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@ARTICLE{Rippke:282361,
      author       = {C. Rippke and C. K. Renkamp and C. Attieh and F. Schlüter
                      and C. Buchele and J. Debus$^*$ and M. Alber and S. Klüter},
      title        = {{L}eaf-individual calibration for a double stack multileaf
                      collimator in photon radiotherapy.},
      journal      = {Physics $\&$ Imaging in Radiation Oncology},
      volume       = {27},
      issn         = {2405-6316},
      address      = {Amsterdam [u. a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2023-01745},
      pages        = {100477},
      year         = {2023},
      abstract     = {In online adaptive stereotactic body radiotherapy
                      treatments, linear accelerator delivery accuracy is
                      essential. Recently introduced double stack multileaf
                      collimators (MLCs) have new facets in their calibration. We
                      established a radiation-based leaf-individual calibration
                      (LIMCA) method for double stack MLCs.MLC leaf positions were
                      evaluated from four cardinal angles with test patterns at
                      measurement positions throughout the radiation field on EBT3
                      radiochromic film for each single stack. The accuracy of the
                      method and repeatability of the results were assessed. The
                      effect of MLC positioning errors was characterized for a
                      measured output factor curve and a clinical patient plan.All
                      positions in the motor step - position calibration file were
                      optimized in the established LIMCA method. The resulting
                      double stack mean accuracy for all angles was 0.2 ± 0.1 mm
                      for X1 (left bank) and 0.2 ± 0.2 mm for X2 (right bank).
                      The accuracy of the leaf position evaluation was 0.2 mm
                      $(95\%$ confidence level). The MLC calibration remained
                      stable over four months. Small MLC leaf position errors
                      (e.g. 1.2 mm field size reduction) resulted in important
                      dose errors (-5.8 $\%)$ for small quadratic fields of 0.83
                      × 0.83 cm2. Single stack position accuracy was essential
                      for highly modulated treatment plans.LIMCA is a new double
                      stack MLC calibration method that increases treatment
                      accuracy from four angles and for all moving leaves.},
      keywords     = {Adaptive radiotherapy (Other) / Image guided radiotherapy
                      (Other) / MR-Linac (Other) / MR-guided radiotherapy (Other)
                      / Multileaf collimator (Other) / Photon radiotherapy (Other)
                      / Quality assurance (Other) / Quality control (Other) /
                      Small field dosimetry (Other)},
      cin          = {E050 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)E050-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37635846},
      pmc          = {pmc:PMC10457557},
      doi          = {10.1016/j.phro.2023.100477},
      url          = {https://inrepo02.dkfz.de/record/282361},
}