Quality of treatment plans and accuracy of in vivo portal dosimetry in hybrid intensity- modulated radiation therapy and volumetric modulated arc therapy.

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Quality of treatment plans and accuracy of in vivo portal dosimetry in hybrid intensity- modulated radiation therapy and volumetric modulated arc therapy for prostate cancer  James L. Bedford, Gregory Smyth, Ian M. Hanson, Alison C. Tree, David P. Dearnaley, Vibeke N. Hansen  Radiotherapy and Oncology  Volume 120, Issue 2, Pages 320-326 (August 2016) DOI: 10.1016/j.radonc.2016.07.004 Copyright © 2016 The Royal Marsden NHS Foundation Trust Terms and Conditions

Fig. 1 Schematic diagram showing the concept of hybrid IMRT and VMAT optimisation and delivery. (a) The arc is divided into segment groups and fluence is optimised for each group. (b) The segment groups are further optimised for either VMAT delivery (blue) or IMRT delivery (red). VMAT segments are distributed over the gantry range of each segment group, while IMRT segments are all positioned at the central gantry angle of each segment group. The whole sequence is delivered as a single beam. Radiotherapy and Oncology 2016 120, 320-326DOI: (10.1016/j.radonc.2016.07.004) Copyright © 2016 The Royal Marsden NHS Foundation Trust Terms and Conditions

Fig. 2 Mean dose–volume histograms for the seven different types of treatment plan. The insets to the histograms for PTV74, PTV71 and PTV60 show the transaxial, sagittal and coronal dose distributions, respectively, for HY25. Radiotherapy and Oncology 2016 120, 320-326DOI: (10.1016/j.radonc.2016.07.004) Copyright © 2016 The Royal Marsden NHS Foundation Trust Terms and Conditions

Fig. 3 Typical portal imaging results for HY25. (a) predicted image, (b) measured image, and (c) gamma distribution for 3% and 3mm. Radiotherapy and Oncology 2016 120, 320-326DOI: (10.1016/j.radonc.2016.07.004) Copyright © 2016 The Royal Marsden NHS Foundation Trust Terms and Conditions

Supplementary Fig. 1 Distribution of IMRT segment groups among the hybrid plans in the five patients. Radiotherapy and Oncology 2016 120, 320-326DOI: (10.1016/j.radonc.2016.07.004) Copyright © 2016 The Royal Marsden NHS Foundation Trust Terms and Conditions