SU-G-TeP4-07: Automatic EPID-Based 2D Measurement of MLC Leaf Offset as a Quality Control Tool.

Academic Article


  • PURPOSE: The MLC dosimetric leaf gap (DLG) and transmission are measured parameters which impact the dosimetric accuracy of IMRT and VMAT plans. This investigation aims to develop an efficient and accurate routine constancy check of the physical DLG in two dimensions. METHODS: The manufacturer's recommended DLG measurement method was modified by using 5 fields instead of 11 and by utilizing the Electronic Portal Imaging Device (EPID). Validations were accomplished using an ion chamber (IC) in solid water and a 2D IC array. EPID data was collected for 6 months on multiple TrueBeam linacs using both Millennium and HD MLCs at 5 different clinics in an international consortium. Matlab code was written to automatically analyze the images and calculate the 2D results. Sensitivity was investigated by introducing deliberate leaf position errors. MLC calibration and initialization history was recorded to allow quantification of their impact. Results were analyzed using statistical process control (SPC). RESULTS: The EPID method took approximately 5 minutes. Due to detector response, the EPID measured DLG and transmission differed from the IC values but were reproducible and consistent with changes measured using the ICs. For the Millennium MLC, the EPID measured DLG and transmission were both consistently lower than IC results. The EPID method was implemented as leaf offset and transmission constancy tests (LOC and TC). Based on 6 months of measurements, the initial leaf-specific action thresholds for changes from baseline were set to 0.1 mm. Upper and lower control limits for variation were developed for each machine. CONCLUSION: Leaf offset and transmission constancy tests were implemented on Varian HD and Millennium MLCs using an EPID and found to be efficient and accurate. The test is effective for monitoring MLC performance using dynamic delivery and performing process control on the DLG in 2D, thus enhancing dosimetric accuracy. This work was supported by a grant from Varian Medical Systems.
  • Published In

  • Medical Physics  Journal
  • Medical Physics  Journal
  • Keywords

  • Image analysis, Image guided radiation therapy, Intensity modulated radiation therapy, Ionization chambers, Linear accelerators, Medical imaging, Multileaf collimators, Process monitoring and control, Quality assurance, Transmission measurement
  • Digital Object Identifier (doi)

    Author List

  • Ritter T; Schultz B; Kim G; Barnes M; Perez M; Farrey K; Popple R; Greer P; Moran J
  • Start Page

  • 3686
  • Volume

  • 43
  • Issue

  • 6