- •Use of VMAT technique for radiosurgery.
- •Comparison of VMAT and 3D-conformal arc therapy for radiosurgery.
- •Influence of the MLC leaf size on the dosimetric quality of the technique.
To study the influence of Multileaf Collimator (MLC) leaf width in radiosurgery treatment planning for Volumetric Modulated Arc Therapy (VMAT) and 3D Dynamic Conformal Arc Therapy (3D-DCA).
Material and methods
16 patients with solitary brain metastases treated with radiosurgery via the non-coplanar VMAT were replanned for the 3D-DCA. For each planning technique two MLC leaf width sizes were utilized, i.e. 5 mm and 2.5 mm. These treatment plans were compared using dosimetric indices (conformity, gradient and mean dose for brain tissue) and the normal tissue complication probability (NTCP).
An improvement in planning quality for VMAT was observed versus 3D-DCA for any MLC leaf width, mainly with regards to dose conformity and to a lesser extent regards dose gradient. No significant difference was observed for any of both techniques using smaller leaf width. However, dose gradient was improved in favor of the 2.5 mm MLC for either of both techniques (15% VMAT and 10% 3D-DCA); being noticeable for lesions smaller than 10 cm3. Nonetheless, the NTCP index was not significantly affected by variations in the dose gradient index.
This, our present study, suggests that the use of an MLC leaf width of 2.5 mm via the noncoplanar VMAT and 3D-DCA techniques provides improvement in terms of dose gradient for small volumes, over those results obtained with an MLC leaf width of 5 mm. The 3D-DCA does also benefit from MLC leaf widths of a smaller size, mainly in terms of conformity.
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Published online: February 18, 2015
Accepted: January 20, 2015
Received in revised form: January 19, 2015
Received: October 30, 2014
© 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Inc. All rights reserved.