The impact of pitch and modulation factor to Tomotherapy treatment plan optimization for motion target

Abstract

The influence on target motion resulted from the respiratory process, the pitch and modulation factor presented in Tomotherapy. This study was aimed to investigate the effect of motion management using CT-images obtained from the fusion process between the static and dynamic scanning mode on the CIRS Thorax Phantom. The images were created using axial and helical modes which amplitudes were varied from 10 mm, 15 mm, and 20 mm. Then, the organ structures were planned using TomoPlan TPS with the variation of pitch ranging from 0.25 to 0.5, and the modulation factor (MF) in the range 2 to 3. Furthermore, evaluation of radiotherapy planning was performed using dose parameters on target, the organ at risk, homogeneity index (HI), and mean leaf open time (LOT). Target volume for static mode was 3.53 cc, whereas target volume has changed to 10.9 cc, 10.3 cc, 16.1 cc for axial and 6.6 cc, 8.5 cc, 14.9 cc for helical scanning. The HI value obtained was less than 0.07 and lower HI was resulted for a larger MF. It means that the higher modulation factor values will provide a uniform dose distribution to the target and lower dose to the OAR. The greater value of pitch gave the greater mean LOT. The optimum parameters were at the pitch of 0.5 and MF of 3 based on the evaluation of mean LOT and HI. Axial scanning mode provides a larger target volume compared to a helical scanning mode. Therefore, the increment of the target volume in delineating organ should be considered.