Assessment of MLC tracking performance during hypofractionated prostate radiotherapy using real-time dose reconstruction

Physics in Medicine and Biology
Martin F FastUwe Oelfke

Abstract

By adapting to the actual patient anatomy during treatment, tracked multi-leaf collimator (MLC) treatment deliveries offer an opportunity for margin reduction and healthy tissue sparing. This is assumed to be especially relevant for hypofractionated protocols in which intrafractional motion does not easily average out. In order to confidently deliver tracked treatments with potentially reduced margins, it is necessary to monitor not only the patient anatomy but also the actually delivered dose during irradiation. In this study, we present a novel real-time online dose reconstruction tool which calculates actually delivered dose based on pre-calculated dose influence data in less than 10 ms at a rate of 25 Hz. Using this tool we investigate the impact of clinical target volume (CTV) to planning target volume (PTV) margins on CTV coverage and organ-at-risk dose. On our research linear accelerator, a set of four different CTV-to-PTV margins were tested for three patient cases subject to four different motion conditions. Based on this data, we can conclude that tracking eliminates dose cold spots which can occur in the CTV during conventional deliveries even for the smallest CTV-to-PTV margin of 1 mm. Changes of organ-at-risk dose ...Continue Reading

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Citations

May 12, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Martin J MentenUwe Oelfke
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Software Mentioned

DynaPlan
DynaTrack
gcc
Calypso
Elekta
Synergy
Windows 7
Pinnacle
μKonRad
RayStation

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