ArticleJournal of applied clinical medical physics2023
The effects of flattening filter-free beams and aperture shape controller on the complexity of conventional large-field treatment plans.
Article in Journal of applied clinical medical physics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed, 7 citations in OpenAlex.
- Evaluating the trade-off between plan complexity, dosimetric accuracy, and treatment efficiency: Role of aperture shape controller settings in HyperArc for intracranial oligometastases.Precision radiation oncology · 2025Article
- The effects of flattening filter-free beams and aperture shape controller on the complexity of conventional large-field treatment plans.Journal of applied clinical medical physics · 2023Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to investigate the impact of using flattening filter-free (FFF) beams and the aperture shape controller (ASC) on the complexity of conventional large-field treatment plans. METHODS AND MATERIALS: A total of 24 head and neck (H&N) and 24 prostate with pelvic nodes treatment plans were used in this study. Each plan was reoptimized using the original clinical objectives with both flattened and FFF beams, as well as six different ASC settings. The dosimetric qualities of each plan cohort were evaluated using commonly used dose-volume histogram values, and plan complexities were assessed through metrics including monitor unit (MU)/Dose, change in gantry speed, multileaf collimator (MLC) speed, the edge area ratio metric (EM), and the equivalent square length.
resultsNo significant differences in dosimetric qualities were found between plans with flattened and FFF beams. The ASC settings did not have significant effects on dosimetric qualities in the H&N plan cohort, but the "very high" ASC setting resulted in poorer dosimetric results for the prostate plans. Plans with FFF beams had significantly higher MU/Dose compared to plans with flattened beams. The use of flattening filter (FF) had significant effects on the change in gantry speed, with flattened beams producing plans that required higher change in gantry speed. However, the FF did not have significant effects on MLC speed, EM, or equivalent square length. In contrast, ASC settings had significant effects on these three metrics; increasing the ASC level resulted in plans with decreasing MLC speed, lower edge area ratio, and higher equivalent square length.
conclusionThis study demonstrated that using FFF beams with various ASC settings, except for the "very high" level, can produce plans with reduced complexities without compromising dosimetric qualities in conventional large-field treatment plans.
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