This chapter describes the basic principles of intensity-modulated radiation therapy (IMRT), providing the necessary background for subsequent clinical chapters. We start by describing the IMRT treatment planning and delivery process, introducing the wide range of different approaches and technologies currently in clinical use. Then, other topics important in the implementation of IMRT are disc...

AIM To examine the impact of beam rate on dose distribution in IMRT plans and then to evaluate agreement of calculated and measured dose distributions for various beam rate values. BACKGROUND Accelerators used in radiotherapy utilize some beam rate modes which can shorten irradiation time and thus reduce ability of patient movement during a treatment session. This aspect should be considered ...

The purpose of this study is to examine plan quality, treatment planning time, and estimated treatment delivery time for 5- and 9-field sliding window IMRT, single and dual arc RapidArc, and tomotherapy. For four phantoms, 5- and 9-field IMRT, single and dual arc RapidArc and tomotherapy plans were created. Plans were evaluated based on the ability to meet dose-volume constraints, dose homogene...

Collimator systems used in Intensity Modulated Radiation Therapy can form different geometric aperture shapes depending on their physical capabilities. We compare the efficiency of using regular, rotating and dual multileaf collimator (MLC) systems under different combinations of consecutiveness, interdigitation and rectangular constraints. We also create a virtual freeform collimator, which ca...

Although portal dosimetry is used to provide quality assurance (QA) for intensity-modulated radiation therapy (IMRT) treatment plans, trends in agreement between the portal dose prediction (PDP) and the measured dose have not been clarified. In this work, we evaluated three scalar parameters of agreement for 152 treatment plans (1152 treatment fields): maximum gamma (gamma max), average gamma (...

Malignant pleural mesothelioma (MPM) is an extremely difficult disease to treat. This pilot study investigates the feasibility of using volumetric-modulated arc therapy (VMAT) for malignant pleural mesothelioma (MPM), and compares VMAT to static field intensity-modulated radiotherapy (IMRT) for five patients. To identify the best treatment technique for MPM, in five patients, we made a represen...

Volumetric-modulated arc therapy (VMAT) has been shown to be able to deliver plans equivalent to intensity-modulated radiation therapy (IMRT) in a fraction of the treatment time. This improvement is important for patient immobilization/localization compliance due to comfort and treatment duration, as well as patient throughput. Previous authors have suggested commissioning methods for this moda...

Since the clinical implementation of novel rotational forms of intensity-modulated radiotherapy, a variety of planning studies have been published that reinforce the major selling points of the technique. Namely, comparable or even improved dose distributions with a reduction in both monitor units and treatment times, when compared with static gantry intensity-modulated radiotherapy. Although t...

The use of intensity-modulated radiation therapy (IMRT) has led to an increase in the number of complex fields that require measurement and comparison to calculated dose distributions in 2D. Current dose-evaluation techniques, including isodose line comparisons, displays of the dose difference between calculated and measured distributions, and distance-to-agreement (DTA) comparisons, are useful...

While modulated arc (mARC) capabilities have been available on Siemens linear accelerators for almost two years now, there was, until recently, only one treatment planning system capable of planning these treatments. The Eclipse treatment planning system now offers a module that can plan for mARC treatments. The purpose of this work was to test the module to determine whether it is capable of c...