| Luo Suming,Wu Hao,Xue Xian,et al.Development of methodology for the positioning accuracy of MLC leaves in IMRT[J].Chinese Journal of Radiological Medicine and Protection,2019,39(2):121-127 |
| Development of methodology for the positioning accuracy of MLC leaves in IMRT |
| Received:May 07, 2018 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.02.007 |
| KeyWords:Intensity modulated radiation therapy Radiochomic film MLC leaves Positioning accuracy Quality audit |
| FundProject:IAEA资助项目（17821/CRP） |
| Author Name | Affiliation | | Luo Suming | Key laboratory of Radiological Protection and Nuclear Emergency, China CDC, National Institute for Radiological Proteciton, Chinese Centre for Disease Control and Prevention, Beijing 100088, China | | Wu Hao | Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100036, China | | Xue Xian | Key laboratory of Radiological Protection and Nuclear Emergency, China CDC, National Institute for Radiological Proteciton, Chinese Centre for Disease Control and Prevention, Beijing 100088, China | | He Zhijian | Key laboratory of Radiological Protection and Nuclear Emergency, China CDC, National Institute for Radiological Proteciton, Chinese Centre for Disease Control and Prevention, Beijing 100088, China | | Ma Xinxing | Department of Radiological Health Monitoring and Evaluation, Hubei Province Centre for Disease Control and Prevention, Wuhan 610041, China | | Cheng Xiaojun | Department of Radiological Health, Henan Institute for Occupational Medicine, Zhengzhou 450052, China | | Liu Ran | Institute of Occupational Health and Radiological Health, Sichuan Province Centre for Disease Control and Prevention, Chengdu 450052, China | | Yang Chunyong | Department of Radiation Protection, Jiangsu Province Centre for Disease Control and Prevention, Nanjing 430079, China |
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| Abstract:: |
| Objective To develop measurement methodology using film for the positioning accuracy of MLC leaves in IMRT. Methods The solid water phantom of 30 cm x 30 cm was scanned and the scanned images were transferred to TPS for treatment plan formulation. The five MLC strip picket fence pattern was formed by MLC leaves, each 3.0 cm long×6.0 mm wide. The separation between strip and strip is 3.0 cm. SAD is 100 cm at dmax for 6 MV X-ray, with 250 MU per MLC strip. EBT2 radiochomic film was put on the phantom for delivery of IMRT, for each MLC strip. The present study focused on 30 accelerators of Varian, Elekta and Siemens designs at 27 hospitals with highly skilled physicists all over Jiangsu, Sichuan, Hubei and Henan provinces. The study was conducted in the same way as used in international multi-radiotherapy center (IMRC). The irradiated films were sent respectively to IAEA dosimetry laboratory and external audit group (EGA) of China for measurement, analysis and calculation. Results According to IAEA requirements, the differenc of film-measured and TPS-planned of MLC leaf position for each strip should be within ±0.5 mm. China had participated in the research of IMRC, with the result of 0.3, 0.2, 0.0, -0.1, and -0.2 mm, respectively. For 30 accelerators in four provinces involved in the study, the IAEA's verification results of MLC leaf position were within 0.6-1.0 mm for 5 accelerators and within ±0.5 mm for other 25 ones. Whereas the verification results of EAG were within 0.6-1.0 mm for 6 accelerators and within ±0.5 mm for other 24 ones. According to IAEA requirements, the film-measured MLC leaf position deviation for each pair of leaves and average all pairs of leaves should be within ±0.5 mm. China had participated in IMRC's research, with the measured result being 0.04 mm. The verification result of EGA for 30 accelerators showed the measured MLC leaf position deviations were all <0.3 mm per strip, consistent with IAEA requirements. The IAEA's result showed the measured deviations of MLC leaf position for 29 accelerators were within ±0.5 mm, with only other one being -0.7 mm not consistent with the IAEA requirements. As required by IAEA, the difference of film-measured difference of MLC opening width should be within ±0.75 mm between each pair and average all pairs of leaves. China's result in research of IMRC showed the difference of minimum width to mean width was -0.2 mm whereas the difference of maximum width to mean width was 0.4 mm. For 30 accelerators involved in IAEA' verification study, the measured result shown that the difference between maximum and average of film-measured of MLC leaf width, and between minmum and average, were within ±0.75 mm for 24 accelerators, in line with the IAEA requirements. For other 6 ones, the values were beyond ±0.75 mm, not in line with the IAEA requirements. For the verification result of EAG, the difference between maximum and average widths and between minmum and average widths for 25 accelerators were within ±0.75 mm as required by IAEA, whereas for other 5 ones the value were beyond ±0.75 mm, not consistent with IAEA requirements. The standard deviation of film-measured MLC opening width between each pair and average all pairs should be within 0.3 mm as required by IAEA. China's IMRC result was 0.12 mm. The verification result of IAEA shown the standard deviation of MLC opening position were <0.3 mm for 26 accelerators and > 0.3 mm for other 4 accelerators. EAG verification result were the same as IAEA result. Conclusions The method using radiochromic film for measuring accuracy of MLC leaf position is convenient and practicable as a quality audit. It is suitable for quality verification in medical institutions owing to easy to post and repeated measurements. |
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