Cao D, Shepard D
Swedish Cancer Institute, Seattle, WA.
Med Phys. 2012 Jun;39(6Part19):3835. doi: 10.1118/1.4735652.
Rotational IMRT delivery has attracted considerable attention. Some people believe that rotational IMRT should provide better plan quality with more beam angles to irradiate the target. In this work, we will study the impact of the number of fields and MLC segments on the IMRT plan quality.
The RPC IMRT benchmark phantom was used in the IMRT planning. The number of gantry angles used ranges from 3 to 90 with various numbers of segments. All IMRT plans were created using Pinnacle3 DMPO module using the same objectives. The final objective value is used to quantify the plan quality.
When the number of beam angles is more than 3, the objective value decreases dramatically with increasing segments till the number reaches around 60. When the number of segments is small, the availability of more beam angles can clearly improve the IMRT plan quality. However, such a plan quality improvement becomes less dramatic as the number of total segments increases. For example, when the number of segments is 30, increasing the number of beam angles from 3 to 18 can reduce the objective value by 75%. Such a reduction reduces to 44% when the number of segments increases to 60. Single-arc VMAT plans showed less desirable plan quality comparing to fixed-field IMRT plans using the same number of beam-angles and segments.
The number of segments has dramatic impact on the IMRT plan quality when the number of fields is more than 5. If enough segments are used in IMRT planning, increasing the number of beam angles can only slightly improve the plan quality. The increase in plan quality led by increasing beam angles can be limited by the MLC motion constraint for rotational IMRT delivery.
旋转调强放疗(IMRT)技术已引起广泛关注。一些人认为,旋转IMRT通过增加射野角度来照射靶区,应能提供更好的计划质量。在本研究中,我们将探讨射野数和多叶准直器(MLC)子野数对IMRT计划质量的影响。
采用RPC IMRT标准体模进行IMRT计划设计。使用不同子野数,机架角范围为3°至90°。所有IMRT计划均使用Pinnacle3 DMPO模块创建,目标相同。最终目标值用于量化计划质量。
当射野数大于3时,随着子野数增加,目标值急剧下降,直至子野数达到约60时趋于稳定。当子野数较少时,增加射野数可显著提高IMRT计划质量。然而,随着总子野数增加,计划质量的提升幅度逐渐减小。例如,当子野数为30时,将射野数从3个增加到18个,目标值可降低75%。当子野数增加到60时,这一降幅降至44%。与使用相同射野数和子野数的固定野IMRT计划相比,单弧容积调强放疗(VMAT)计划的质量较差。
当射野数大于5时,子野数对IMRT计划质量有显著影响。如果在IMRT计划中使用足够的子野数,增加射野数只能略微提高计划质量。对于旋转IMRT技术,由于MLC运动限制,增加射野数导致的计划质量提升可能受限。