THE INFLUENCE OF MACHINE MODEL AND OPTIMIZATION PARAMETERS ON THE GENERATION OF NARROW SEGMENTS IN STEP AND SHOOT INTENSITY MODULATED RADIOTHERAPY PLANS FOR SIMPLIFIED GEOMETRIES

Abstract

<p>Generation of narrow segments is a matter of concern in step-and-shoot intensity modulated radiotherapy for several reasons. The measurement, calculation and delivery of dose from narrow segments may be complicated due to: the dosimetric properties of the detector; the effect of beam penumbra and heterogeneities within the patient; and the requirement for high geometric delivery precision respectively. The main purpose of this thesis was to investigate the parameters affecting the generation of narrow beam segments in IMRT optimization. Parameters such as effective source size, Gaussian height and width, density of the target volume, and gap between the tumor and normal tissue were varied to determine their influence on the number of narrow leaf pair separations. The gradient and penumbra were also examined. Two simple geometric models (thick model and thin model) with different dimensions were used. In the thick model, two 6-MV photon beams were incident on the target at right angles. A rectangular target was centered in a phantom with dimensions 20.25 cm×5.25 cm×20.25 cm. In the thin model, one 6-MV photon beam was normally incident on a 20.25 cm×1.25 cm×20.25 cm slab phantom. The relationship between the penumbra and number of narrow separated leaf pairs were examined for the thick model. The results did not show a consistent pattern. For the thin model, creating a gap between the target and the OAR decreased the total number of narrowly separated leaf pairs along the interface but increased the average dose delivered to the OAR. By varying the OAR max dose or the gap between the target and OAR, a peak was created in the dose profiles to compensate the penumbra. As gradient increased the peak height increased to compensate the dose fall-off. The width of the peak at half maximum changed with gradient but not in a predictable fashion.</p>