Rounded leaf end effect of multileaf collimator on penumbra width and radiation field offset: an analytical and numerical study Dong Zhou, Hui Zhang, Peiqing Ye Department of Mechanical Engineering, Tsinghua University, Beijing, China Radiol Oncol 2015; 49(3): 299-306. Received 1 February 2015 Accepted 22 March 2015 Correspondence to: Prof. Peiqing Ye, Ph.D., Department of Mechanical Engineering, Tsinghua University, Beijing, China. Phone: +86 010 6277 3269; E-mail: yepq@tsinghua.edu.cn Disclosure: No potential conflicts of interest were disclosed. Background. Penumbra characteristics play a significant role in dose delivery accuracy for radiation therapy. For treatment planning, penumbra width and radiation field offset strongly influence target dose conformity and organ at risk sparing. Methods. In this study, we present an analytical and numerical approach for evaluation of the rounded leaf end effect on penumbra characteristics. Based on the rule of half-value layer, algorithms for leaf position calculation and radiation field offset correction were developed, which were advantageous particularly in dealing with large radius leaf end. Computer simulation was performed based on the Monte Carlo codes of EGSnrc/BEAMnrc, with groups of leaf end radii and source sizes. Data processing technique of curve fitting was employed for deriving penumbra width and radiation field offset. Results. Results showed that penumbra width increased with source size. Penumbra width curves for large radius leaf end were U-shaped. This observation was probably related to the fact that radiation beams penetrated through the proximal and distal leaf sides. In contrast, source size had negligible impact on radiation field offset. Radiation field offsets were found to be constant both for analytical method and numerical simulation. However, the overall resulting values of radiation field offset obtained by analytical method were slightly smaller compared with Monte Carlo simulation. Conclusions. The method we proposed could provide insight into the investigation of rounded leaf end effects on penumbra characteristics. Penumbra width and radiation field offset calibration should be carefully performed to commission multileaf collimator for intensity modulated radiotherapy. Key words: multileaf collimator; rounded leaf end effect; penumbra width; radiation field offset; Monte Carlo simulation Introduction Multileaf collimator system was introduced as a replacement of shielding block for beam shaping and beam intensity modulation, which has become an essential component for modern radiation therapy and a standard of care for radiation oncology fa-cilities.1 Penumbra characteristics of multileaf colli-mator are closely related to healthy tissues involvement, which is of interest to medical physicists, do-simetrists and radiation oncologists.2 Single-focused multileaf collimator is characterized by linear leaf motion perpendicular to colli-mator rotation axis, which has been widely used by virtue of its compact space and simplified structures. The rounded leaf end design of single-focused multileaf collimator for following beam divergence has a strong impact on penumbra charac-teristics.3 In order to avoid tumour underdose and normal tissue overdose, the rounded leaf end effect of single-focused multileaf collimator on penumbra characteristics should be carefully modelled FIGURE 1. Components of treatment head are comprised of source, diaphragm, multileaf collimator, and scoring plane. Leaf positions on scoring plane are classified into nominal leaf position N, geometric leaf position G and physical leaf position P. SAD = source to axis distance; SCD = source to collimator distance; SDD = source to diaphragm distance in treatment planning system, otherwise it would result in dose error particularly when sharp dose gradient is intended for stereotactic body radiotherapy. For the purpose of precision radiation therapy, intensive research efforts have been made on the dosimetric measurement and Monte Carlo simulation of multileaf collimator systems.45 Studies have revealed that dosimetric characteristics of multileaf collimator are influenced by the factors, including but not limited to geometry of treatment modality, radiation source properties, leaf end shape and leaf position with respect to central axis.6 It was found that dosimetric penumbra of multileaf collimator is the combined effect of geometric penumbra, transmission penumbra and phantom scatter.7 Quality assurance has been implemented to determine penumbra width and the offset between light field edge and radiation field edge during commissioning of multileaf collimator.89 Results have shown that penumbra width and radiation offset are leaf position dependent and largely attributed to leaf end shape. It is reported that the projected leaf position on scoring plane, light field edge and radiation field edge follow a nonlinear relationship. Calibrations of leaf position offset and radiation field offset were performed to minimize the error between planned doses and delivered doses.1011 Rule of half-value layer12 has been proposed for calculation of radiation field offset based on geometrical approach.13 However, previous studies were confined to single source energy distribution, normally simplified as Gaussian shaped, and limited leaf ends in the shape of circular arc were investigated. There is a lack of consistency in the quantitative study into rounded leaf end effect on penumbra characteristics of multileaf collimator in literature. Besides, there is no literature available, to our knowledge, reporting on algorithms of leaf position calculation and radiation field offset correction for large radius leaf end. Consequently, the aim of this study was to explore the rounded leaf end effect and efforts were made to reveal the source energy distribution and leaf end shape related penumbra characteristics. An analytical method for radiation field offset correction was developed and numerical simulation with various leaf end radii and source sizes was conducted based on Monte Carlo codes. Materials and methods In this section, leaf positions are classified and geometry based algorithms for radiation field offset correction are developed. With treatment head modelling, Monte Carlo simulation is introduced to investigate the rounded leaf effect on penumbra characteristics. Data processing techniques for deriving penumbra width and radiation field offset are proposed. Algorithms for leaf position calculation and radiation field offset correction Leaf positions on scoring plane are divided into projected leaf end position (nominal leaf position), light field edge (geometric leaf position), and radiation field edge (physical leaf position).14 Nominal leaf position is usually calibrated so that it corresponds to the light field edge or the radiation field edge. In this study, nominal leaf position is designated to coincide with the projected leaf position without calibration. As depicted in Figure 1, mechanical leaf position is referred to as the leaf tip location relative to collimator rotation axis, which is shown as point E. Nominal leaf position, geometric leaf position and physical leaf position on the scoring plane are represented by point N, point G, and point P, respectively. Leaf position offset (LPO) is defined as the distance between geometric leaf position and nominal leaf position. Radiation field offset (RFO) is defined as the distance between physical leaf position and geometric leaf position. The term of physical-nominal offset (PNO) is proposed, which is defined as the distance between physical leaf position and nominal leaf position. Place the origin of coordinate in coincidence with isocenter O. Therefore, the Z-coordinates are zero for point N, G and P. Point N is obtained by projecting of mechanical leaf position E onto the scoring plane. Point G is obtained by deriving the tangent line of circular arc leaf end from source S. Point P is obtained by rule of half-value layer. Equations for the LPO, RFO and PNO derivation are presented, RFO = Xj,-Xf, PNO = x,,-x,, [1] Algorithms for calculation the X-coordinates of leaf positions are illustrated as follows. Consider a specific nominal leaf position, which is designated as point N in Figure 1, Point E is obtained by back-projecting leaf end point N onto the collimator middle plane, that is SCD X^ =X^ X- " ^ SAD [2] where SCD is used to stand for source to collima-tor distance, while SAD stands for source to axis distance. The circular arc center C is shifted to the positive side of point E with a length of radius R, that is, Xc=x,,+R [3] Denote the distance between source S and arc centre C as D, which is used as a reference, [4] Firstly, point G is obtained by deriving the tangent line of circular arc leaf end from source S. The relationship between point G and point T is, = ,, SAD ^^^ ^^""sAD-z^ [5] Thus, the prerequisite for point G derivation is to obtain point T. The X-coordinate of point T should satisfy the condition of ^ < Point T can be obtained by the following equations, (ZT -ZSX^T -ZC) + (^T -^SX^T -^C) = 0 [6] In case that the tangent point falls out of circular arc or S falls within circle, denote the tangent point as the intersection point of circular arc with proximal or distal leaf side. The intersection points are depicted as point U and point V, respectively. Algorithm is illustrated as follows, for leaf height of Ih, Xj = ifz^ 6[Zc-tt/2,Zc+/Ä/2] Xc-^lR^-ilhHf, otherwise [7] z^+lhH, \iD7?andzT >Zc+lh/2 z^-lh/l, ifD>Rmdz^Randz.^ e[zc-lh/2,z,,+lh/2] [8] Secondly, point P is obtained by the half-value layer rule. Draw a secant line from source S to the point P, the secant point A and B fall on the left side of C, that is, Xf^ Z^+lh/2 or D 0. For clinical application, leaf end radius is commonly larger than half of leaf width. The maximum of H is written, H = R- CK =R-. < 8 / 2 - ^(8 / 2)' - (- In (0.5) / 0.96 / if =0.016 cm [15] Normally, source energy distribution for treatment modality is with FWHM ranging from 1 to 3 mm. Note that the H is small compared with source size. Secondly, suppose that source energy distribution is approximately symmetric about central axis. Divide source energy into three parts, the left part S1, the middle part S2 and the right part S3 with respect to the central axis. Denote that total source energy as 1, it is written that, 5i+52+53=1 [16] ^X = [17] The attenuation weight for the beams from source part S1, S2 and S3 to the point P are defined as w1, w2 and w3, respectively. The rule of half value layer tells that w2 = 0.5. On account that H is small, beams irradiate from the left part of source are supposed to reach P without attenuation, that is w1 = 1, while for the right part, beams penetrate through leaf entity to reach P with path length larger than half value layer, that is, 0 < w3 < 0.5. Consequently, the radiation intensity EP of point P is written as follows, £p = w,S, + w^S^ + W3S3 > S, + 0.5 • S^ = 0.5 ■(81+8^+3^) = 0.5 (18) Therefore, it is implied that the physical edge of radiation field P50 should be on the right side of P, that is, Xf < Xf^. This is a simple physical explanation why "geometric optics" formulae systematically underestimate the physical-nominal offset. Since the segmentation of source energy is coarse, further study is suggested with Ray Tracing algorithm, which is implemented by computation of the weighed beam integral based on the law of exponential attenuation. It is suggested that modifications for analytical RFO correction should be performed in order to fit in well with treatment modalities. Path length larger than the half-value layer would be beneficial. The rounded leaf end design of multileaf col-limators leads to partial transmission of radiation beams, which have a significant impact on dose delivery accuracy of IMRT, SBRT and VMAT. Based on Monte Carlo simulation for SBRT multileaf collimator, Asnaashari et al.5 have revealed that dosi-metric penumbra is influenced by source energy, beam collimators and field size. This observation is in good agreement with our study. It is suggested that dosimetric characteristics of multileaf collima-tor should be calibrated and comprehensive rou- Scoring Plane FIGURE 9. Geometry of treatment head tor simple physical explanation of why the rule of half value layer systematically underestimates the physical-nominal offset. SAD = source to axis distance; SCD = source to collimator distance; SDD = source to diaphragm distance tine quality assurance should be performed before they are implemented for IMRT applications.3 Further study is needed both for theoretical investigation and dosimetric measurement of rounded leaf end effect. In our study, penumbra width and radiation field offset of single leaf are intensively studied. In contrast, Szpala et al.11 investigated the value of dosimetric leaf gap (DLG) for leaf pairs in treatment planning. It was demonstrate that the DLG depends on the size of mulileaf collimator slit. Such effect is probably caused by scatter variation from the opposite leaf with different slit widths. Furthermore, they proposed a method by expanding the DLG parameter from a single value to a function of distance from the nominal leaf position and displacement of the opposite leaf. However, efforts should made to improve dose calculation accuracy in VMAT treatment planning, not merely by adjusting single parameter, such as leaf transmission or DLG. Better modeling rounded leaf end effect is of significance for future works. Conclusions In summary, the algorithms we proposed for leaf position calculation and radiation field offset correction are effective for leaf end with large radius. Results of Monte Carlo simulation show that source size influences penumbra width, while for radiation field offset, the source size impact is negligible. Penumbra width performance could be improved by carefully choosing the radius of circular arc leaf end. In this study, the leaf positions, including mechanical leaf position, nominal leaf position, geometric leaf position and physical leaf position are classified and rigorously deduced. Correction of leaf position offset, radiation field offset and physical-nominal offset are realized based on analytical method. In general, results of analytical method agree well with numerical simulation. However, a slight gap exists between analytical radiation field offset and numerical radiation field offset, which implies that modification should be introduced when applying the empirical rule of half-value layer. For better treatment planning, the rounded leaf end effect on penumbra characteristics should be taken with care in order to achieve dose delivery accuracy. 12. Boyer AL, Li S. Geometric analysis of light-field position of a multileaf collimator with curved ends. Med Phys 1997; 24: 757-62. 13. Wu JM, Lee TF, Yeh SA, Hsiao KY, Chen HH, Chao PJ, et al. A Light-Field-Based Method to Adjust On-Axis Rounded Leaf End MLC Position to Predict Off-Axis MLC Penumbra Region Dosimetric Performance in a Radiation Therapy Planning System. Biomed Res Int 2013; 2013: 461801. 14. Vial P, Oliver L, Greer PB, Baldock C. 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