Adjustment of multi-leaf collimator parameters in 4-MV and 6-MV IMRT: A study of veterinary clinical cases

Abstract

Background: For optimal treatment, it is important to maintain optimal multi-leaf collimator (MLC) transmission in intensity-modulated radiation  therapy (IMRT). However, adjustment of transmissions has not been reported in veterinary medicine.

Aim: To demonstrate that appropriate MLC parameter adjustment for IMRT using 4- and 6-MV energy can reduce the need for quality assurance  revalidation in real companion animal clinical cases.

Methods: The MLC parameters (leaf transmission and leaf offset) of the treatment planning system were adjusted by evaluating seven plans (10 ×  10 cm, 3ABUT, DMLC, 7segA, FOURL, HDMLC, and HIMRT) and 20 preclinical cases (10 cases each in 4- and 6-MV groups). Subsequently, 101 IMRT  plans of 88 cases (77 dogs and 11 cats) were evaluated for absolute dose of plan target volume (PTV) and organs at risk (OAR) and were analyzed for  the relative dose distribution by gamma analysis (3%/3 mm, >10%) using EBT3 film.

Results: After adjustment of the MLC parameters (leaf  transmission and leaf offset, 4 MV: 0.008 and 0, 6 MV: 0.005 and 0, respectively), the data from 101 plans (4 MV: 64 plans and 6 MV: 37 plans) treated  with IMRT showed PTV <3%, OAR <5%, and gamma analysis pass rates ≥95% in all cases.

Conclusion: Clinically meaningful dose distributions can be  created even with a limited validation device if the treatment parameters are adjusted appropriately, even for tumors in canines and felines, where  the irradiation field is small, the target is adjacent to the OAR, and the target is often superficial.