Main Session
Sep 28
PQA 01 - Radiation and Cancer Physics, Sarcoma and Cutaneous Tumors

2061 - External Beam Treatment Delivery Efficiency Assessment via Trajectory Log Analysis

02:30pm - 04:00pm PT
Hall F
Screen: 7
POSTER

Presenter(s)

Ruiming Edmondson, PhD Headshot
Ruiming Edmondson, PhD - Mayo Clinic, Scottsdale, AZ

R. C. Edmondson, S. Shiraishi, D. J. Moseley, and J. Kavanaugh; Department of Radiation Oncology, Mayo Clinic, Rochester, MN

Purpose/Objective(s): In modern clinics it is costly to increase treatment capacity through the addition of treatment machines or extension of treatment hours. Clinics with multiple types of delivery system often triage patients based on simple assumptions such as nominal maximum dose rate equates to more efficient delivery. Here we aim to show that max dose rate is not a good individual predictor of treatment delivery efficiency, and a combined analysis of delivery parameters is a potential better metric.

Materials/Methods: Linear accelerator (linac) treatment log files spanning one month were collected from 14 linacs at one institution and its regional clinics. An in-house MATLAB tool was used to read the logs retrospectively and compute dose rate, gantry speed, dose delivered, and maximum instantaneous speed of the multileaf collimators (MLCs). “% constrained” was calculated as the percentage of beam-on time where the gantry speed, dose rate, or MLC speed is greater than 95% of the maximum achievable values for each parameter. Comparisons between c-arm and ring gantries were conducted using a t-test, with matching colors in table showing compared groups. All treatment plans were generated in a single planning system.

Results: Logs for 606 unique VMAT plans of 535 patients were collected, with 115 plans on ring gantry linacs (6 MV FFF @ max 800 MU/min) and 491 plans on c-arm linacs (6 MV @ max 600 MU/min, 6 MV FFF @ max 1400 MU/min, and 10 MV FFF @ max 2400 MU/min).

Ring gantry beam-on time is significantly shorter than c-arm linacs (p<0.01) despite having more arcs. Ring gantry is also significantly more constrained (p<0.01) than c-arm linacs, suggesting potential higher machine usage efficiency.

Gantry and MLC speed are more likely to reach their max limit for highly modulated plans (pancreas). For SBRT plans, dose rate constraint is more often reached, and MLC and gantry speed constraints are less often reached.

Conclusion: Increased delivery efficiency is gained through maximizing multiple delivery parameters, rather than simply increasing the max dose rate. Additional delivery capacity might be achievable through site/technique specific optimizations that maximize multiple delivery parameters.

Abstract 2061 - Table 1

Mean Dose Rate (MU/min)

Beam On Time (min)

# of Arcs

MLC Speed

Gantry Speed

Dose Rate

Total

% Constrained

Ring Gantry

Total (n=115)

494.5

2.43

3.47

61.4

62.9

34.1

158.4

SBRT (n=20)

752.1

1.97

2.95

0

0

99.0

99.0

Non-SBRT (n=62)

438.3

2.62

3.60

74.5

76.3

19.0

169.8

Prostate (n=23)

687.5

1.83

3.09

22.1

24.2

77.7

124.0

Pancreas (n=20)

382.2

3.22

3.45

82.4

84.1

10.8

177.3

C Arm

6 MV (n=300)

264.4

3.49 p<0.01

2.99

2.2

45.5

9.7

57.4

6 MV FFF (n=101)

1039.6

3.06 p<0.01

2.89

0.3

30.5

52.6

83.4

10 MV FFF (n=90)

1183.7

3.18 p<0.01

2.67

1.9

46.9

28.4

77.2

SBRT (n=38)

1084.1

3.37

2.92

0

39.5

39.7

79.2 P<0.01

Non-SBRT (n=51)

426.7

3.50

2.86

2.3

42.9

14.5

59.7 P<0.01

Prostate (n=36)

499.3

2.95

2.39

4.8

47.2

13.5

65.5 P<0.01

Pancreas (n=11)

185.2

5.90

2.72

0

51.3

5.3

56.6 P<0.01