AAPM Task Group 264: The safe clinical implementation of MLC tracking in radiotherapy.

Journal: Medical physics
Published Date:

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 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.

Authors

  • Paul J Keall
    Image X Institute, University of Sydney, Sydney, Australia. Electronic address: paul.keall@sydney.edu.au.
  • Amit Sawant
    Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
  • Ross I Berbeco
    Radiation Oncology, Brigham and Women's Hospital, Boston, MA, 02115, USA.
  • Jeremy T Booth
    Royal North Shore Hospital, Northern Sydney Cancer Centre, St Leonards, NSW, Australia.
  • Byungchul Cho
    Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.
  • Laura I Cerviño
    Radiation Medicine & Applied Sciences, Radiation Oncology PET/CT Center, UC San Diego, LA Jolla, CA, 92093-0865, USA.
  • Eileen Cirino
    Lahey Health and Medical Center, Burlington, MA, 01805, USA.
  • Sonja Dieterich
    Department of Radiation Oncology, UC Davis Medical Center, Sacramento, CA, 95618, USA.
  • Martin F Fast
    Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Peter B Greer
    School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, Australia; Department of Radiation Oncology, Calvary Mater, Newcastle, Australia.
  • Per Munck Af Rosenschold
    Radiation Medicine Research Center, Rigshospitalet, Copenhagen, Denmark; Niels Bohr Institute, University of Copenhagen, Denmark.
  • Parag J Parikh
    Department of Radiation Oncology, Washington University, St. Louis, Missouri.
  • Per Rugaard Poulsen
    Department of Oncology, Aarhus University Hospital, 8000, Aarhus, Denmark.
  • Lakshmi Santanam
    Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
  • George W Sherouse
    Sherouse Medical Physics, Charlotte, NC, 28220-1973, USA.
  • Jie Shi
    Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Key Laboratory of Oilseeds processing, Ministry of Agriculture, Oil Crops and Lipids Process Technology National & Local Joint Engineering Laboratory, Hubei Key Laboratory of Lipid Chemistry and Nutrition, Wuhan 430062, China.
  • Sotirios Stathakis
    University of Texas Health San Antonio Cancer Center, San Antonio, TX, 78229, USA.