ArticleJournal of applied clinical medical physics2022
Impact of systematic MLC positional uncertainties on the quality of single-isocenter multi-target VMAT-SRS treatment plans.
Article in Journal of applied clinical medical physics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Evaluation of dosimetric impact and plan robustness of MLC motion and setup errors in SRS for multiple brain metastases.Journal of applied clinical medical physics · 2026Article
- A pathway away from measurement-based patient-specific QA: A review of contemporary quality assurance for external-beam radiotherapy sub-systems.Journal of applied clinical medical physics · 2025Review
- Comparison of log file-based and measurement-based QA for detecting MLC positional errors and evaluating dosimetric impacts of MLC defects.Journal of applied clinical medical physics · 2025Article
- Impact of two-dimensional dosimetric leaf gap on SRS-VMAT for single-isocenter multi-target brain metastases.Scientific reports · 2025Article
- A novel protocol for parametrization of a beam model for small stereotactic beams.Journal of applied clinical medical physics · 2025Article
- Evaluation of an improved picket fence style test for routine MLC positional QA.Journal of applied clinical medical physics · 2025Article
- Systematic evaluation of spatial resolution and gamma criteria for quality assurance with detector arrays in stereotactic radiosurgery.Journal of applied clinical medical physics · 2024Article
- Dosimetric impact of MLC positional errors on dose distribution in IMRT.Journal of applied clinical medical physics · 2024Article
- Impact of MLC error on dose distribution in SRS treatment of single-isocenter multiple brain metastases: comparison between DCAT and VMAT techniques.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2024Article
- Article
- Impact of systematic MLC positional uncertainties on the quality of single-isocenter multi-target VMAT-SRS treatment plans.Journal of applied clinical medical physics · 2022Article
- Delineation Errors Caused by Replication and Expansion Operations in Monaco.Technology in cancer research & treatmentArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
purposeTo study the impact of systematic MLC leaf positional uncertainties (stemming from mechanical inaccuracies or sub-optimal MLC modeling) on the quality of intracranial single-isocenter multi-target VMAT-SRS treatment plans. An estimation of appropriate tolerance levels is attempted.
methodsFive patients, with three to four metastases and at least one target lying in close proximity to organs-at-risk (OARs) were included in this study. A single-isocenter multi-arc VMAT plan per patient was prepared, which served as the reference for dosimetric impact evaluation. A range of leaf offsets was introduced (±0.03 mm up to ±0.30 mm defined at the MLC plane) to both leaf banks, by varying the leaf offset MLC modeling parameter in Monaco for all the prepared plans, in order to simulate projected leaf offsets of ±0.09 mm up to ±0.94 mm at the isocenter plane, respectively. For all offsets simulated and cases studied, dose distributions were re-calculated and compared with the corresponding reference ones. An experimental dosimetric procedure using the SRS mapCHECK diode array was also performed to support the simulation study results and investigate its suitability to detect small systematic leaf positional errors.
resultsProjected leaf offsets of ±0.09 mm were well-tolerated with respect to both target dosimetry and OAR-sparing. A linear relationship was found between D
conclusionsPlan quality indices and dose-volume metrics are very sensitive to systematic sub-millimeter leaf positional inaccuracies, projected at the isocenter plane. Acceptable and tolerance levels in systematic MLC uncertainties need to be tailored to VMAT-SRS spatial and dosimetric accuracy requirements.
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