The Royal Marsden

NHS Foundation Trust

Physical characterisation of a new concept design

of an Elekta radiation head with integrated
160-leaf multi-leaf collimator
VP Cosgrove, C Thompson, D Christophides, SJ Weston, DI Thwaites, CJ Evans – St. James’s Institute of Oncology, Leeds Teaching Hospitals NHS Trust, UK
MDR Thomas, AP Warrington – Royal Marsden Hospital NHS Trust, Sutton UK. MG Thompson, KJ Brown – Elekta Ltd, Crawley UK
N Reynaert*, C De Wagter – Gent University, Belgium. *currently at Centre Oscar Lambret, Lille, France

Figure 1: Patient’s eye view of the 160-leaf prototype Elekta MLC, showing the diaphragms of novel, sculpted design.

Introduction
This study provides the first published information The prototype MLC consists of 160 interdigitating
on a prototype 160-leaf multi-leaf collimator (MLC) tungsten alloy leaves with a width projected to There is a single set of diaphragms, which move
for Elekta linear accelerators. The important physical the isocentre of 5mm. The leaves are mounted on perpendicular to the MLC and can overtravel the
characteristics of the new MLC and its performance dynamic leaf guides (DLG) that can move up to central axis by up to 15cm. The diaphragms are of a
are described, including transmission through leaves, 15cm; relative to the guide the leaves can extend up novel, sculpted design to reduce their thickness where
diaphragms and combinations, the tongue and groove to 20cm. The leaf sides are flat and the gaps between leaves will always provide additional shielding (see
effect and the penumbra of diaphragms and leaves. the leaves are tilted to reduce overall transmission. Fig. 1). Leaf and diaphragm ends are rounded.

Method
The head was attached to Elekta digital accelerators data in Fig. 8 and Table 2 were measured using verified with optical tracking measurements. All
operating at 6 MV at the Royal Marsden and Gafchromic EBT film. Monte Carlo modelling was leaves were moving simultaneously and the maximum
St. James’s. All the transmission and penumbra performed at Gent University using the BEAMnrc speed results, which are reported in Table 3, were
data (Fig. 2 to 7) were obtained in a PTW MP3 code. For the measurements of inter-tip transmission obtained in the most unfavourable conditions, with
water phantom with a PTW 60008 photon p-type in Fig. 4, the physical gap size was set using feeler the leaves, DLGs and diaphragms moving in the
Si diode (~1 mm2 sensitive area), with the detector gauges. Leaf, DLG and diaphragm speeds were vertical direction, against gravity. All data were
axis parallel to the beam axis. The tongue and groove determined experimentally using dynamic log files, acquired in the isocentre plane.

Results 7

0.14 0.35
20%-80% Penumbra width (mm)

0cm offset Leaves 6

5cm offset Leaves 0.12 0.30
0.5 10cm offset Leaves + DLG 5
Transmission (%)

Transmission (%)

0.10 0.25
15cm offset Leaves + DLG
0.08 0.20 4
0.4 G(X1) T(X2) A(Y2) B(Y1)
0.06 0.15
Transmission (%)

3
0.3 0.04 0.10

2
Diaphragm tip, measured
0.02 0.05 Diaphragm tip, Monte Carlo
0.2 0.00 0.00 1
Leaf tip, Monte Carlo
-20 -15 -10 -5 0 5 10 15 20 -20 -15 -10 -5 0 5 10 15 20 Leaf tip, measured
Off axis distance (cm) Off axis distance (cm) overtravel
0.1 0
-20 -15 -10 -5 0 5 10 15 20
Travel position (cm)
0.0
-20 -15 -10 -5 0 5 10 15 20 B Figure 6: Penumbra: Measurement of leaf and diaphragm tip penumbra
Distance from CAX (cm)
for a 10cmx10cm field at depth=10cm, with varying offset along the AB
Figure 2: Leaf transmission at various offsets along the leaves (depth=dmax). travel direction (head angle is set to 90° in the case of the diaphragms).
Transmission is normalised to the centre of a 10cmx10cm open field. A comparison between measurements and Monte Carlo simulations is shown.

0.5 7
20%-80% Penumbra width (mm)

1
6
0.4
5
Transmission (%)

0.3

G T
4

3 3
0.2

2 Leaf tip
2

0.1
Measured Diaphragm tip
Monte Carlo 1 Leaf side
overtravel
0.0 0
-5 -4 -3 -2 -1 0 1 2 3 4 5 -20 -15 -10 -5 0 5 10 15 20
Distance from CAX (cm) Table 1 – Transmission results for the Travel position (cm)

Figure 3: CAX leaf transmission: comparison between experiments and different areas shown in the diagram. Figure 7: Penumbra: Measurement of leaf tip, leaf side and diaphragm tip
Monte Carlo modelling. penumbra for a 5cmx5cm field at depth=10cm, with varying offset along
1 Leaves + DiaphragmsThick <0.07% the travel direction (head angle is set to 0° in all measurements).
4.0
A 2 Leaves + DiaphragmsThin <0.13%
3.5 110

0 gap 3 DiaphragmsThick alone <0.35% 100

3.0
0.25mm gap 90
0.5mm gap
Transmission (%)

2.5 80
1mm gap Figure 5: Transmission measured for combinations of leaves and diaphragms, accounting for
70
the sculpted shape (see Table 1). The leaves are opened to form a 5cm wide strip along the
Dose (%)

2.0
60
diaphragm spine. Transmission is measured at depth=dmax and is normalised to the centre of
a 10cmx10cm open field.
50 Max
1.5
Table 2 Average StDev variation
40
1.0 30 Peak deficit (%) 25.01 1.34 4.4
20
0.5
10 FWHM (mm) 3.33 0.13 0.38
0.0 0
100 110 120 130 140 150 160 170 180 Leaves 35mm/s -90 -70 -50 -30 -10 10 30 50 70 90
Off axis distance (mm) Table 3 – Measured Off axis distance (mm)
maximum speeds at Dynamic Leaf Guides 30mm/s
Figure 4: Measurements of transmission between the tips of opposing leaves, for varying the isocentre plane Figure 8: Tongue and groove effect: this profile was obtained by delivering
size of the physical inter-tip gap as set using feeler gauges. The profile is acquired at Diaphragms 90mm/s two complementary field shapes on the same film (depth= 10cm).
depth=dmax and is normalised to the centre of a 10cmx10cm field. A quantitative analysis of the underdosage regions is shown in Table 2.

Conclusions
This new MLC is a promising design. The transmission is extremely low, less than 0.5%. elements, where the use of integrated dynamic leaf
transmission and penumbra measurements indicate This result is in agreement with the Monte Carlo guides can increase the effective leaf speed up to
a significant improvement on the published data simulation. Another important feature of this new 65mm/s. Further work is ongoing to develop its full
for comparable equipment. In particular leaf MLC design is the high speed of the collimating clinical potential for dynamic treatments.