Transmission, Penumbra and Leaf Positional Accuracy in Commissioning and Quality Assurance Program of a Multileaf Collimator for Step-and-Shoot IMRT Treatments

Abstract

The performance characteristics of a commercial multileaf collimator (MLC) for intensity modulated radiation therapy (IMRT) and a comprehensive quality assurance program (QA) to be performed during the commissioning of the MLC were investigated. The midleaf transmission and interleaf leakage, the in-plane penumbra and its in-plane/cross-plane variation, the cross-plane penumbra and its in-plane/cross-plane variation, and the leaf positional accuracy of a high-energy photon (6 MV) Sli Precise Elekta linear accelerator were measured. Kodak EDR2 Ready Pack film was used for MLC transmission measurement; for the other characterization measurements we used Kodak X-Omat XV2 Ready Pack film placed at 5 cm depth in a solid RW3 phantom. Each film was digitized with a laser scanning photodensitometer VXR-12 Plus using the Omni Pro-Accept 6.OA film dosimetry system and converted to dose by means of H&D curves. The dose calibration measurements were performed with a Farmer ionization chamber according to the guidelines of the IAEA Technical Report No. 277. The average midleaf transmission and interleaf leakage were 1.8% +/- 0.1% and 2.1% +/- 0.2%, respectively. The average value of the cross-plane penumbra was 5.4 mm +/- 0.3 mm with maximum variation less than 0.4 mm and 1.0 mm in the in-plane and cross-plane direction, respectively. The average value of the in-plane penumbra was 3.2 mm +/- 0.2 mm and 3.5 mm +/- 0.2 mm for the step side and groove side of the leaves, respectively. A dose profile perpendicular to the direction of the leaf travel passing through the central axis shows a tongue-and-groove effect of about 33%. The positional accuracy of the leaves was investigated according to AAPM Report No. 72 TG50; the deviation of the net optical density along all the match lines was less than +/- 20%. Moreover, the results obtained with a step field technique showed a positional accuracy of less than 1 mm. The results suggest the necessity of extensive knowledge of the MLC dosimetric characteristics for IMRT applications in order to allow physicists to study their influence on treatment delivery and to perform a comprehensive routine QA program of the investigated parameters.