AAPM Task Group 264: The safe clinical implementation of MLC tracking in radiotherapy
Keall, Paul J.; Sawant, Amit; Berbeco, Ross I.; Booth, Jeremy T.; Cho, Byungchul; Cerviño, Laura I.; Cirino, Eileen; Dieterich, Sonja; Fast, Martin F.; Greer, Peter B.; Munck af Rosenschöld, Per; Parikh, Parag J.; Poulsen, Per Rugaard; Santanam, Lakshmi; Sherouse, George W.; Shi, Jie; Stathakis, Sotirios
(2021) Medical Physics, volume 48, issue 5, pp. e44 - e64
(Article)
Abstract
The era of real-time radiotherapy is upon us. Robotic and gimbaled linac tracking are clinically established technologies with the clinical realization of couch tracking in development. Multileaf collimators (MLCs) are a standard equipment for most cancer radiotherapy systems, and therefore MLC tracking is a potentially widely available technology. MLC tracking
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has been the subject of theoretical and experimental research for decades and was first implemented for patient treatments in 2013. The AAPM Task Group 264 Safe Clinical Implementation of MLC Tracking in Radiotherapy Report was charged to proactively provide the broader radiation oncology community with (a) clinical implementation guidelines including hardware, software, and clinical indications for use, (b) commissioning and quality assurance recommendations based on early user experience, as well as guidelines on Failure Mode and Effects Analysis, and (c) a discussion of potential future developments. The deliverables from this report include: an explanation of MLC tracking and its historical development; terms and definitions relevant to MLC tracking; the clinical benefit of, clinical experience with and clinical implementation guidelines for MLC tracking; quality assurance guidelines, including example quality assurance worksheets; a clinical decision pathway, future outlook and overall recommendations.
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Keywords: Humans, Particle Accelerators, Radiation Oncology, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Robotics, Journal Article
ISSN: 0094-2405
Publisher: AAPM - American Association of Physicists in Medicine
Note: Funding Information: The members of TG 264 Safe Clinical Implementation of MLC Tracking in Radiotherapy listed below disclose the following potential Conflict(s) of Interest related to subject matter or materials presented in this document. Paul Keall is an inventor on US patents 7469 035 and 8971 489 and a provisional patent that are related to MLC tracking. Patent 7469 035 and the provisional patent are unlicensed; patent 8971 489 is exclusively licensed. He has previously received an equipment loan and research grants from Varian Medical Systems related to MLC tracking. Amit Sawant receives research support from Varian Medical Systems and VisionRT Inc. Ross Berbeco receives research support from Varian Medical Systems and Viewray Inc. Jeremy Booth received research support from Varian Medical Systems. Martin Fast receives research support for MLC tracking from Elekta AB (Stockholm, Sweden). Per Poulsen has received equipment loans and research grants for MLC tracking from Varian Medical Systems. Peter Greer receives research support from Varian Medical Systems and has research agreements with Siemens Healthineers. Funding Information: We thank Kevin Brown and Nima Hassan‐Rezaeian for their input, Vincent Caillet for providing Fig. 4 and Movie S2 and Emma Colvill for providing Fig. 3 . X. Allen Li and Guang‐Pei Chen Medical College of Wisconsin provided input on their tracking experience. Helen Ball provided administrative support for the report. Paul Keall was supported by a Senior Principal Research Fellowship (APP1112096) from the National Health and Medical Research Council of Australia and Martin Fast acknowledges funding by the Dutch Research Council (NWO) through project #17515 (BREATHE EASY). Publisher Copyright: © 2020 American Association of Physicists in Medicine
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