Loading…

Volumetric modulated arc therapy with dynamic collimator rotation for improved multileaf collimator tracking of the prostate

Abstract Purpose To improve MLC tracking of prostate VMAT plans by dynamic rotation of the collimator to align the MLC leaves with the dominant prostate motion direction. Methods For 22 prostate cancer patients, two dual arc VMAT plans were made with (1) fixed collimators (45° and 315°) and (2) a ro...

Full description

Saved in:
Bibliographic Details
Published in:Radiotherapy and oncology 2017-01, Vol.122 (1), p.109-115
Main Authors: Murtaza, Ghulam, Toftegaard, Jakob, Khan, Ehsan Ullah, Poulsen, Per Rugaard
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Purpose To improve MLC tracking of prostate VMAT plans by dynamic rotation of the collimator to align the MLC leaves with the dominant prostate motion direction. Methods For 22 prostate cancer patients, two dual arc VMAT plans were made with (1) fixed collimators (45° and 315°) and (2) a rotating collimator that aligned the MLC leaves with the dominant prostate motion direction (population-based first principal component). The fixed and rotating collimator plan quality was compared using selected dose–volume indices. Next, MLC tracking treatments were simulated with 695 patient-measured prostate traces. The MLC exposure error (under- and overexposed MLC area in beam’s eye view) was calculated as a surrogate for the MLC tracking error. Finally, motion including dose reconstruction was performed for 35 motion traces for one patient, and the root-mean-square dose error was compared with the MLC exposure error. Results Rotating collimator VMAT plans were of similar quality as the fixed collimator plans, but significantly improved MLC tracking with 33% lower MLC exposure errors ( p ≪ 0.0001). The reductions in MLC exposure error correlated significantly with dose error reductions. Conclusion Prostate VMAT plans with rotating collimator were of similar quality as fixed collimator plans, but more suitable for MLC tracking with significantly better agreement between planned and delivered dose distributions. MLC tracking for prostate cancer patients can therefore be improved without the requirement of additional efforts or hardware changes.
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2016.11.004