ArticlePhysics and imaging in radiation oncology2026
Dose accuracy evaluation of multi-leaf collimator modeling in single-isocenter multi-target stereotactic radiosurgery.
Article in Physics and imaging in radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and purpose: Accurate modeling of multi-leaf collimators is critical for dose calculation in stereotactic radiosurgery (SRS), where steep dose gradients and small target volumes amplify modeling uncertainties. This study compared enhanced leaf modeling and dosimetric leaf gap approaches using two clinically implemented dose calculation algorithms in single-isocenter SRS plans. Materials and methods: Sixty clinical volumetric modulated arc therapy (VMAT) single-isocenter SRS plans (30 single-target, SIST; 30 multi-target, SIMT) were selected and measured with a two-dimensional diode array, normalized to a point measurement. Dose was calculated using both enhanced leaf model (ELM) and dosimetric leaf gap (DLG) models and the anisotropic analytical algorithm (AAA) and Acuros XB (AXB) algorithms across several spot-size configurations. Plan quality assurance was assessed using gamma analysis for several dose-distance criteria. Dose differences were further analyzed as functions of target size and distance from isocenter. Results: Under 2%/1 mm gamma criteria, AXB-DLG having spot size 0.5 × 0.5 mm Conclusions: DLG showed slightly better VMAT SRS agreement than ELM, but differences were clinically negligible. ELM's model-based MLC configuration removes user-specific DLG variability, potentially improving dose-calculation precision and consistency across institutions.
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