Leaf sequencing with secondary beam blocking under leaf positioning constraints for continuously modulated radiotherapy beams.

The creation of arbitrary photon fluence patterns for intensity modulated radiotherapy is addressed. The proposed method is intended for a class of multileaf collimators with a requirement for minimum leaf separation. Unlike the solution of Convery and Webb in which discrete beam intensity modulation was assumed, the present method deals with continuous modulation or that consisting of infinitely small bixels. The method begins with the time-optimal solution of Spirou-Stein-Svensson disregarding the minimum gap requirement. Subsequently, the gaps are restored by mobilizing the secondary beam blocking devices to prevent overexposure resulting from the leaf separation process. The secondary beam blocking is provided by means of two orthogonal backup diaphragms that are computer controlled. The results indicate that the method can be used to accurately deliver the desired modulation while satisfying the leaf positioning constraints. Furthermore, an example is presented which illustrates the efficacy of using the horizontal backup diaphragms (moving in perpendicular direction of the leaves) in addition to the vertical backup diaphragms (moving in the parallel direction of the leaves) to generate zero fluence regions.