title: The MLC tongue-and-groove effect on IMRT dose distributions.
abstract: We have investigated the tongue-and-groove effect on the IMRT dose distributions for a Varian MLC. We have compared the dose distributions calculated using the intensity maps with and without the tongue-and-groove effect. Our results showed that, for one intensity-modulated treatment field, the maximum tongue-and-groove effect could be up to 10% of the maximum dose in the dose distributions. For an IMRT treatment with multiple gantry angles (> or = 5), the difference between the dose distributions with and without the tongue-and-groove effect was hardly visible, less than 1.6% for the two typical clinical cases studied. After considering the patient setup errors, the dose distributions were smoothed with reduced and insignificant differences between plans with and without the tongue-and-groove effect. Therefore, for a multiple-field IMRT plan (> or = 5), the tongue-and-groove effect on the IMRT dose distributions will be generally clinically insignificant due to the smearing effect of individual fields. The tongue-and-groove effect on an IMRT plan with small number of fields (< 5) will vary depending on the number of fields in a plan (coplanar or non-coplanar), the MLC leaf sequences and the patient setup uncertainty, and may be significant (> 5% of maximum dose) in some cases, especially when the patient setup uncertainty is small (< or = 2 mm).
authors.affiliation: Department of Radiation Oncology, Stanford University School of Medicine, CA 94305, USA. jun@reyes.stanford.edu
authors.forename: J
authors.initials: J
authors.lastname: Deng
authors.forename: T
authors.initials: T
authors.lastname: Pawlicki
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: S B
authors.initials: SB
authors.lastname: Jiang
authors.forename: C M
authors.initials: CM
authors.lastname: Ma
mesh_terms: D001859:Bone Neoplasms / Q000532:radiotherapy; D004583:Electrons; D006801:Humans; D008297:Male; D009010:Monte Carlo Method; D017785:Photons; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D011874:Radiometry / Q000379:methods; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal / Q000295:instrumentation* / Q000379:methods*