Individual QA for IMRT/VMAT plans is required by protocols. Sometimes plans cannot pass the institute's QA criteria. For the Eclipse treatment planning system (TPS) with rounded leaf‐end multileaf collimator (MLC), one practical way to improve the agreement of planned and delivered doses is to tune the value of dosimetric leaf gap (DLG) in the TPS from the measured DLG. We propose that this step may be necessary due to the complexity of the MLC system, including dosimetry of small fields and the tongue‐and‐groove (T&G) effects, and report our use of test fields to obtain linac‐specific optimal DLGs in TPSs. More than 20 original patient plans were reoptimized with the linac‐specific optimal DLG value. We examined the distribution of gaps and T&G extensions in typical patient plans and the effect of using the optimal DLG on the distribution. The QA pass rate of patient plans using the optimal DLG was investigated. The dose‐volume histograms (DVHs) of targets and organs at risk were checked. We tested three MLC systems (Varian millennium 120 MLC, high‐definition 120 MLC, and Siemens 160 MLC) installed in four Varian linear accelerators (linacs) (TrueBEAM STx, Trilogy, Clinac 2300 iX, and Clinac 21 EX) and 1 Siemens linac (Artiste). With an optimal DLG, the individual QA for all those patient plans passed the institute's criteria (95% in DTA test or gamma test with 3%/3 mm/10%), even though most of these plans had failed to pass QA when using original DLGs optimized from typical patient plans or from the optimization process (automodeler) of Pinnacle TPS. Using either our optimal DLG or one optimized from typical patient plans or from the Pinnacle optimization process yielded similar DVHs.PACS number: 87.55Qr

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A physiological quiet standing model, described by a delayed differential equation, subject to a white noise perturbation, is proposed to study the postural control system of human beings. It has been found that the white noise destabilizes the equilibrium state, and inertia accelerates the destabilizing process, and that the position of a person is detected and processed by the person's nervous system with a delay. This paper focuses on the analysis of Hopf bifurcation and its stability in this context. Based on the analytical predictions confirmed by numerical simulations, it has been shown that the posture of a person is controlled in such a way that possible amplitude oscillations are minimized.

X-ray scatter estimation in heterogeneous medium is a challenge in improving the quality of diagnostic projection images and volumetric image reconstruction. For Compton scatter, the statistical behavior of the first order scatter can be accurately described by using the Klein-Nishina expression for Compton scattering cross section provided that the exact information of the medium including the geometry and the attenuation, which in fact is unknown, is known. The authors present an approach to approximately separate the unknowns from the Klein-Nishina formula and express the unknown part by the primary x-ray intensity at the detector. The approximation is fitted to the exact solution of the Klein-Nishina formulas by introducing one parameter, whose value is shown to be not sensitive to the linear attenuation coefficient and thickness of the scatterer. The performance of the approach is evaluated by comparing the result with those from the Klein-Nishina formula and Monte Carlo simulations. The approximation is close to the exact solution and the Monte Carlo simulation result for parallel and cone beam imaging systems with various field sizes, air gaps, and mono- and polyenergy of primary photons and for nonhomogeneous scatterer with various geometries of slabs and cylinders. For a wide range of x-ray energy including those often used in kilo- and megavoltage cone beam computed tomographies, the first order scatter fluence at the detector is mainly from Compton scatter. Thus, the approximate relation between the first order scatter and primary fluences at the detector is useful for scatter estimation in physical phantom projections.