Dosimetric Evaluation of the Parameter Variation with Varying Calculation Grid Size in the IMRT Cases
M Markovic1*, (1) Dept. Of Radiological Studies, University of Texas Helath Science Center, San Antonio, TX S Stathakis1*, (1) Dept. Of Radiological Studies, University of Texas Helath Science Center, San Antonio, TX P Mavroidis2*, (2) Dept. of Medical Physics, Larissa University Hospital, Larissa, Greece A Gutierrez1*, (1) Dept. Of Radiological Studies, University of Texas Helath Science Center, San Antonio, TX C Esquivel1*, (1) Dept. Of Radiological Studies, University of Texas Helath Science Center, San Antonio, TX N Papanikolau1*, (1) Dept. Of Radiological Studies, University of Texas Helath Science Center, San Antonio, TXSU-E-T-601 Sunday 3:00:00 PM - 6:00:00 PM Room: Exhibit Hall
Purpose: The aim of this study is to compare the plan results that are obtained by using different calculation grid sizes ranging from 0.15 to 0.50 cm, and the same dose calculation algorithm (Superposition), in Intensity Modulated Radiotherapy (IMRT) for different treatment sites. Results are then used to study the suitability of dose grid size with respect to site.
Methods: For each of the calculation grid sizes, three different sites; namely, Lung, Prostate, and Head and Neck were analyzed. Treatment plans were created using 6MV photon beam quality and IMRT technique on the CMS XiO (Computerized Medical System, St.Louis, MO) treatment planning system. Dose volume histograms were generated for each of the cases and statistical analysis performed included mean relative difference and Homogeneity Index for target structures. Comparison was done first by using 0.30 cm calculation grid as a golden standard and keeping the same number of monitor units (MUs) per beam for each grid size, then the second part involved renormalizing plans to have the same target coverage (100% of the prescription dose covering at least 95% of the target volume) for each grid size used. Future study plans include treatment plans delivery on Varian 21EX linear accelerator with Millennium (120) MLC and their verification with the Sun Nuclear Mapcheck 2D array. To increase the diode array resolution, 2D array will be shifted in 1 mm increments in x and y direction. Measured fields will be merged using Sun Nuclear Files Combined function and compared with intensity maps exported from the CMS XiO treatment planning system calculated with minimum segment size of 1 cm.
Results: The maximum percentage of variation recorded between calculation grid sizes used was in the case of the Head and Neck treatments. For the lung and prostate cases there was little variation in the results based on the calculation grid size chosen, specifically between 0.30, 0.20 and 0.15 cm. However head and neck and prostate cases with nodal involvement showed significant variation in the dosimetric results based on the grid size chosen. Overall results vary from case to case and also depend on the plan complexity. For larger treatment areas calculating with the grid size smaller than 0.30 cm may be impossible as time needed for calculation rises exponentially with the field size involved.
Conclusions: IMRT places a higher requirement on dose grid resolution than conventional radiation therapy. While 0.30-0.40 cm grid was assumed adequate for conformal treatment planning, smaller dose grid is required at least in the areas of high dose. In the cases where steep dose gradients exist smaller grid size should be used while calculating and evaluating treatment plans, as the choice of the calculation grid size may in certain cases even influence clinical results.