Abstract
We have investigated the tongue-and-groove effect on the IMRT dosedistributions for a Varian MLC. We have compared the dose distributionscalculated using the intensity maps with and without the tongue-and-grooveeffect. Our results showed that, for one intensity-modulated treatment field,the maximum tongue-and-groove effect could be up to 10% of the maximum dosein the dose distributions. For an IMRT treatment with multiple gantry angles(⩾5), the difference between the dose distributions with and without thetongue-and-groove effect was hardly visible, less than 1.6% for the twotypical clinical cases studied. After considering the patient setup errors,the dose distributions were smoothed with reduced and insignificantdifferences between plans with and without the tongue-and-groove effect.Therefore, for a multiple-field IMRT plan (⩾5), the tongue-and-grooveeffect on the IMRT dose distributions will be generally clinicallyinsignificant due to the smearing effect of individual fields. Thetongue-and-groove effect on an IMRT plan with small number of fields (<5)will vary depending on the number of fields in a plan (coplanar ornon-coplanar), the MLC leaf sequences and the patient setup uncertainty, andmay be significant (>5% of maximum dose) in some cases, especially whenthe patient setup uncertainty is small (⩽2 mm).
Published Version
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