with precision and accuracy. In some cases, the position of the target volume relative to surrounding critical structures demands careful evaluation of fixed beam paths so that dose to these critical structures can be minimized. Micromultileaf collimators aid in conforming dose to the target volume but may not allow adjustment of an individual beam's intensity (intensity modulation) in an effort to achieve dose uniformity throughout the treatment volume. Enhanced dynamic wedge (EDW) is demonstrated to be a valuable tool in improving the dose distribution in stereotactic radiotherapy treatments in which these fixed, conformal fields must be used due to constraints in beam trajectories. Four cases are presented which show the potential for gain in dose uniformity with the addition of EDW. These cases represent typical applications of EDW to conformal stereotactic radiotherapy.
authors.affiliation: Department of Radiation Oncology. University of Utah School of Medicine, Salt Lake City USA.
authors.forename: D D
authors.initials: DD
authors.lastname: Leavitt
authors.forename: G
authors.initials: G
authors.lastname: Williams
authors.forename: M
authors.initials: M
authors.lastname: Tobler
authors.forename: J H
authors.initials: JH
authors.lastname: Moeller
authors.forename: F A
authors.initials: FA
authors.lastname: Gibbs
authors.forename: D K
authors.initials: DK
authors.lastname: Gaffney
mesh_terms: D006801:Humans; D008579:Meningioma / Q000532:radiotherapy; D010255:Paranasal Sinus Neoplasms / Q000532:radiotherapy; D010911:Pituitary Neoplasms / Q000532:radiotherapy; D011878:Radiotherapy / Q000379:methods*; D011879:Radiotherapy Dosage; D013238:Stereotaxic Techniques