Evaluation of two methods of predicting MLC leaf positions using EPID measurements.

In intensity modulated radiation treatments (IMRT), the position of the field edges and the modulation within the beam are often achieved with a multileaf collimator (MLC). During the MLC calibration process, due to the finite accuracy of leaf position measurements, a systematic error may be introduced to leaf positions. Thereafter leaf positions of the MLC depend on the systematic error introduced on each leaf during MLC calibration and on the accuracy of the leaf position control system (random errors). This study presents and evaluates two methods to predict the systematic errors on the leaf positions introduced during the MLC calibration. The two presented methods are based on a series of electronic portal imaging device (EPID) measurements. A comparison with film measurements showed that the EPID could be used to measure leaf positions without introducing any bias. The first method, referred to as the "central leaf method," is based on the method currently used at this center for MLC leaf calibration. It mimics the manner in which leaf calibration parameters are specified in the MLC control system and consequently is also used by other centers. The second method, a new method proposed by the authors and referred to as the "individual leaf method," involves the measurement of two positions for each leaf (-5 and +15 cm) and the interpolation and extrapolation from these two points to any other given position. The central leaf method and the individual leaf method predicted leaf positions at prescribed positions of -11, 0, 5, and 10 cm within 2.3 and 1.0 mm, respectively, with a standard deviation (SD) of 0.3 and 0.2 mm, respectively. The individual leaf method provided a better prediction of the leaf positions than the central leaf method. Reproducibility tests for leaf positions of -5 and +15 cm were performed. The reproducibility was within 0.4 mm on the same day and 0.4 mm six weeks later (1 SD). Measurements at gantry angles of 0 degrees, 90 degrees, and 270 degrees for leaf positions of -5 and +15 cm showed no significant effect of gravity. The individual leaf method could be used in various applications to improve the accuracy of radiotherapy treatment from planning to delivery. Three cases are discussed: IMRT beam verification, MLC calibration and dose calculation.