The effect of motion on IMRT – looking at interplay with 3D measurements

Clinical recommendations to address tumor motion management have been derived from studies dealing with simulations and 2D measurements. 3D measurements may provide more insight and possibly alter the current motion management guidelines. This study provides an initial look at true 3D measurements involving leaf motion deliveries by use of a motion phantom and the PRESAGE/DLOS dosimetry system. An IMRT and VMAT plan were delivered to the phantom and analyzed by means of DVHs to determine whether the expansion of treatment volumes based on known imaging motion adequately cover the target. DVHs confirmed that for these deliveries the expansion volumes were adequate to treat the intended target although further studies should be conducted to allow for differences in parameters that could alter the results, such as delivery dose and breathe rate.