Commissioning of volumetric modulated arc therapy (VMAT) in a dual-vendor environment

Dobler, Barbara; Groeger, Christian; Treutwein, Marius; Alvarez-Moret, Judith; Goetzfried, Thomas; Weidner, Karin; Haertl, Petra; Koelbl, Oliver

doi:10.1016/j.radonc.2011.01.024

Cited by 22 publications

(14 citation statements)

References 32 publications

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“…The system has been commissioned especially for VMAT application with BeamModulator™ head first25 and later also for Agility™ head 23. The software supports variable gantry speed, which was set to a maximum value of 6.0 degree per second, and variable dose rate with a set minimum value of 20 MU per minute.…”

Section: Methodsmentioning

confidence: 99%

Volumetric‐modulated arc therapy and intensity‐modulated radiation therapy treatment planning for prostate cancer with flattened beam and flattening filter free linear accelerators

Treutwein¹,

Hipp

Koelbl³

et al. 2017

J Applied Clin Med Phys

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This study on patients with localized prostate cancer was set up to investigate valuable differences using flattened beam (FB) and flattening filter free (FFF) mode in the application of intensity‐modulated radiotherapy (IMRT) and volumetric‐modulated arc therapy (VMAT). For ten patients, four different plans were calculated with Oncentra planning system of Elekta, using Synergy machines: IMRT and VMAT, with and without flattening filter. Homogeneity and conformity indexes, dose to the organs at risk, and measurements of peripheral dose and dosimetric plan verification including record of the delivery times were analyzed and statistically evaluated. The indexes for homogeneity and conformity (CTV and PTV) are either advantageous or not significantly different for FFF compared to FB with one minor exception. Regarding the doses to the organs at risk and the measured peripheral dose, equivalent or lower doses were delivered for FFF than with FB. Furthermore, the delivery times were significantly shorter for FFF. VMAT compared to IMRT reveals benefits or at least equivalent values. VMAT‐FFF combines the most advantageous plan quality parameters with the shortest delivery times and reduced peripheral dose and is therefore recommended for the given equipment and cancer localization.

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Section: Methodsmentioning

confidence: 99%

Volumetric‐modulated arc therapy and intensity‐modulated radiation therapy treatment planning for prostate cancer with flattened beam and flattening filter free linear accelerators

Treutwein¹,

Hipp

Koelbl³

et al. 2017

J Applied Clin Med Phys

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“…For verification all 60 plans were transferred to a CT scan of the MatriXX Evolution™ 2D-ionisation-chamber-array (IBA Dosimetry, Schwarzenbruck, Germany) set up in between one 10 cm (bottom) and one 9.7 cm (top) stack of RW3 slabs (PTW, Freiburg, Germany) for measurement in a coronal plane [25, 26]. Measurements were corrected for angular dependencies and couch attenuation in the software OmniPro I’mRT v.1.7a (IBA Dosimetry, Schwarzenbruck, Germany) which is steering the measurement and used for evaluation.…”

Section: Methodsmentioning

confidence: 99%

Simultaneous integrated boost (SIB) radiation therapy of right sided breast cancer with and without flattening filter - A treatment planning study

et al. 2016

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BackgroundThe aim of the study was to compare the two irradiation modes with (FF) and without flattening filter (FFF) for three different treatment techniques for simultaneous integrated boost radiation therapy of patients with right sided breast cancer.MethodsAn Elekta Synergy linac with Agility collimating device is used to simulate the treatment of 10 patients. Six plans were generated in Monaco 5.0 for each patient treating the whole breast and a simultaneous integrated boost (SIB) volume: intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) and a tangential arc VMAT (tVMAT), each with and without flattening filter. Plan quality was assessed considering target coverage, sparing of the contralateral breast, the lungs, the heart and the normal tissue. All plans were verified by a 2D-ionisation-chamber-array and delivery times were measured and compared. The Wilcoxon test was used for statistical analysis with a significance level of 0.05.ResultsSignificantly best target coverage and homogeneity was achieved using VMAT FFF with V95% = (98.7 ± 0.8) % and HI = (8.2 ± 0.9) % for the SIB and V95% = (98.3 ± 0.7) % for the PTV, whereas tVMAT showed significantly lowest doses to the contralateral organs at risk with a Dmean of (0.7 ± 0.1) Gy for the contralateral lung, (1.0 ± 0.2) Gy for the contralateral breast and (1.4 ± 0.2) Gy for the heart. All plans passed the gamma evaluation with a mean passing rate of (99.2 ± 0.8) %. Delivery times were significantly reduced for VMAT and tVMAT but increased for IMRT, when FFF was used. Lowest delivery times were observed for tVMAT FFF with (1:20 ± 0:07) min.ConclusionBalancing target coverage, OAR sparing and delivery time, VMAT FFF and tVMAT FFF are considered the preferable of the investigated treatment options in simultaneous integrated boost irradiation of right sided breast cancer for the combination of an Elekta Synergy linac with Agility and the treatment planning system Monaco 5.0.

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“…Maximum leaf speed is 2.4 cm/s, the dynamic minimum leaf gap 0.2 cm, and the static minimum leaf gap 0.0 cm [24]. The maximum nominal dose rate is 500 MU/min.…”

Section: Methodsmentioning

confidence: 99%

Searching standard parameters for volumetric modulated arc therapy (VMAT) of prostate cancer

et al. 2012

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BackgroundSince December 2009 a new VMAT planning system tool is available in Oncentra® MasterPlan v3.3 (Nucletron B.V.). The purpose of this study was to work out standard parameters for the optimization of prostate cancer.MethodsFor ten patients with localized prostate cancer plans for simultaneous integrated boost were optimized, varying systematically the number of arcs, collimator angle, the maximum delivery time, and the gantry spacing. Homogeneity in clinical target volume, minimum dose in planning target volume, median dose in the organs at risk, maximum dose in the posterior part of the rectum, and number of monitor units were evaluated using student’s test for statistical analysis. Measurements were performed with a 2D-array, taking the delivery time, and compared to the calculation by the gamma method.ResultsPlans with collimator 45° were superior to plans with collimator 0°. Single arc resulted in higher minimum dose in the planning target volume, but also higher dose values to the organs at risk, requiring less monitor units per fraction dose than dual arc. Single arc needs a higher value (per arc) for the maximum delivery time parameter than dual arc, but as only one arc is needed, the measured delivery time was shorter and stayed below 2.5 min versus 3 to 5 min. Balancing plan quality, dosimetric results and calculation time, a gantry spacing of 4° led to optimal results.ConclusionA set of parameters has been found which can be used as standard for volumetric modulated arc therapy planning of prostate cancer.

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Commissioning of volumetric modulated arc therapy (VMAT) in a dual-vendor environment

Cited by 22 publications

References 32 publications

Volumetric‐modulated arc therapy and intensity‐modulated radiation therapy treatment planning for prostate cancer with flattened beam and flattening filter free linear accelerators

Volumetric‐modulated arc therapy and intensity‐modulated radiation therapy treatment planning for prostate cancer with flattened beam and flattening filter free linear accelerators

Simultaneous integrated boost (SIB) radiation therapy of right sided breast cancer with and without flattening filter - A treatment planning study

Searching standard parameters for volumetric modulated arc therapy (VMAT) of prostate cancer

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