Performance of different Strength of Aperture Shape Controller on VMAT technique for Head and Neck, Pelvis, and Breast Cancer using Halcyon Machine

Document Type : Original Paper

Authors

1 Faculty of Sciences, LPHE-M&S, Mohammed V University, Rabat, Morocco

2 Hassan First University of Settat, High Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Settat, Morocco

3 Private Hospital Casablanca-AKDITAL, Morocco

4 Department of physics, University of Mohammed 1st, Oujda, Morocco

5 Departement of Physics, Laboratory of High Energy Physics, Modelling and Simulation, Faculty of Science, Mohammed V Agdal University, Rabat, Kingdom of Morocco

Abstract

Introduction: Before starting optimization using the Volumetric Modulated Arc Therapy (VMAT) technique, the choice of the convenient aperture shape controller can be one of the most important factors that affect the plan quality.
Material and Methods: Three different clinical cases were selected: head and neck cancer, pelvic cancer (prostate, cervix, and endometrium), and breast cancer treated with the VMAT technique. By keeping the same conditions, plans were reoptimized by varying aperture shape controllers (OFF, VERY LOW, LOW, MODERATE, HIGH, VERY HIGH). For plans evaluation, the homogeneity index (HI), conformity index (CI), target coverage (D98% and V98%), dose max (DMAX) and near max (D2%), treatment time delivery (MUs), and gamma index passing rate were analyzed.
Results: All the studied localizations treated with the VMAT technique met clinical objectives. The VERY LOW technique achieved the best dose conformity for all localizations. A slight improvement in terms of PTV coverage and max dose is obtained in a VERY LOW technique for pelvic cancer. For breast cancer, almost the same results were obtained. However, for head and neck treatments, better results were observed with the HIGH and VERY HIGH techniques, where coverage and maximum dose improved by up to 6%.
Conclusion: Changing the Strength of Aperture Shape Controller in VMAT optimization can affect dose calculation, especially in concave volumes such as Head and Neck.

Keywords

Main Subjects


  1. Arnfield M, Siebers J, Kim J, Wu Q, Keall P, Mohan R. A method for determining multileaf collimator transmission and scatter for dynamic intensity modulated radiotherapy. Med Phys. 2000;27:2231–
  2. Zygmanski P, Rosca F, Kadam D, Lrenz F, Nalichowski A, Chin L. Determination of depth and field size dependence of multileaf collimator transmission in intensity‐modulated radiation therapy beams. JAppl Clin Med Phys. 2007;8:2693.
  3. Lorenz F, Nalichowski A, Rosca F, Kung J, Wenz F, ZygmanskiP. Spatial dependence of MLC transmission in IMRT delivery. Phys MedBiol. 2007;52:5985–
  4. Thompson C, Weston S, Cosgrove V, Thwaites D. A dosimetric characterization of a novel linear accelerator collimator. Med Phys. 2014;41:031713.
  5. Galvin J, Smith A, Lally B. Characterization of a multileafcollimatorsystem. Int J Radiat Oncol Biol Phys. 1993;25:181–
  6. Maleki N, Kijewski P. Analysis of the field defining properties of amultileaf collimator. Med Phys. 1984;11:390.
  7. Helyer S, Heisig S. Multileaf collimation versus conventional shieldingblocks – a time and motion study of beam shaping in radiotherapy.Radiother Oncol. 1995;37:61–
  8. Huq M, Das I, Steinberg T, Galvin J. A dosimetric comparison of various multileaf collimators. Phys Med Biol. 2002;47:N159–
  9. Jin J, Yin F, Ryu S, Ajlouni M, Kim J. Dosimetric study using differentleaf-width MLCs for treatment planning of dynamic conformal arcsand intensity‐modulated radiosurgery. Med Phys. 2005;32:405–
  10. Losasso T. IMRT delivery performance with a varianmultileaf collimator. Int J Radiat Oncol Biol Phys. 2008;71:S85S88.
  11. Webb S. A new concept of multileaf collimator (the shuttling MLC) –an interpreter for high‐efficiency IMRT. Phys Med Biol. 2000;45:3343–
  12. Tacke M, Nill S, Haring P, Oelfke U. 6 MV dosimetric characterization of the 160 MLC, the new Siemens multileafcollimator. MedPhys. 2008;35:1634–
  13. Cai B, Li H, Yang D, Rodriguez V, Curcuru A, Wang Y, et al. Performance of a multi leaf collimator system for MR‐guided radiation therapy. Medical physics. 2017 Dec;44(12):6504-14.
  14. Fiveash J, Murshed H, Duan J. Effect of multileafcollimator leaf width on physical dose distributions in the
  15. treatment of CNS and head and neck neoplasms withintensity modulated radiation therapy. Med Phys. 2002;29:1116–
  16. Cosgrove V, Jahn U, Pfaender M, Bauer S, Budach V, WurmR. Commissioning of a micro multi‐leaf collimator and planningsystem for stereotactic radiosurgery. Radiother Oncol. 1999;50:325–
  17. Bernard V, Fafi S, Nguyen D, Khodri M. 33 Commissioning and dosimetric characteristics of new halcyon system. Physica Medica: European Journal of Medical Physics. 2018 Dec 1;56:54.
  18. Withers D, Kidane G, Crees L, Farmakidis D, Greenwood J, Isaacs É, et al. Treatment planning for a 6MV FFF Halcyon linac as a replacement for a 10MV-capable Clinac. InRadiotherapy and Oncology. 2018 Apr 1;127: 1073.
  19. Halcyon System. Available from: https://www.varian. com/oncology/products/treatment-delivery/halcyon.
  20. RDS Treatment Planning Instructions for Use Eclipse 15.1.1. Report No.: P1017375‐004‐D.
  21. De Roover R, Crijns W, Poels K, Michiels S, Nulens A, Vanstraelen B, et al. Validation and IMRT/VMAT delivery quality of a preconfigured fast‐rotating O‐ring linac system. Medical physics. 2019 Jan;46(1):328-39.
  22. Lloyd SA, Lim TY, Fave X, Flores‐Martinez E, Atwood TF, Moiseenko V. TG‐51 reference dosimetry for the Halcyon™: a clinical experience. Journal of applied clinical medical physics. 2018 Jul;19(4):98-102.
  23. Binny D, Spalding M, Crowe SB, Jolly D, Kairn T, Trapp JV, Walsh A. Investigating the use of aperture shape controller in VMAT treatment deliveries. Medical Dosimetry. 2020 Sep 1;45(3):284-92.
  24. Grégoire V, Ang K, Budach W, Grau C, Hamoir M, Langendijk JA, et al. Delineation of the neck node levels for head and neck tumors: a 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensusguidelines. Radiother Oncol. 2013;110:172–
  25. Brouwer CL, Steenbakkers RJHM, Bourhis J, Budach W, Grau C, Grégoire V, et al. CT-based delineation of organs at risk in the head and neck region: DAHANCA, EORTC, GORTEC, HKNPCSG, NCIC CTG, NCRI, NRG Oncology and TROG consensus guidelines. Radiother Oncol. 2015;117:83–
  26. Kataria T, Sharma K, Subramani V, Karrthick K P, Bisht SS. Homogeneity Index: an objective tool for assessment of conformalradiation treatments. J Med Phys. 2012; 37: 207–
  27. Yoon M, Park SY, Shin D, Lee SB, Pyo HR, Kim DY, et al. A new homogeneity index based on statistical analysis of the dose–volume histogram. Journal of applied clinical medical physics. 2007 Mar;8(2):9-17.
  28. Kim H, Huq MS, Lalonde R, Houser CJ, Beriwal S, Heron DE. Early clinical experience with varian halcyon V2 linear accelerator: Dual-isocenter IMRT planning and delivery with portal dosimetry for gynecological cancer treatments. J Appl Clin Med Phys. 2019 Nov;20(11):111-20.
  29. De Roover R, Crijns W, Poels K, Michiels S, Nulens A, Vanstraelen B, et al. Validation and IMRT/VMAT delivery quality of a preconfigured fast‐rotating O‐ring linac system. Medical physics. 2019 Jan;46(1):328-39.
  30. Michiels S, Poels K, Crijns W, Delombaerde L, De Roover R, Vanstraelen B, et al. Volumetric modulated arc therapy of head-and-neck cancer on a fast-rotating O-ring linac: Plan quality and delivery time comparison with a C-arm linac. Radiotherapy and Oncology. 2018 Sep 1;128(3):479-84.
  31. Binny D, Spalding M, Crowe SB, Jolly D, Kairn T, Trapp JV, et al. Investigating the use of aperture shape controller in VMAT treatment deliveries. Medical Dosimetry. 2020 Sep 1;45(3):284-92.