Journal of Medical Physics
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Year : 2002  |  Volume : 27  |  Issue : 2  |  Page : 41-50

Quality Assurance (QA) And Implementation Of Intensity Modulated Radiotherapy (IMRT) With Dynamic Multileaf Collimator (DMLC) On 2100 C/D Linear Accelerator



Correspondence Address:
D D Deshpande


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Source of Support: None, Conflict of Interest: None


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Intensity Modulated Radiation Therapy (IMRT) involves the modulation of radiation beam intensities in order to conform the target volumes and spare surrounding critical structures and normal tissues, IMRT can improve the dose distribution to a large extent compared to conventional 3DCRT. The purpose of this article is to discuss the methodology adopted in the Quality Assurance (QA) program for the implementation of IMRT on 2100 CID linear accelerator at our center. QA of Multi-Leaf Collimator (MLC) including mechanical tests, radiation tests, dynamic MLC tests and patient specific QA of the final IMRT plan has been described here in detail. The average transmission values were found to be 1.31% and 1.40% for A bank and B bank, respectively, for 6 MV photon beam measured with the parallel plate chamber. From film measurements, we got the maximum interleaf transmission value of 1.88%. The speed of the MLC leaves was found to be within the specification of the manufacturer. The MLC positional accuracy with the methods mentioned gave a precision of 1 mm, irrespective of the gantry positions. The absolute dose for 6 and 15 MV photons was estimated for the Dynamic MLC (DMLC) field periodically and was found to be consistent. The inverse-planning algorithm produced satisfactory dose distribution and adequate Planning Target Volume (PN) coverage with critical organ dose-volume parameters, within the respective tolerances. The percentage deviation between the measured and the calculated absolute dose for the intensity Modulated (IM) fields is found to be less than 3%. The clinical implementation of inverse planning and treatment delivery with DMLC is extremely complex and involves a substantial developmental effort. The dose delivery in a comprehensive QA is mandatory to ensure the safe and accurate dose delivery. DMLC mode needs a confirmation using established QA program that is both stringent and efficient. However, a comprehensive QA is mandatory to ensure the safe and accurate dose delivery.


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