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British Journal of Radiology (2006) 79, 401-408
© 2006 British Institute of Radiology
doi: 10.1259/bjr/91588055
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A quantitative study of IMRT delivery effects in commercial planning systems for the case of oesophagus and prostate tumours

J Seco, PhD, C H Clark, PhD, P M Evans, DPhil and S Webb, PhD, DIC

Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT, UK


Figure 1
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  		Figure 1. Dose–volume histograms (DVHs) of the optimum dose (OPT_PTV) or delivered dose to the planning target volume (PTV) by (a) 3 and (b) 5 intensity-modulated radiotherapy (IMRT) plans. The delivery techniques represented are the (i) multiple static fields (MSF) with 2%/compensator (red), 5% (blue) and 10% (green) error tolerance for the 3 beam and 5% (blue) and 10% (green) for the 5 beam and the (ii) compensator (orange) for the 5 beam case.

 

Figure 2
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  		Figure 2. A standard oesophageal dose distribution obtained from the(a) optimal and actual fluence delivered with MSF for (b) 2% and (c) 5% error tolerance. The 98%, 80%, 50% and 20% isodose levels are shown, respectively, as red, green, blue and yellow and the planning target volume (PTV) is thick red.

 

Figure 3
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  		Figure 3. Dose–volume histograms (DVHs) obtained for the spinal cord in the case of (a) the 3 and (b) the 5 beam plans. The delivery techniques represented are the (i) multiple static fields (MSF) with 2% (red), 5% (blue) and 10% (green) error tolerance for the 3 beam and 5% (blue) and 10% (green) for the 5 beam and the (ii) compensator (orange) for the 5 beam case.

 

Figure 4
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  		Figure 4. Dose–volume histograms (DVHs) obtained for the left and right lungs in the case of the 3 and 5 beams intensity-modulated radiotherapy (IMRT) plan.

 

Figure 5
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  		Figure 5. A dose–volume histogram (DVH) of an example patient with prostate carcinoma and nodal involvement (with right (Node_RT) and left (Node_LT) nodes considered separately). The organs at risk considered are the bladder, small bowel and rectum. The dose values are presented for the two cases: (i) before (BEF) shown as points and (ii) after (continuous lines) leaf sequencing with the planning target volume (PTV) dose being normalized to 70 Gy. Arrows indicate the increase in the dose delivered to the volume of interest due to leaf-sequencing effects.

 




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