Miniature multileaf collimator as an alternative to traditional circular collimators for stereotactic radiosurgery and stereotactic radiotherapy.

Purpose: To evaluate the miniature multileaf collimator (MMLC) as an alternative to traditional circular collimators for radiosurgery.

Materials And Methods: 'Circular' fields were created with the Radionics MMLC (leaf width 3.53 mm at isocenter). Beam data, including tissue maximum ratios, output factors, penumbrae and isodose distributions of these fields were measured. These were compared to the Radionics circular collimators traditionally used for radiosurgery. The MMLC data were input to the XKnife Treatment Planning System. Treatment plans were completed and evaluated using both the MMLC 'circular' fields and the circular collimators.

Results: MMLC fields using 3, 5, 7, 9, 11, and 13 leaves on each side of the Radionics MMLC were created to approximate circular fields. The TMRs are essentially identical to those of comparable-size circular collimators. Measured at isocenter at 5-cm depth for 6 MV, the 80-20% penumbra widths are comparable to circular collimators, but are increased by as much as 1 mm at the leaf intersections (steps) where scalloping occurs. Isodose distributions were matched to those of circular collimators with comparable 50% isodose widths. Treatment plans for the MMLC 'circular' fields with four arcs (totaling 360 degrees) are essentially identical to those of comparable circular collimators. Dose-volume histograms revealed clinically insignificant differences between the two in doses to the target, to the volume surrounding the target, and to adjacent critical normal tissues. There is very little discrepancy between the dose distribution calculated with the approximated MMLC fields and with those of simulated arcs with the actual MMLC fields.

Conclusions: With the MMLC simulating circular fields, dose distributions may be obtained which are essentially identical to comparable-size circular collimators. The mechanical accuracy of the MMLC is as good as that of the circular collimators, and the leakage dose is less. The diameter of 'circular' fields is limited by the MMLC leaf width to 1 cm and greater in increments of 7 mm. Attention needs to be paid to mechanical collisions because the MMLC is bulkier than the circular collimators.