Evidence map›Paper›PMID 40653786›Full record

ArticleJournal of applied clinical medical physics2025

Evaluation of the accuracy of an enhanced MLC leaf model for Linac-based stereotactic radiosurgery.

Yun Yang, Khayrullo Shoniyozov, Taoran Li, Virginia Lockamy, Michael Bieda, Boon-Keng Kevin Teo, Suneel Nagda, Michelle Alonso-Basanta, Wenbo Gu

Abstract readEvaluation Study
In one paragraph

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 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yun YangDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Khayrullo ShoniyozovDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Taoran LiVarian, a Siemens Healthineers Company, Palo Alto, California, USA.
Virginia LockamyDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0009-0003-5306-9570
Michael BiedaDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Boon-Keng Kevin TeoDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Suneel NagdaDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Michelle Alonso-BasantaDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Wenbo GuDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFor LINAC-based stereotactic radiosurgery (SRS) treatments, the binary MLC models utilizing single dosimetric leaf gap (DLG) parameters in Eclipse versions prior to v18 can result in imperfect agreement between measured and calculated doses, increased commissioning complexity, and user-dependent variability. This study aims to evaluate the efficiency and accuracy of the enhanced leaf model (ELM) in Eclipse version 18.0, which incorporates the actual rounded-end MLC design in dose calculations.

methodsELM parameters were determined from measurements and configuration in a test Eclipse v18.0 system for an Edge LINAC with High Definition MLC (HDMLC) and a TrueBeam LINAC with the Millennium 120-leaf MLC (M120). The anisotropic analytical algorithm (AAA) was used to calculate doses for both 10FFF and 6FFF energies. The v18 ELM model was compared to the current version 16.1 (v16) model, which utilized single DLG parameter. Dose calculations were performed and compared for (1) static small on-axis fields, (2) static small off-axis fields, (3) single-isocenter single-target (SIST) HyperArc plans, and (4) single-isocenter multiple-target (SIMT) HyperArc plans. Gafchromic EBT4 film and myQA SRS device were used for dose verification.

resultsThe measurement required for ELM was similar to that of the original DLG, but ELM configuration provided significant time savings. The measurements showed comparable or improved accuracy with the ELM model for both static fields and patient-specific plans. A significant improvement in dose calculation accuracy was observed with the ELM particularly for SIMT patients with a large number of small targets.

conclusionThe new ELM introduced in Eclipse v18 substantially improves efficiency and consistency of the modeling process in the Eclipse dose calculation algorithm while maintaining comparable or superior accuracy for Linac-based SRS.

Indexed as

AlgorithmsNeoplasmsParticle AcceleratorsPhantoms, ImagingRadiosurgeryRadiotherapy, Intensity-ModulatedRadiotherapy Planning, Computer-AssistedHumansOrgans at RiskRadiometryRadiotherapy DosageDLGELMLinac‐based SRSMLC

Identifiers

PMID40653786
PMCPMC12256662

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.