ArticleJournal of applied clinical medical physics2025
Impact of enhanced leaf model on dose calculation accuracy in single-isocenter multitarget stereotactic radiosurgery treatments.
Article in Journal of applied clinical medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Dose accuracy evaluation of multi-leaf collimator modeling in single-isocenter multi-target stereotactic radiosurgery.Physics and imaging in radiation oncology · 2026Article
- Multi-institutional study of multileaf collimator parameters and dose calculation accuracy using the enhanced leaf model.Radiological physics and technology · 2026Article
- Benchmarking a new radiochromic film type for photon and proton beam dosimetry.Physics and imaging in radiation oncology · 2026Article
- Multi-institutional study on the commissioning and clinical implementation of the TrueBeam enhanced leaf model in the Eclipse treatment planning system.Journal of applied clinical medical physics · 2025Article
- Effective spot size parameters for Acuros dose calculation algorithm using enhanced leaf modelling: Estimation based on small rectangular MLC fields.Journal of applied clinical medical physics · 2025Article
- Evaluation of the accuracy of an enhanced MLC leaf model for Linac-based stereotactic radiosurgery.Journal of applied clinical medical physics · 2025Article
- Impact of enhanced leaf model on dose calculation accuracy in single-isocenter multitarget stereotactic radiosurgery treatments.Journal of applied clinical medical physics · 2025Article
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4 authors.
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Abstract
purposeSingle-isocenter multitarget (SIMT) radiosurgery has become increasingly popular as advancement in planning and delivery systems have made this approach clinically viable. With targets varying in size and distance from isocenter, SIMT plans are highly complex with dynamic multileaf collimator (MLC) motion. Our department recently commissioned Eclipse Treatment Planning System v18.0, which included a novel enhanced leaf model (ELM) for photon dose calculation. ELM represents the biggest update in MLC modeling on a commercial treatment planning system over the past decade, yielding improvements in leaf modeling and ray tracing. Considering its dependence on dynamic MLC movements, we set out to assess the potential clinical impact of ELM on SIMT.
methodsDynamic zebra crosswalk (DZC) plans were delivered on a Varian Edge to investigate ELM. DZCs consisted of sweeping MLC gaps (ranging 1-15 mm) across a 3 cm width at isocenter, 4 cm, 8 cm, and 12 cm along the x-axis. Phantom dose calculations were performed using AAA v15.6 and v18.0 (with ELM) for 6 MV flattening filter free DZC plans and compared to measurements using stereotactic radiosurgery MapCHECK (Sun Nuclear Corporation) and Gafchromic EBT4 films (Ashland). To assess potential impact on SIMT, ten patients were retrospectively planned with RapidArc and HyperArc. Both versions of AAA were used for dose calculation.
resultsDZC measurements showed improved agreement with ELM; differences between measured and calculated doses were reduced by as much as 19% for the smallest sweeping gaps at off-axis distances. Differences in central profile dose for DZCs increased with reduced gap size and increased off-axis position. SIMT plans showed up to 4.0% increase in planning target volume (PTV) maximum dose when switching from AAA v15.6 to v18.0.
conclusionDose calculations with ELM mirrored diode and film measurements for highly modulated SIMT plans. ELM represents a major improvement in MLC modeling that more accurately reflects current treatment delivery practice.
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