title: Consequences of leaf calibration errors on IMRT delivery.
abstract: IMRT treatments using multi-leaf collimators may involve a large number of segments in order to spare the organs at risk. When a large proportion of these segments are small, leaf positioning errors may become relevant and have therapeutic consequences. The performance of four head and neck IMRT treatments under eight different cases of leaf positioning errors has been studied. Systematic leaf pair offset errors in the range of +/-2.0 mm were introduced, thus modifying the segment sizes of the original IMRT plans. Thirty-six films were irradiated with the original and modified segments. The dose difference and the gamma index (with 2%/2 mm criteria) were used for evaluating the discrepancies between the irradiated films. The median dose differences were linearly related to the simulated leaf pair errors. In the worst case, a 2.0 mm error generated a median dose difference of 1.5%. Following the gamma analysis, two out of the 32 modified plans were not acceptable. In conclusion, small systematic leaf bank positioning errors have a measurable impact on the delivered dose and may have consequences for the therapeutic outcome of IMRT.
authors.affiliation: Department of Medical Physics, The Norwegian Radium Hospital, Montebello, N-0310 Oslo, Norway, and Department of Radiotherapy, University Medical Center Utrecht, The Netherlands. maria.sastre@radiumhospitalet.no
authors.forename: M
authors.initials: M
authors.lastname: Sastre-Padro
authors.forename: J
authors.initials: J
authors.lastname: Welleweerd
authors.forename: E
authors.initials: E
authors.lastname: Malinen
authors.forename: K
authors.initials: K
authors.lastname: Eilertsen
authors.forename: D R
authors.initials: DR
authors.lastname: Olsen
authors.forename: U A
authors.initials: UA
authors.lastname: van der Heide
mesh_terms: D016477:Artifacts; D002138:Calibration; D019583:Dose Fractionation, Radiation; D005373:Film Dosimetry / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D010315:Particle Accelerators; D019047:Phantoms, Imaging; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012062:Relative Biological Effectiveness; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity