Verification and implementation of dynamic wedge calculations in a treatment planning system based on a dose-to-energy-fluence formalism.

The use of dynamic movements on linear accelerators during irradiation has found a revised interest lately due to the integration of computers to control the accelerator. In this paper, dynamic wedge fields that are produced by moving one of the collimator blocks during irradiation are studied. Since these wedge fields differ from those of mechanical wedges, certain requirements are to be met on the treatment planning system. A pencil-beam-based treatment planning system that uses the resultant energy fluence distribution from the dynamic collimator movement has been extensively reviewed. In calculations, the system treats the dynamic collimated field as a single, modulated field that yields calculation times close to those for open beams. Details are given on the theoretical model used for the calculation of dynamically generated dose distributions. Measurements of depth doses, profiles, and output factors in dynamic wedge fields indicate that calculations accurately predict the outcome from dynamic wedges without any additional measurements other than those used for characterization of static open beams.