SU-F-T-305: Clinical Effects of Dosimetric Leaf Gap (DLG) Values Between Matched Varian Truebeam (TB) Linacs

Purpose: The dosimetric leaf gap (DLG) is an important parameter to be measured for dynamic beam delivery of modern linacs, like the Varian Truebeam (TB). The clinical effects of DLG-values on IMRT and/or VMAT commissioning of two “matched” TB linacs will be presented.Methods and Materials: The DLG values on two TB linacs were measured for all energy modalities (filtered and FFF-modes) as part of the dynamic delivery mode commissioning (IMRT and/or VMAT. After the standard beam data was modeled in eclipse treatment planning system (TPS) and validated, IMRT validation was performed based on TG1191 benchmark, IROC Head-Neck (H&N) phantom and sample of clinical cases, all measured on both linacs. Although there was a single-set of data entered in the TPS, a noticeable difference was observed for the DLG-values between the linacs. The TG119, IROC phantom and selected patient plans were furnished with DLG-values of TB1 for both linacs and the delivery was performed on both TB linacs for comparison. Results: The DLG values of TB1 was first used for both linacs to perform the testing comparisons. The QA comparison of TG119 plans revealed a great dependence of the results to the DLG-values used for the linac for all energy modalities studied, especially when moving from 3%/3mm to 2%/2mm γ-analysis. Conclusion: The DLG-values have a definite influence on the dynamic dose, delivery that increases with the plan complexity. We recommend that the measured DLG-values are assigned to each of the “matched” linacs, even if a single set of beam data describes multiple linacs. The user should perform a detail test of the dynamic delivery of each linac based on end-to-end benchmark suites like TG119 and IROC phantoms.1Ezzel G., et al., “IMRT commissioning: Multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119.” Med. Phys. 36:5359–5373 (2009). partly supported by CAMC Cancer Center and Alliance Oncology