MLC quality assurance techniques for IMRT applications.

Intensity modulated radiotherapy (IMRT) requires extensive knowledge of multileaf collimator (MLC) leaf positioning accuracy, precision, and long-term reproducibility. We have developed a technique to efficiently measure the absolute position of each MLC leaf, over the range of leaf positions utilized in IMRT, based on dosimetric information. A single radiographic film was exposed to 6 MV x-rays for twelve exposures: one open field with a radio-opaque marker tray present, and eleven fields (1 x 28 cm strips via 1 cm gaps between opposed leaf pairs) separated by 2 cm center to center. The process was repeated while varying direction of leaf travel; each film was digitized using a commercial film dosimetry system. The digital images were manipulated to remove translation and rotation of the film data with respect to the collimator coordinate system by extraction of radiation dose profiles perpendicular to the MLC leaf motion and measuring the center of the x-ray leakage between leaves. Radiation dose profiles in the direction of leaf motion were acquired through the center of each leaf pair (leaves 2-28), which provided leaf position information every 2 cm with 0.2 mm precision. Nine separate leaf reproducibility studies over a 90 day period which evaluated 600 measurement points on each film show 0.3 mm precision for 95% confidence, while hysteresis studies show 0.5 mm precision. Absolute leaf position error measurements demonstrated a radial dependence, with a maximum of 1.5 mm at 16.4 cm from central axis, due to rotational error at calibration. Recalibration of the MLC leaves based utilizing this tool yields absolute leaf position measurements where 91.5% of all leaves/positions were within 0.5 mm, with a mean error of 0.1 mm and a maximum error less than 1.0 mm.