Presentation on theme: "Dosimetric leaf gap (DLG): Dosimetric consequences"— Presentation transcript:
1Dosimetric leaf gap (DLG): Dosimetric consequences Lars H. Præstegaard, Mai-Britt K. Jørgensenand Lone HoffmannAarhus University HospitalJanuary 2012
2Dosimetric leaf gap (DLG) Increase of field size due to transmission trough leaf endField size (mm) = MLC field size (mm) + DLG (mm)
3Direct measurement of DLG MLC transmission (function of W)Aarhus:Adjustment of DLS in Eclipse using chair planT. LoSasso et. al., Med. Phys. 28, 2209–
4Constancy check of DLG in Aarhus Sweeping gap test:
5DLG for Varian Clinacs in Aarhus 10 Varian Clinac accelerators in Aarhus with MLC version 7.2Adjustment of DLG using MLC HyperTerminal:Command: diagAdjustSysOffsetsParameter: System Leaf Gap OffsetSweeping gap ratios (SGRs) for System Leaf Gap Offset = 0:AcceleratorSGR10.78220.772340.79550.80660.79070.79180.79790.80310Max. range of the sweeping gap ratios in Aarhus:
6Dosimetric effect of different DLG Accelerator 3Mean dose relative to SGR=0.773 Sweeping gap ratio (SGR)0.8260.8080.773System Leaf Gap Offset [mm]0.60.5PlanSiteDose -#FractionsModulation#ArcsComments1HHIMRT68/66/60/50-34892 MU 1.91.5Typical IMRT plan2prost + LNRA74/55-37500MU0.8Standard modulation1000MUHigh modulation30.91.64tonsil68/60/50-3184.108.40.206.220.127.116.11Analysis:Mean prostate, 500 MU 1.00.0Mean prostate, 1000 MU 2.0Mean tonsil, 500 MU 1.2Mean tonsil, 1000 MU 3.02.4
7Dosimetric effect of changes of DLG Change of DLG: Largest effect on dose for highly modulated test plans (opposing MLC leafs are closer during treatment)Dose change is twice as large for 1000 MU in comparison to 500 MU (half the distance of opposing MLC leafs)Largest effect on dose (plan 4): 1.3% (500 MU) and 2.6 % (1000 MU) for a change of the sweeping gap ratio from to 0.808System Leaf Gap Offset=0: For a highly modulated plan the dose will change up to 2.6 % if patient is moved from accelerator 3 to 5 (systematic effect)
8Adjustment of DLG in Aarhus Clinical demand:Free movement of patients between all accelerators for effective handling of:Scheduled accelerator maintenanceAccelerator errorsAll Clinacs are adjusted for the same value of SGR (DLG):SGR = (System Leaf Gap Offset = -0.7 to -0.3)MLC Version 7.2:Rough scale for leaf gap offset (step of 0.1 mm) Spread of SGR (DLG) around 0.825 Need for increased tolerance for SGR (0.010.015)
9Stability of SGR (DLG) System Leaf Gap Offset ≠ 0: Change of SGR during the day or following MLC initializationRough scale for leaf gap offset SGR variation for specific accelerator: Up to 0.015 Random dose error of up to 1.2 % (for 1000 MU)System Leaf Gap Offset = 0:Max. variation of sweeping gap ratio = 0.002Result:Better SGR (DLG) stability for System Leaf Gap Offset = 0Need for same SGR (DLG) for all accelerator for System Leaf Gap Offset = 0. How to do that?
10Discussion How do you measure DLG? What is the range of DLGs for System Leaf Gap Offset = 0 in your clinic?Can the DLG for System Leaf Gap Offset = 0 be adjusted?How much modulation do you use for RapidArc plans?Do you think the dosimetric consequence of different DLGs is significant?Other comments?