• Proceedings of the KOSOMBE Conference
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• v.1996 no.05
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• pp.157-160
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• 1996

We have developed the prototype Multi-leaf Collimator(MLC) for medical linear acclerator. In this study, we have examined the clinical effectiveness of our newly developed MLC by analysing treatment pattern of radiation therapy and studied the radiation safety by measuring the transmitted radiation and the leakage radiation. Over 81% patients can be treated with new MLC(20 pairs of leaves) and 98% with 30 pairs of leafed-MLC, while 95% with commercial MLC. New MLC showed superior properties of radiation leakage and transmission to commercially available MLC.

• Progress in Medical Physics
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• v.32 no.4
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• pp.116-121
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• 2021

Purpose: To investigate the effects of dose rate on intensity-modulated radiation therapy (IMRT) quality assurance (QA). Methods: We performed gamma tests using portal dose image prediction and log files of a multileaf collimator. Thirty treatment plans were randomly selected for the IMRT QA plan, and three verification plans for each treatment plan were generated with different dose rates (200, 400, and 600 monitor units [MU]/min). These verification plans were delivered to an electronic portal imager attached to a Varian medical linear accelerator, which recorded and compared with the planned dose. Root-mean-square (RMS) error values of the log files were also compared. Results: With an increase in dose rate, the 2%/2-mm gamma passing rate decreased from 90.9% to 85.5%, indicating that a higher dose rate was associated with lower radiation delivery accuracy. Accordingly, the average RMS error value increased from 0.0170 to 0.0381 cm as dose rate increased. In contrast, the radiation delivery time reduced from 3.83 to 1.49 minutes as the dose rate increased from 200 to 600 MU/min. Conclusions: Our results indicated that radiation delivery accuracy was lower at higher dose rates; however, the accuracy was still clinically acceptable at dose rates of up to 600 MU/min.

• Progress in Medical Physics
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• v.15 no.1
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• pp.1-8
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• 2004

Patient dose verification is one of the most Important responsibilities of the physician in the treatment delivery of radiation therapy. For the task, it is necessary to use an accurate dosimeter that can verify the patient dose profile, and it is also necessary to determine the physical characteristics of beams used in intensity modulated radiation therapy (IMRT) The Beam Intensity Scanner (BInS) System is presented for the dosimetric verification of the two dimensional photon beam. The BInS has a scintillator, made of phosphor Terbium-doped Gadolinium Oxysulphide (Gd$_2$O$_2$S:Tb), to produce fluorescence from the irradiation of photon and electron beams. These fluoroscopic signals are collected and digitized by a digital video camera (DVC) and then processed by custom made software to express the relative dose profile in a 3 dimensional (3D) plot. As an application of the BInS, measurements related to IWRT are made and presented in this work. Using a static multileaf collimator (SMLC) technique, the intensity modulated beam (IMB) is delivered via a sequence of static portals made by controlled leaves. Thus, when static subfields are generated by a sequence of abutting portals, the penumbras and scattered photons of the delivered beams overlap in abutting field regions and this results in the creation of “hot spots”. Using the BInS, inter-step “hot spots” inherent in SMLC are measured and an empirical method to remove them is proposed. Another major MLC technique in IMRT, the dynamic multileaf collimator (DMLC) technique, has different characteristics from SMLC due to a different leaf operation mechanism during the irradiation of photon and electron beams. By using the BInS, the actual delivered doses by SMLC and DMLC techniques are measured and compared. Even if the planned dose to a target volume is equal in our experimental setting, the actual delivered dose by DMLC technique is measured to be larger by 14.8% than that by SMLC, and this is due to scattered photons and contaminant electrons at d$_{max}$.

• The Journal of the Korea Contents Association
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• v.8 no.11
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• pp.182-188
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• 2008

The MLC(multi leaf collimator) in charge of important role in radiation therapy field recently have been exchanging from shielding block into it rapidly, owing to being convenient. However, MLC can be occurred the leakage dose of inter_leaves and the error of algorithm in imput and output from digital signal. We compared the difference of imput method to MLC made by Varian Cop. with the error and effective field induced by MLC shaper and film scanner based on XimaVision value as using MLC layer of various shapes. According to comparing standard value with them to basic MLC layer (test1-5), MLC shaper was $0{\sim}0.29cm$, $0.23{\sim}3.59cm^2$ and film scanner was $0{\sim}0.78cm$, $0.24{\sim}3.89cm^2$. At the MLC layer to be applied in clinic, MLC shaper was $0{\sim}0.54cm$, $0.04{\sim}1.68cm^2$ and film scanner was $0{\sim}0.78cm$, $0.24{\sim}3.89cm^2$. The more distance and field from axis of central line increase, the more bigger the error value increases. There is a few mm error from standard point at the process which imput various information to apply MLC in clinic. and effective field did not have variation of monitor unit and dose owing to being a few cm2 error against real field. But there are some problem to shield critical organs because some part of target volume induced by the movement of organs can be not included, therefore we have to pay attention on the process to imput MLC layer

• Progress in Medical Physics
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• v.13 no.2
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• pp.62-68
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• 2002

A muiltileaf collimator (MLC) is used as a replacement for conventional blocks. The MLC, however may not be appropriate for a fine field shaping. For the fine field shaping, conventional block can be added under the MLC. But it may significantly affect on the dosimetric characteristics such as surface dose of skin, buildup region and percent depth doses. We performed the study to evaluate the surface dose and the maximum depth dose using MLC conjunction with conventional blocks for various field sizes and energies. We confirmed the surface dose was increased by using the additional conventional block under the MLC ranging from 10 to 35.6％ according to various field sizes and radiation beam energies. The surface dose was effectively reduced by application of 2 or 3 m thickness of lead plate as electron filter.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.93-100
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• 2017

Purpose: A purpose of this study was to compare dose of junction between breast and SCL fields in radiation therapy by MLC located at the junction. Materials and Methods: With 6 MV of 21EX-S equipped with 120-leaf Millennium MLC, treatment plans were designed with 30 patients who underwent radiation therapy using TFT. Plan 1 where the MLC was all used at the junction. In plan 2 and plan 3, MCLs were retracted 5 mm from breast and SCL, respectively. Plan 4 with all of MLC retracted at the junction were designed. In all of the plans, collimator angle for SCL field was divided into $0^{\circ}$ and $270^{\circ}$. To verify junction dose, the dose at 3cm depth of junction was compared with average value by MapCHECK. Results: In case of the SCL field with $0^{\circ}$ collimator angle, average value of D3cm was 4131.1, 4215.9, 4351.4, and 4423.0 cGy. In case of the SCL field with $270^{\circ}$ collimator angle, average value of D3cm was 4044.3, 4246.7, 4291.1, and 4441.2 cGy. In plan1 and 3, change in average dose depending on collimator angle was changed more significantly than paln2 and 4. Dose measured at 3cm depth of junction was similar to treatment plan. Conclusion: In radiation therapy plan for breast cancer with SCL, retracting MLCs from junction between breast and SCL fields will lead to decrease effect of dose of the junction.

• Progress in Medical Physics
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• v.14 no.3
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• pp.151-160
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• 2003

The application of more complex radiotherapy techniques using multileaf collimation (MLC), such as 3D conformal radiation therapy and intensity-modulated radiation therapy (IMRT), has increased the significance of verifying leaf position and motion. Due to thier reliability and empirical robustness, quality assurance (QA) of MLC. However easy use and the ability to provide digital data of electronic portal imaging devices (EPIDs) have attracted attention to portal films as an alternatives to films for routine qualify assurance, despite concerns about their clinical feasibility, efficacy, and the cost to benefit ratio. In this study, we developed method for daily QA of MLC using electronic portal images (EPIs). EPID availability for routine QA was verified by comparing of the portal films, which were simultaneously obtained when radiation was delivered and known prescription input to MLC controller. Specially designed two-test patterns of dynamic MLC were applied for image acquisition. Quantitative off-line analysis using an edge detection algorithm enhanced the verification procedure as well as on-line qualitative visual assessment. In conclusion, the availability of EPI was enough for daily QA of MLC leaf position with the accuracy of portal films.

• Radiation Oncology Journal
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• v.14 no.4
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• pp.333-338
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• 1996

Purpose : To evaluate the clinical implications of scallop penumbra width that comes from multileaf collimator(MLC) effect by the daily routine patient setup error. Materials and Methods : The anales of $0^{circ},{\;}15^{circ},{\;}30^{circ},{\;}45^{circ},{\;}60^{circ},{\;}and{\;}75^{circ}$ inclined -radiation blocked fields were generated using the both conventional cerrobend block and the MLC. Film dosimetry in the phantom were performed to measure penumbral widths of differences between the dose distributions from the cerrobend block and those of respect the MLC. The patient setup error effect on scallop penumbra was simulated with respect to the table of setup error distribution. Same procedures are repeated for the cerrobend block generated field. Results : There are penumbral widths of to 3mm difference between the dose distributioins from two kinds of field shaping tools, the conventional block and the MLC with 4mm setup error model and resolution of 1cm leaf at the isocenter. Conclusion : We need not additive margin for MLC, if planning target volume is selected according to the recommendation of ICRU 50. For particular cases, we can include the target volume with less than 3mm additive margin.

• Journal of Radiation Protection and Research
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• v.39 no.4
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• pp.168-175
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• 2014

This study was designed to assess whether the conventional tangential technique, using a multileaf collimator (MLC), allows a reduced dose to the organs at risk (OAR) in breast radiation therapy. A total of forty right and left 20 for each breast cancer patients that underwent radiation therapy after breast conserving surgery were included in this study. For each patient, the planning target volume (PTV) and OAR (heart, left anterior descending artery (LAD), liver and lung) were defined and dose distribution were produced for conventional tangential beams using 6 MV photons. The treatment plans were made using the following two techniques for all patients. For the first plan (P1), MLC was designed to shield as much of OAR as possible without compromising the coverage of PTV. In the second plan (P2), the treatment plan was created without using MLC. Dose-volume histograms for OARs were calculated for all plans. For left breast cancer, the percentage of maximum dose ($D_{max%}$) and mean dose ($D_{mean%}$) of OARs (heart and LAD) were calculated, and for right breast cancer, the percentage of the mean dose ($D_{mean%}$) of the liver was calculated. The $D_{mean%}$ of the lung was calculated in all patients. The mean values of $D_{max%}$ of the heart ($86.9{\pm}19.5%$ range, 35.1-100.6%) in P1 were significantly lower than in P2 ($98.3{\pm}3.4%$ range, 91.7-105.2%) (p=0.001). The mean values of $D_{max%}$ of LAD ($78.4{\pm}22.5%$ range, 26.5-99.7%) in P1 was significantly lower than in P2 ($93.3{\pm}8.1%$ range, 67.9-102.1%) (p<0.001). In P1, the mean values of $D_{mean%}$ of the liver ($4.8{\pm}2.0%$) were significantly lower than in P2 ($6.2{\pm}2.5%$) (p<0.001). The mean values of $D_{mean%}$ of the lung were significantly lower in P1 ($9.3{\pm}2.3%$) than in P2 ($9.7{\pm}2.4%$) (p<0.001). P1, by using MLC, allows a significantly reduced dose to OAR compared with P2. We can suggest that it is reasonable to routinely use MLC in the conventional tangential technique for breast radiation therapy considering the primary tumor location.

• Progress in Medical Physics
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• v.29 no.1
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• pp.8-15
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• 2018

This work reports the acceptance testing and commissioning experience of the Robotic Intensity-Modulated Radiation Therapy (IMRT) M6 system with a newly released $InCise^{TM}2$ Multileaf Collimator (MLC) installed at the Yonsei Cancer Center. Acceptance testing included a mechanical interdigitation test, leaf positional accuracy, leakage check, and End-to-End (E2E) tests. Beam data measurements included tissue-phantom ratios (TPRs), off-center ratios (OCRs), output factors collected at 11 field sizes (the smallest field size was $7.6mm{\times}7.7mm$ and largest field size was $115.0mm{\times}100.1mm$ at 800 mm source-to-axis distance), and open beam profiles. The beam model was verified by checking patient-specific quality assurance (QA) in four fiducial-inserted phantoms, using 10 intracranial and extracranial patient plans. All measurements for acceptance testing satisfied manufacturing specifications. Mean leaf position offsets using the Garden Fence test were found to be $0.01{\pm}0.06mm$ and $0.07{\pm}0.05mm$ for X1 and X2 leaf banks, respectively. Maximum and average leaf leakages were 0.20% and 0.18%, respectively. E2E tests for five tracking modes showed 0.26 mm (6D Skull), 0.3 mm (Fiducial), 0.26 mm (Xsight Spine), 0.62 mm (Xsight Lung), and 0.6 mm (Synchrony). TPRs, OCRs, output factors, and open beams measured under various conditions agreed with composite data provided from the manufacturer to within 2%. Patient-specific QA results were evaluated in two ways. Point dose measurements with an ion chamber were all within the 5% absolute-dose agreement, and relative-dose measurements using an array ion chamber detector all satisfied the 3%/3 mm gamma criterion for more than 90% of the measurement points. The Robotic IMRT M6 system equipped with the $InCise^{TM}2$ MLC was proven to be accurate and reliable.