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KMID : 1151820200140020105
Journal of the Korean Society of Radiology
2020 Volume.14 No. 2 p.105 ~ p.109
Verification of Clinical Usefulness of Jaw Tracking in IMRT
Kim Jin-Young

Kim Ki-Hwan
Abstract
Intensity-modulated radiotherapy(IMRT) has disadvantages such as increasing the low doses of irradiation to normal tissues and accumulated dose for the whole volume by leakage and transmission of the Multi Leaf Collimator (MLC). The accumulated dose and low dose may increase the occurrence of secondary malignant neoplasms. For this reasons, the jaw tracking function of the TrueBeam (Varian Medical Systems, Palo Alto, CA) was developed to reduce the leakage and transmission dose of the MLC with existing linear accelerators. But quantitative analysis of the dose reduction has not been verified. Therefore, in the present study, we intended to verify the clinical possibility of utilizing the jaw tracking function in brain tumor with comparison of treatment plans. To accomplish this, 3 types of original treatment plans were made using Eclipse11 (Varian Medical Systems, Palo Alto, CA): 1) beyond 2 cm distance from the Organs At Risk (OARs); 2) within 2 cm distance from the OARs; and 3) intersecting with the OARs. Jaw tracking treatment plans were also made with copies of the original treatment planning using Smart LMC Version 11.0.31 (Varian Medical Systems, Palo Alto, CA). A comparison between the 2 types of treatment planning methods was performed using the difference of the mean dose and maximum dose to the OARs in cumulative Dose Volume Histogram (DVH). In the DVH comparison, the maximum difference of 0.5 % was observed between the planning methods in the case of over 2 cm distance, and the maximum of 0.6 % was obtained for within the 2 cm distance. For the case intersecting with the OAR, the maximum difference of 2 % was achieved. According to these results, it could be realized that the differences of mean dose and maximum dose to the OARs was larger when the OARs and PTV were closer. Therefore, treatment plans with the jaw tracking function consistently affected the dose reduction and the clinical possibility could be verified.
KEYWORD
Intensity-modulated radiotherapy , Multi Leaf Collimator(MLC) , Jaw tracking
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