PURPOSE To calculate an optimal collimator angle at each of sectional arcs in a full-arc volumetric modulated arc therapy (VMAT) plan and evaluate dosimetric quality of these VMAT plans comparing full-arc VMAT plans with a fixed collimator angle. METHODS Seventeen patients who had irregularly-shaped target in abdominal, head and neck, and chest cases were selected retrospectively. To calculat...

The unwanted radiation transmission through the multileaf collimators could be reduced by the jaw tracking technique which is commercially available on Varian TrueBeam accelerators. On the basis of identical plans, this study aims to investigate the dosimetric impact of jaw tracking on the volumetric-modulated arc therapy (VMAT) plans. Using Eclipse treatment planning system (TPS), 40 jaw-track...

A recent control system update for Elekta linear accelerators includes the ability to deliver volumetric-modulated arc therapy (VMAT) with continuously variable dose rate (CVDR), rather than a number of fixed binned dose rates (BDR). The capacity to select from a larger range of dose rates allows the linac to maintain higher gantry speeds, resulting in faster, smoother deliveries. The purpose o...

This article presents an overview of pre-treatment verification of volumetric modulated arc therapy (VMAT) with electronic portal imaging devices (EPIDs). Challenges to VMAT verification with EPIDs are discussed including EPID sag/flex during rotation, acquisition using cine-mode imaging, image artefacts during VMAT and determining the gantry angle for each image. The major methods that have be...

An algorithm for dynamic multileaf-collimator (dMLC) tracking of a target performing a known a priori, rigid-body motion during volumetric modulated arc therapy (VMAT), has been experimentally validated and applied to investigate the potential of the Agility (Elekta AB, Stockholm, Sweden) multileaf-collimator (MLC) for use in motion-compensated VMAT delivery. For five VMAT patients, dosimetric ...

We have successfully created a single arc volumetric modulated arc therapy (VMAT) plan for treating post-surgical left breast/chest wall and regional nodes using Elekta multileaf collimator (MLC). Dose volume histograms (DVHs) were compared between the VMAT plans and conventional tangential beam plans using a field-in-field technique, leading to significant DVH advantages in the VMAT plans. The...

In this study, we have characterized the efficiency of an Elekta linac in the delivery of gated radiotherapy. We have explored techniques to reduce the beam-on delay and to improve the delivery efficiency, and have investigated the impact of frequent beam interruptions on the dosimetric accuracy of gated deliveries. A newly available gating interface was installed on an Elekta Synergy. Gating s...

PURPOSE To evaluate the performance of a model-based optimisation process for volumetric modulated arc therapy, VMAT, applied to whole breast irradiation. METHODS AND MATERIALS A set of 150 VMAT dose plans with simultaneous integrated boost were selected to train a model for the prediction of dose-volume constraints. The dosimetric validation was done on different groups of patients from thre...

Hypofractionated treatments generally increase the complexity of a treatment plan due to the more stringent constraints of normal tissues and target coverage. As a result, treatment plans contain more modulated MLC motions that may require extra efforts for accurate dose calculation. This study explores methods to minimize the differences between in-house dose calculation and actual delivery of...

PURPOSE To track prostate motion during clinical arc radiotherapy using a novel statistical motion tracking algorithm in both phantom and patient systems. METHODS For the phantom study, a dynamic phantom with a custom tumor model and radiopaque fiducials was used. For the patient study, the clinical data from two prostate patients were acquired during volumetric modulated arc therapy (VMAT). ...