PMID- 25060175
OWN - NLM
STAT- MEDLINE
DCOM- 20150107
LR  - 20211021
IS  - 1439-099X (Electronic)
IS  - 0179-7158 (Linking)
VI  - 190
IP  - 11
DP  - 2014 Oct
TI  - New possibilities for volumetric-modulated arc therapy using the Agility 
      160-leaf multileaf collimator.
PG  - 1066-74
LID - 10.1007/s00066-014-0692-3 [doi]
AB  - PURPOSE: This study compares the quality of intensity-modulated radiotherapy 
      (IMRT) and volumetric-modulated arc therapy (VMAT) plans optimized for an Elekta 
      Agility(TM) (Elekta, Stockholm, Sweden) multileaf collimator (MLC; leaf width 5 
      mm) and an Elekta MLCi2 (leaf width 10 mm) for complex target volumes (anal, AC; 
      head and neck, H&N and prostate cancer, PC). PATIENTS AND METHODS: For plan 
      comparisons, 15 patients who had been treated with IMRT or VMAT using the MLCi2 
      were selected. For each patient, a retrospective treatment plan using the MLCi2 
      for the technique not applied was created, as were treatment plans for both 
      techniques using the Agility(TM) MLC. Dose-volume histograms (DHVs) for planning 
      target volumes (PTVs) and organs at risk (OARs) were compared. Further parameters 
      relating to dose conformity, dose homogeneity and mean dose (Dmean) to the PTV, 
      compliance with the intended OAR dose criteria and overall dose to normal tissue 
      were analyzed. Verification measurements were performed and optimization and 
      treatment times were compared. RESULTS: Compared to the MLCi2 plans, the 
      Agility(TM) IMRT and VMAT plans show better or equivalent results in terms of PTV 
      dose conformity and homogeneity. Compliance with the intended OAR dose criteria 
      does not differ according to technique or MLC type. Slight differences are shown 
      for dose distributions in OARs and normal tissue. Verification measurements show 
      that all plans fulfill the acceptance criteria of a minimum of 95 % matched dose 
      points for the 3 %/3 mm gamma criterion. Optimization times for the VMAT plans 
      increase compared to the IMRT plans, whereas treatment times decrease. 
      CONCLUSION: With the MLCi2, treatment of complex target volumes with VMAT was 
      only possible with compromises in terms of target coverage. Using the Agility(TM) 
      MLC, even complex target volumes can be treated with VMAT without compromising 
      target coverage or resulting in higher exposure of OARs or normal tissue.
FAU - Blumer, Nadine
AU  - Blumer N
AD  - Klinik fur Strahlentherapie und Onkologie, Universitatsklinikum Frankfurt, 
      Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany, Nadine.Bluemer@kgu.de.
FAU - Scherf, Christian
AU  - Scherf C
FAU - Kohn, Janett
AU  - Kohn J
FAU - Kara, Eugen
AU  - Kara E
FAU - Loutfi-Krauss, Britta
AU  - Loutfi-Krauss B
FAU - Imhoff, Detlef
AU  - Imhoff D
FAU - Rodel, Claus
AU  - Rodel C
FAU - Ramm, Ulla
AU  - Ramm U
FAU - Licher, Jorg
AU  - Licher J
LA  - eng
PT  - Journal Article
DEP - 20140725
PL  - Germany
TA  - Strahlenther Onkol
JT  - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et 
      al]
JID - 8603469
SB  - IM
MH  - Equipment Design
MH  - Equipment Failure Analysis
MH  - Humans
MH  - Neoplasms/*radiotherapy
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*instrumentation/*methods
MH  - Radiotherapy, Intensity-Modulated/*instrumentation
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
EDAT- 2014/07/26 06:00
MHDA- 2015/01/08 06:00
CRDT- 2014/07/26 06:00
PHST- 2013/12/18 00:00 [received]
PHST- 2014/05/14 00:00 [accepted]
PHST- 2014/07/26 06:00 [entrez]
PHST- 2014/07/26 06:00 [pubmed]
PHST- 2015/01/08 06:00 [medline]
AID - 10.1007/s00066-014-0692-3 [doi]
PST - ppublish
SO  - Strahlenther Onkol. 2014 Oct;190(11):1066-74. doi: 10.1007/s00066-014-0692-3. 
      Epub 2014 Jul 25.