Dosimetric evaluation and gradient analysis of various MLC leaf-width effects in external beam radiation therapy: TrueBeam Vs Halcyon

Abstract

IntroductionThis study investigates dosimetric influence and gradient-analysis of leaf-width of various Multi-leaf-collimators (MLC) from Truebeam and Halcyon linear accelerators. MethodsThe leaf-width effects of Millennium120 and HD120MLC from Truebeam and SX1 and SX2 from Halcyon were studied using virtual phantom in Eclipse16.1.2 TPS. Target structures consist of bore and wave cylinders of equally spaced projected Planning target volume (PTV) of diameters ranging from 1-to-5 cm and 20 cm length. Treatment plans for all PTVs, and four different MLCs configurations from both machines were created utilizing 6MVFFF beam to deliver dose of 50Gy/25# using IMRT and VMAT. Plans were evaluated using plan quality indices including dose conformity, homogeneity, gradient radius, and Monitor-unit (MU). Also, dose gradients were analyzed by estimating distinct integral volume VD% and paired-t-tests were performed to evaluate statistical differences. ResultsAll the plan satisfied the minimum criteria of D95 %≥prescription dose and V107 %≤2cc. Mean conformity and homogeneity indices for SX1MLC(CI = 0.680,HI = 0.022) were found significantly higher and lower than SX2(CI = 0.746,HI = 0.016), Millennium120 (CI = 0.739,HI = 0.012), and HD120MLC(CI = 0.745,HI = 0.017), respectively. However, CI and HI for SX2, Millennium120, and HD120MLC found comparable. Gradient radius enclosing 50 % of isodose observed maximum and minimum for SX1 and HD120MLC, respectively. Plan MUs for Truebeam MLCs were found approximately 25 % higher than Halcyon MLCs. Dose distribution generated using SX2 and Millennium120 found comparable, however p ≤ 0.05 ascertained substantial differences among SX1, Millennium120, and HD120MLC. ConclusionMLC leaf-width influences intensity-modulation and significantly alters dosimetric outcome depending on the magnitude of the leaf-width. HD120MLC does not show much significant advantages over SX2 and Millennium120 except gradient control. Implications for practiceHalcyon SX1MLC produces least effective plan compared to all other MLC types. However, SX2 and Millennium120 can produce plans of comparable quality except plan MUs difference.