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Guo J, Zhu M, Zeng W, Wang H, Qin S, Li Z, Tang Y, Ying B, Sang J, Ji M, Meng K, Hui Z, Wang J, Zhou J, Zhou Y, Huan J. Multileaf Collimator Modeling and Commissioning for Complex Radiation Treatment Plans Using 2-Dimensional (2D) Diode Array MapCHECK2. Technol Cancer Res Treat 2024; 23:15330338231225864. [PMID: 38311933 PMCID: PMC10846010 DOI: 10.1177/15330338231225864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 09/27/2023] [Accepted: 12/17/2023] [Indexed: 02/06/2024] Open
Abstract
Purpose: This study aims to develop a data-collecting package ExpressMLC and investigate the applicability of MapCHECK2 for multileaf collimator (MLC) modeling and commissioning for complex radiation treatment plans. Materials and methods: The MLC model incorporates realistic parameters to account for sophisticated MLC features. A set of 8 single-beam plans, denoted by ExpressMLC, is created for the determination of parameters. For the commissioning of the MLC model, 4 intensity modulated radiation therapy (IMRT) plans specified by the AAPM TG 119 report were transferred to a computed tomography study of MapCHECK2, recalculated, and compared to measurements on a Varian accelerator. Both per-beam and composite-beam dose verification were conducted. Results: Through sufficient characterization of the MLC model, under 3%/2 mm and 2%/2 mm criteria, MapCHECK2 can be used to accurately verify per beam dose with gamma passing rate better than 90.9% and 89.3%, respectively, while the Gafchromic EBT3 films can achieve gamma passing rate better than 89.3% and 85.7%, respectively. Under the same criteria, MapCHECK2 can achieve composite beam dose verification with a gamma passing rate better than 95.9% and 90.3%, while the Gafchromic EBT3 films can achieve a gamma passing rate better than 96.1% and 91.8%; the p-value from the Mann Whitney test between gamma passing rates of the per beam dose verification using full MapCHECK2 package calibrated MLC model and film calibrated MLC model is .44 and .47, respectively; the p-value between those of the true composite beam dose verification is .62 and .36, respectively. Conclusion: It is confirmed that the 2-dimensional (2D) diode array MapCHECK2 can be used for data collection for MLC modeling with the combination of the ExpressMLC package of plans, whose doses are sufficient for the determination of MLC parameters. It could be a fitting alternative to films to boost the efficiency of MLC modeling and commissioning without sacrificing accuracy.
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Affiliation(s)
- Jian Guo
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Meng Zhu
- Qiusuo Health Technologies Inc., Suzhou, China
| | - Weijin Zeng
- Department of Radiation Oncology, Yihui Foundation Hospital, Shanwei, China
| | - He Wang
- Qiusuo Health Technologies Inc., Suzhou, China
| | - Songbing Qin
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhibin Li
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yu Tang
- Qiusuo Health Technologies Inc., Suzhou, China
| | - Binbin Ying
- Department of Stomatology, Ningbo First Hospital, Ningbo, China
| | - Jiugao Sang
- Department of Radiation Oncology, Rudong County Hospital, Nantong, China
| | - Ming Ji
- Qiusuo Health Technologies Inc., Suzhou, China
| | - Kuo Meng
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhouguang Hui
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianyang Wang
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Juying Zhou
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yin Zhou
- Homology Medical Technologies Inc., Ningbo, China
| | - Jian Huan
- Department of Radiation Oncology, Suzhou Science and Technology Town Hospital, Suzhou, China
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Qingya P, Yizhong F, Fuke Z, Shengjie L, Linzhao T, Yuling L. STANDARD-DEVIATION BASED CONFORMITY INDEX FOR EVALUATING TREATMENT PLAN OF INTENSITY MODULATED RADIOTHERAPY IN LUNG CANCER. RADIATION PROTECTION DOSIMETRY 2023; 199:87-94. [PMID: 36420536 DOI: 10.1093/rpd/ncac228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/13/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
This paper attempts to find a new conformity index (CI) calculation method with slice and angle information for evaluating lung cancer radiation treatment plan. A total of 20 lung cancer patients in 2016-2019 were selected. Treatment plans were made for each patient. Parameters used in the process of making treatment plans were set the same. The CI and the standard-deviation based CI (SDCI) that contains angle and slice information were calculated. Comparison of results calculated with SDCI and CI were made. The results of the two methods for the patients showed the same trend. Different shapes of simulated dose distribution line shows SDCI can provide more detail information about the target area. Special shapes of simulated dose distribution line for SDCI showed inaccuracy in angle information. The parameter SDCI has more advantage towards the traditional CI for it can provide angle and slice information. However, more angles need to be calculated.
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Affiliation(s)
- Pan Qingya
- Department of Chemo-Radiotherapy Oncology, QingHe Center Hospital, 80 SanYang Road, Qinghe, 054800 HeBei, China
| | - Fan Yizhong
- Department of Chemo-Radiotherapy Oncology, QingHe Center Hospital, 80 SanYang Road, Qinghe, 054800 HeBei, China
| | - Zhang Fuke
- Department of Chemo-Radiotherapy Oncology, QingHe Center Hospital, 80 SanYang Road, Qinghe, 054800 HeBei, China
| | - Luan Shengjie
- Department of Chemo-Radiotherapy Oncology, QingHe Center Hospital, 80 SanYang Road, Qinghe, 054800 HeBei, China
| | - Tian Linzhao
- Department of Chemo-Radiotherapy Oncology, QingHe Center Hospital, 80 SanYang Road, Qinghe, 054800 HeBei, China
| | - Lv Yuling
- Department of Chemo-Radiotherapy Oncology, QingHe Center Hospital, 80 SanYang Road, Qinghe, 054800 HeBei, China
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Chen J, Dai J, Nobah A, Bai S, Bi N, Lai Y, Li M, Tian Y, Wang X, Fu Q, Liang B, Zhang T, Xia W, Xu Y, Ren W, Yan X, Zhu J, Chen D, Yang J. A Special Report on 2019 International Planning Competition and a Comprehensive Analysis of Its Results. Front Oncol 2020; 10:571644. [PMID: 33344231 PMCID: PMC7746833 DOI: 10.3389/fonc.2020.571644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/30/2020] [Indexed: 02/05/2023] Open
Abstract
Purpose The aim of this work is to introduce the 2019 International Planning Competition and to analyze its results. Methods and materials A locally advanced non-small cell lung cancer (LA-NSCLC) case using the simultaneous integrated boost approach was selected. The plan quality was evaluated by using a ranking system in accordance with practice guidelines. Planners used their clinical Treatment Planning System (TPS) to generate the best possible plan along with a survey, designed to obtain medical physics aspects information. We investigated the quality of the large population of plans designed by worldwide planners using different planning and delivery systems. The correlations of plan quality with relevant planner characteristics (work experience, department scale, and competition experience) and with technological parameters (TPS and modality) were examined. Results The number of the qualified plans was 287 with a wide range of scores (38.61–97.99). The scores showed statistically significant differences by the following factors: 1) department scale: the mean score (89.76 ± 8.36) for planners from the departments treating >2,000 patients annually was the highest of all; 2) competition experience: the mean score for the 107 planners with previous competition experience was 88.92 ± 9.59, statistically significantly from first-time participants (p = .001); 3) techniques: the mean scores for planners using VMAT (89.18 ± 6.43) and TOMO (90.62 ± 7.60) were higher than those using IMRT (82.28 ± 12.47), with statistical differences (p <.001). The plan scores were negligibly correlated with the planner’s years of work experience or the type of TPS used. Regression analysis demonstrated that plan score was associated with dosimetric objectives that were difficult to achieve, which is generally consistent with a clinical practice evaluation. However, 51.2% of the planners abandoned the difficult component of total lung receiving a dose of 5 Gy in their plan design to achieve the optimal plan. Conclusion The 2019 international planning competition was carried out successfully, and its results were analyzed. Plan quality was not correlated with work experiences or the TPS used, but it was correlated with department scale, modality, and competition experience. These findings differed from those reported in previous studies.
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Affiliation(s)
- Jiayun Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianrong Dai
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ahmad Nobah
- Radiation Physics Section, Biomedical Physics Department, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Sen Bai
- Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Nan Bi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youqun Lai
- Department of Radiation Oncology, Fujian Medical University Xiamen Humanity Hospital, Xiamen, China
| | - Minghui Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Tian
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuetao Wang
- Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Qi Fu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Liang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tao Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenlong Xia
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Xu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenting Ren
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuena Yan
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ji Zhu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Deqi Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiming Yang
- Department of Radiotherapy and Chemotherapy, Ningbo First Hospital, Ningbo, China
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Wang D, Chen J, Zhang X, Zhang T, Wang L, Feng Q, Zhou Z, Dai J, Bi N. Sparing Organs at Risk with Simultaneous Integrated Boost Volumetric Modulated Arc Therapy for Locally Advanced Non-Small Cell Lung Cancer: An Automatic Treatment Planning Study. Cancer Manag Res 2020; 12:9643-9653. [PMID: 33116824 PMCID: PMC7547766 DOI: 10.2147/cmar.s273197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 08/28/2020] [Indexed: 12/25/2022] Open
Abstract
Background The technique of simultaneous integrated boost volumetric modulated arc therapy (SIB-VMAT) has been widely used in locally advanced non-small cell lung cancer; however, its dosimetric advantages are seldom reported. This study aimed to quantify dosimetric advantages of SIB-VMAT. Methods Forty patients with stage III non-small cell lung cancer in our hospital were retrospectively included. SIB-VMAT and conventional VMAT (C-VMAT) plans were generated for every patient using the automatic treatment planning system. A reduced dose was delivered to PTV in SIB-VAMT plans compared to C-VMAT plans (50.4Gy vs 60Gy). The prescribed dose was 50.4 Gy in 28 fractions to PTV and 59.92 Gy in 28 fractions to PGTV in SIB-VMAT plans, while 60 Gy in 30 fractions to PTV in C-VMAT plans. Dose-volume metrics of PTV, total lung, heart, esophagus and spinal cord were recorded. The quality score was used to evaluate organs at risk (OAR) protection for two type prescription plans. Results Conformal coverage of the targets (PGTV/PTV) by 95% of the prescription dose was well achieved in radiation plans. SIB-VMAT plans achieved significantly higher quality score than C-VMAT plans (Mean: 68.15±13.32 vs 49.15±13.35, P<0.001). More plans scored above sixty in SIB-VMAT group compared to C-VMAT group (72.5% vs 20%, P<0.001). Notable reductions in mean dose, V30, V40 and V50 of total lung were observed in SIB-VMAT plans compared to C-VMAT plans, with median decreased proportions of 6.5%, 8.7%, 19.6% and 32.1%, respectively. Statistically significant decrease in heart V30 and V40 was also achieved in SIB-VMAT plans, with median decreased proportions of 26.1% and 38.8%. SIB-VMAT plans achieved significant reductions in the maximum doses to both esophagus and spinal cord. Patients with CTV/(GTV+GTVnd) ≥8.6 showed more notable decrease in total lung V50 (median, 33.6% vs 28.8%, P=0.001) in SIB-VMAT plans compared to those with the ratio being less than 8.6. Conclusion SIB-VMAT technique could lead to a substantial sparing of normal organs, including lung, heart, esophagus and cord, mainly through reducing high and inter-median dose exposure. Patients with CTV/(GTV+GTVnd) ≥8.6 might benefit more from SIB-VMAT.
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Affiliation(s)
- Daquan Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Jiayun Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Xiaodong Zhang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tao Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Luhua Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Qinfu Feng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Zongmei Zhou
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Jianrong Dai
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Nan Bi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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Chen J, Cui W, Fu Q, Zhang H, Huang X, Han F, Xia W, Liang B, Dai J. Influence of maximum MLC leaf speed on the quality of volumetric modulated arc therapy plans. J Appl Clin Med Phys 2020; 21:37-47. [PMID: 33047486 PMCID: PMC7700941 DOI: 10.1002/acm2.13020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/01/2020] [Accepted: 08/06/2020] [Indexed: 11/11/2022] Open
Abstract
Purpose Maximum leaf speed is a configurable parameter of MLC in a treatment‐planning system. This study investigated the influence of MLC on the quality of VMAT plans. Methods Seven MLCs with different maximum leaf speeds (1.0, 1.5, 2.25, 3.5, 5.0, 7.5, and 10 cm/s) were configured for an accelerator in treatment‐planning system. Correspondingly, seven treatment plans, with the identical initial optimization parameter, were designed with the mdaccAutoPlan system. Six nasopharyngeal carcinoma (NPC) patients and nine rectal cancer patients were selected, representing complex and simple clinical circumstances. VMAT plan quality was evaluated with PlanIQTM software. The results were statistically analyzed with a one‐way analysis of variance (ANOVA) and pairwise comparison tests. Results The relative changes of plan scores achieved by the seven configured accelerators, with specific maximum MLC leaf speed (MMLS) for each patient, were studied. Two apparent trends of MMLS influence on VMAT plan scores were observed: Plan scores increased with MMLS; Plan scores increased rapidly when MMLS increased from 1 to 3.5, thus the relative change of plan score decreased in this MMLS range. The stationary point of maximum MLC speed (MMSSP) is defined, for the specific MMLS when the relative changes of plan scores is first <5%, as MMLS increases from 1.0 to 10. For rectal plans, MMSSPs were 2.25 for six patients and 3.5 for the other three patients. For NPC plans, MMSSPs were 3.5 for five patients and 2.25 for one patient. Conclusion This work indicates that MMLS directly influences VMAT plan quality in NPC cases and rectal cancer cases. VMAT plan quality improved conspicuously as MMLS increased from 1 to 3.5, VMAT plan quality with marginal improvement when MMLS is above 3.5.
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Affiliation(s)
- Jiayun Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weijie Cui
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qi Fu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haojia Zhang
- Department of Oncology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Xiaodong Huang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Han
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenlong Xia
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Liang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianrong Dai
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Li C, Chen J, Zhu J, Gong G, Tao C, Li Z, Lu J, Yin Y. Plan quality comparison for cervical carcinoma treated with Halcyon and Trilogy intensity-modulated radiotherapy. J Cancer 2019; 10:6135-6141. [PMID: 31762823 PMCID: PMC6856582 DOI: 10.7150/jca.32500] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 08/18/2019] [Indexed: 11/09/2022] Open
Abstract
Purpose: Varian Halcyon is a novel machine with dual-layer leaves, single flattening filter free (FFF) energy and an enclosed bore. The purpose of this study was to compare the differences in dosimetry and plan parameters of intensity-modulated radiation therapy (IMRT) plans between the Halcyon and Trilogy accelerators. Methods and Materials: A total of 30 IMRT plans from cervical carcinoma patients were retrospectively analyzed on the Trilogy and Eclipse v13.5 treatment planning systems (TPSs). For each patient, a new plan based on Halcyon was created with the same planning parameters and optimization constraints using the Eclipse Version 15.1 TPS. To compare plan qualities, dosimetry parameters regarding planning target volume (PTV), organs at risk (OARs), monitor unit (MU) efficiency, segment size and treatment time were evaluated. Evaluation of the helical diode array system was performed with gamma-index analysis. Results: The dose distribution of the target volume of the Halcyon and Trilogy plans showed no significant difference (p > 0.05). The mean doses of rectum and both femoral heads for Halcyon plans were significantly reduced compared to those for Trilogy plans (p < 0.05). Compared to Trilogy, Halcyon increased the number of MUs from 1542.9±248.3 MU to 2514.9±328.2 MU (p = 0.00) and decreased the delivery time from 11.28±1.36 min to 3.26±0.26 min (p = 0.00). The average segment areas of Halcyon plans for proximal and distal multileaf collimators (MLCs) were 42.1 ± 31.2 cm2 and 28.4 ± 23.7 cm2, respectively, and that of Trilogy plans was 27.3 ± 16.9 cm2. The mean gamma index (3 mm/3%) results for the Halcyon and Trilogy plans were 99.41±0.26 and 99.76±0.32 (p > 0.05), respectively. Conclusions: All Halcyon treatment plans were recognized as clinically acceptable and had statistically better OAR sparing with higher delivery efficiency. The Halcyon system exhibited fast treatment delivery of IMRT with good dosimetric agreement using ArcCHECK.
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Affiliation(s)
| | | | | | | | | | | | | | - Yong Yin
- Department of Radiation Oncology Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China
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