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Letter to the Editor on 'Single-Arc IMRT?'*

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Karl Otto

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LETTER TO THE EDITOR

In the note 'Single Arc IMRT?' (Bortfeld and Webb 2009 Phys. Med. Biol. 54 N9–20), Bortfeld and Webb present a theoretical investigation of static gantry IMRT (S-IMRT), single-arc IMRT and tomotherapy. Based on their assumptions they conclude that single-arc IMRT is inherently limited in treating complex cases without compromising delivery efficiency. Here we present an expansion of their work based on the capabilities of the Varian RapidArc single-arc IMRT system. Using the same theoretical framework we derive clinically deliverable single-arc IMRT plans based on these specific capabilities. In particular, we consider the range of leaf motion, the ability to rapidly and continuously vary the dose rate and the choice of collimator angle used for delivery. In contrast to the results of Bortfeld and Webb, our results show that single-arc IMRT plans can be generated that closely match the theoretical optimum. The disparity in the results of each investigation emphasizes that the capabilities of the delivery system, along with the ability of the optimization algorithm to exploit those capabilities, are of particular importance in single-arc IMRT. We conclude that, given the capabilities available with the RapidArc system, single-arc IMRT can produce complex treatment plans that are delivered efficiently (in approximately 2 min).


Footnote
*  Conflict of interest notification: The BC Cancer Agency has a research collaboration agreement with Varian Medical Systems Inc.
PACS

87.55.-x Treatment strategy

87.56.J- Collimation

87.53.Bn Dosimetry/exposure assessment

87.53.Kn Conformal radiation treatment

Subjects

Medical physics

Dates

Issue 8 (21 April 2009)

Received 13 January 2009

Published 20 March 2009



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