title: Spatial variation of dosimetric leaf gap and its impact on dose delivery.
abstract: OBJECTIVE
  During dose calculation, the Eclipse treatment planning system (TPS) retracts the multileaf collimator (MLC) leaf positions by half of the dosimetric leaf gap (DLG) value (measured at central axis) for all leaf positions in a dynamic MLC plan to accurately model the rounded leaf ends. The aim of this study is to map the variation of DLG along the travel path of each MLC leaf pair and quantify how this variation impacts delivered dose.
  
  
  METHODS
  6 MV DLG values were measured for all MLC leaf pairs in increments of 1.0 cm (from the line intersecting the CAX and perpendicular to MLC motion) to 13.0 cm off axis distance at dmax. The measurements were performed on two Varian linear accelerators, both employing the Millennium 120-leaf MLCs. The measurements were performed at several locations in the beam with both a Sun Nuclear MapCHECK device and a PTW pinpoint ion chamber.
  
  
  RESULTS
  The measured DLGs for the middle 40 MLC leaf pairs (each 0.5 cm width) at positions along a line through the CAX and perpendicular to MLC leaf travel direction were very similar, varying maximally by only 0.2 mm. The outer 20 MLC leaf pairs (each 1.0 cm width) have much lower DLG values, about 0.3-0.5 mm lower than the central MLC leaf pair, at their respective central line position. Overall, the mean and the maximum variation between the 0.5 cm width leaves and the 1.0 cm width leaf pairs are 0.32 and 0.65 mm, respectively.
  
  
  CONCLUSIONS
  The spatial variation in DLG is caused by the variation of intraleaf transmission through MLC leaves. Fluences centered on the CAX would not be affected since DLG does not vary; but any fluences residing significantly off axis with narrow sweeping leaves may exhibit significant dose differences. This is due to the fact that there are differences in DLG between the true DLG exhibited by the 1.0 cm width outer leaves and the constant DLG value utilized by the TPS for dose calculation. Since there are large differences in DLG between the 0.5 cm width leaf pairs and 1.0 cm width leaf pairs, there is a need to correct the TPS plans, especially those with high modulation (narrow dynamic MLC gap), with 2D variation of DLG.
authors.affiliation: Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, New York 14263 and Department of Cell Stress Biology, Roswell Park Cancer Institute, Buffalo, New York 14263.
authors.forename: Lalith K
authors.initials: LK
authors.lastname: Kumaraswamy
authors.affiliation: Department of Radiation Medicine, RadAmerica, LLC-MedStar Health, Baltimore, Maryland 21237.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Schmitt
authors.affiliation: Department of Radiation Oncology, Northside Hospital, Atlanta, Georgia 30342.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Bailey
authors.affiliation: Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, New York 14263 and Department of Physiology and Biophysics, State University of New York at Buffalo, Buffalo, New York 14260.
authors.forename: Zheng Zheng
authors.initials: ZZ
authors.lastname: Xu
authors.affiliation: Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, New York 14263; Department of Cell Stress Biology, Roswell Park Cancer Institute, Buffalo, New York 14263; and Department of Physiology and Biophysics, State University of New York at Buffalo, Buffalo, New York 14260.
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Podgorsak
mesh_terms: D000465:Algorithms; D006801:Humans; D009038:Motion; D010315:Particle Accelerators; D011829:Radiation Dosage; D011874:Radiometry / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D020266:Radiotherapy, Conformal / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D015203:Reproducibility of Results