Technical Note: Dosimetric characterization of the dynamic beam flattening MLC sequence on a ring shaped, Jawless Linear Accelerator with double stacked MLC.

PURPOSE: To characterize the dosimetric features and limitations of the dynamic beam flattening (DBF) on the Halcyon 2.0 linear accelerator (Varian Medical Systems). METHODS: A predefined multi-leaf collimator (MLC) sequence was introduced and used to flatten the 6 MV flattening filter free (FFF) beam on the Halcyon 2.0. Dosimetric characterizations of the flattened beams, including beam flatness, symmetry, percent depth dose (PDD), output factor and MU linearity, were investigated. Flatness and symmetry were obtained from profile measurements with both radiographic films (EDR2) and a two dimensional ion-chamber array (IC Profiler, Sun Nuclear Corporation). MU linearity, output factors, and PDDs were measured in a water tank with a CC13 ion chamber (Scanditronix Wellhöfer, Nuremburg, Germany). In addition, the effect of the DBF sequence on 3D plan quality was evaluated by creating DBF plans for a 4-field box rectum and an AP/PA spine plan. Patient specific QA was performed on these plans. RESULTS: At 100 cm SSD and 10 cm depth, a flatness of <3% was observed on both transversal and radial profiles for all square field sizes ≥10 cm with DBF. For both larger and smaller field sizes the flatness showed a tendency to increase as the fields got bigger or smaller, respectively. Similar trends in flatness were observed at all depths measured. All measured output factors for square field sizes ≥5 cm were within 1% of the TPS prediction. Linearity was ≤2.02% for all measurements. For both treatment sites, the MD judged the plans created for the Halcyon without the use of DBF not to be clinically acceptable, however considered both the TrueBeam plan and the Halcyon plan with the DBF sequence to be clinically acceptable. CONCLUSIONS: The DBF sequence on the Halcyon and its characteristics were investigated. The analysis indicates that the DBF sequence can be used on the Halcyon to generate clinically acceptable 3D treatment plans.

Dosimetric Characterization of the Dual Layer MLC System for an O-Ring Linear Accelerator.

The Halcyon is Varian's latest linear accelerator that offers a single 6X flattening-filter-free beam with a jawless design that features a new dual layer multileaf collimator system with faster speed and reduced transmission. Dosimetric characteristics of the dual layer multileaf collimator system including transmission, dosimetric leaf gap, and tongue and groove effects were measured. Ionization chambers, diode arrays, and an electronic portal imaging device were used to measure various multileaf collimator characteristics. Transmission through both multileaf collimator banks was found to be 0.008%, while the distal and proximal banks alone had transmission values of 0.4%. The penumbra was slightly sharper for fields using only the distal multileaf collimator bank but found to be largely independent of leaf position with values between 2.7 to 3.0 mm at dmax for the combined multileaf collimator banks. The dosimetric leaf gap was measured for the proximal and distal multileaf collimator banks both individually and together and found to have values of -0.216 mm, -0.225 mm, and 0.964 mm, respectively. Measurements of dosimetric leaf gap at the leaf edge and midline were also performed. Tongue and groove effects were investigated with both the electronic portal imaging device and a 2-dimensional array of diodes.

Characterization and validation of an intra-fraction motion management system for masked-based radiosurgery.

PURPOSE: Characterize the intra-fraction motion management (IFMM) system found on the Gamma Knife Icon (GKI), including spatial accuracy, latency, temporal performance, and overall effect on delivered dose. METHODS: A phantom was constructed, consisting of a three-axis translation mount, a remote motorized flipper, and a thermoplastic sphere surrounding a radiation detector. An infrared marker was placed on the translation mount secured to the flipper. The spatial accuracy of the IFMM was measured via the translation mount in all Cartesian planes. The detector was centered at the radiation focal point. A remote signal was used to move the marker out of the IFMM tolerance and pause the beam. A two-channel electrometer was used to record the signals from the detector and the flipper when motion was signaled. These signals determined the latency and temporal performance of the GKI. RESULTS: The spatial accuracy of the IFMM was found to be <0.1 mm. The measured latency was <200 ms. The dose difference with five interruptions was <0.5%. CONCLUSION: This work provides a quantitative characterization of the GKI IFMM system as required by the Nuclear Regulatory Commission. This provides a methodology for GKI users to satisfy these requirements using common laboratory equipment in lieu of a commercial solution.