Multibeam tomotherapy: A new treatment unit devised for multileaf collimation, intensity-modulated radiation therapy

Medical Physics

Volumn 34, Issue 10, 2007, Pages 3926-3942

  Achterberg, Nils ^a   Müller, Reinhold G ^a  

^a NONE

Author keywords

Flattening filter; IMRT; Intensity modulated radiation therapy; Medical linear accelerator; MLC; Multileaf collimator; Tomotherapy; Treatment time

Indexed keywords

BIOMEDICAL ENGINEERING; COMPUTERIZED TOMOGRAPHY; ELECTRON BEAMS; ELECTRONS; LINEAR ACCELERATORS; OPTICAL COLLIMATORS;

FLATTENING FILTERS; IMRT; INTENSITY MODULATED RADIATION THERAPY; MULTILEAF COLLIMATORS; TOMOTHERAPY; TREATMENT TIME;

RADIOTHERAPY;

ARTICLE; CONCEPTUAL FRAMEWORK; CONTROLLED STUDY; ELECTRON BEAM; HUMAN; INTENSITY MODULATED RADIATION THERAPY; MOTION ANALYSIS SYSTEM; PATIENT CARE; PATIENT POSITIONING; PRIORITY JOURNAL; RADIATION BEAM; RADIOSURGERY; RADIOTHERAPY; RELIABILITY; THREE DIMENSIONAL IMAGING;

EID: 34748843942     PISSN: 00942405     EISSN: None     Source Type: Journal    
DOI: 10.1118/1.2779129     Document Type: Article

References (117)

1. D. I. Thwaites and J. B. Tuohy, " Back to the future: The history and development of the clinical linear accelerator., " Phys. Med. Biol. 51, R343-R362 (2006).
2. S. M. Bentzen, " Radiation therapy: Intensity modulated, image guided, biologically optimized and evidence based., " Radiother. Oncol. 77, 227-230 (2005).
3. T. R. Mackie, T. Holmes, S. Swerdloff, P. Reckwerdt, J. O. Deasy, J. Yang, B. Paliwal, and T. Kinsella, " Tomotherapy: A new concept for the delivery of dynamic conformal radiotherapy., " Med. Phys. 20, 1709-1719 (1993).
4. T. R. Mackie, " History of tomotherapy., " Phys. Med. Biol. 51, R427-R453 (2006).
5. G. Bauman, " A prospective evaluation of helical tomotherapy., " Int. J. Radiat. Oncol., Biol., Phys. 68, 632-641 (2007).
6. P. J. Keall, " The management of respiratory motion in radiation oncology report of AAPM Task Group 76., " Med. Phys. 33, 3874-3900 (2006).
7. J. Z. Wang, X. A. Li, W. D. D'Souza, and R. D. Stewart, " Impact of prolonged fraction delivery times on tumor control: A note of caution for intensity-modulated radiation therapy (IMRT)., " Int. J. Radiat. Oncol., Biol., Phys. 57, 543-552 (2003).
8. J. F. Fowler, J. S. Welsh, and S. P. Howard, " Loss of biological effect in prolonged fraction delivery., " Int. J. Radiat. Oncol., Biol., Phys. 59, 242-249 (2004).
9. A. W. Beavis, " Is tomotherapy the future of IMRT?, " Br. J. Radiol. 77, 285-295 (2004).
10. C. Yu, " Intensity-modulated arc therapy with dynamic multileaf collimation: An alternative to tomotherapy., " Phys. Med. Biol. 40, 1435-1449 (1995).
11. Deutsches Patent-und Markenamt, DPA 100 41 473 (2000), 10 2006 029 557.9 (2006), and 10 2007 019 355.8 (2007); European Patent Office, EP 1311322 (2005) and 07110677.7 (2007); U.S. Patent Office 7,167,540 (2007) and 11/767,697 (2007).
12. N. Achterberg, " Entwurf und Simulation einer Bestrahlungsanlage für die multifokale statische Tomotherapie., " thesis, Friedrich-Alexander-Universität Erlangen-Nürnberg, 2002.
13. S. Söderström and A. Brahme, " Which is the most suitable number of photon beam portals in coplanar radiation therapy?, " Int. J. Radiat. Oncol., Biol., Phys. 33, 151-159 (1995).
14. R. Mohan and C. C. Ling, " When becometh less more?, " Int. J. Radiat. Oncol., Biol., Phys. 33, 235-237 (1995).
15. S. Söderström and A. Brahme, " Small is beautiful-And often enough: In response to Drs. Mohan and Ling., " Int. J. Radiat. Oncol., Biol., Phys. 34, 757-758 (1996).
16. R. Mohan, C. C. Ling, J. Stein, and X.-H. Wang, " The number of beams in intensity modulated treatments: In response to Drs. Söderström and Brahme., " Int. J. Radiat. Oncol., Biol., Phys. 34, 758-759 (1996).
17. S. Söderström and A. Brahme, " Selection of suitable beam orientations in radiation therapy using entropy and Fourier transform measures., " Phys. Med. Biol. 37, 911-924 (1992).
18. T. Bortfeld and W. Schlegel, " Optimization of beam orientations in radiation therapy: Some theoretical considerations., " Phys. Med. Biol. 38, 291-304 (1993).
19. S. Webb, " Optimizing the planning of intensity-modulated radiotherapy., " Phys. Med. Biol. 39, 2229-2246 (1994).
20. M. Braunstein and R. Y. Levine, " Optimum beam configurations in tomographic intensity modulated radiation therapy., " Phys. Med. Biol. 45, 305-328 (2000).
21. A. B. Pugachev, A. L. Boyer, and L. Xing, " Beam orientation optimization in intensity-modulated radiation treatment planning., " Med. Phys. 27, 1238-1245 (2000).
22. A. Pugachev, J. G. Li, A. L. Boyer, S. L. Hancock, Q. Le, S. S. Donaldson, and L. Xing, " Role of beam orientation optimization in intensity-modulated radiation therapy., " Int. J. Radiat. Oncol., Biol., Phys. 50, 551-560 (2001).
23. B. Pickett, M. Roach III, P. Horne, L. Verhey, and T. L. Phillips, " Optimization of the oblique angles in the treatment of prostate cancer during six-field conformal radiotherapy., " Med. Dosim. 19, 237-254 (1994).
24. C. G. Rowbottom, S. Webb, and M. Oldham, " Improvements in prostate radiotherapy from the customization of beam directions., " Med. Phys. 25, 1171-1179 (1998).
25. E. Schreibmann and L. Xing, " Feasibility study of beam orientation class-solutions for prostate IMRT., " Med. Phys. 31, 2863-2870 (2004).
26. J. Stein, R. Mohan, X.-H. Wang, T. Bortfeld, Q. Wu, K. Preiser, W. Schlegel, and C. C. Ling, " Optimum number and orientations of beams for intensity-modulated treatments., " Med. Phys. 23, 1063 (1996).
27. J. Stein, R. Mohan, X.-H. Wang, T. Bortfeld, Q. Wu, K. Preiser, C. C. Ling, and W. Schlegel, " Number and orientations of beams in intensity-modulated radiation treatments., " Med. Phys. 24, 149-160 (1997).
28. D. M. Shepard, G. Olivera, L. Angelos, O. Sauer, P. Reckwerdt, and T. R. Mackie, " A simple model for examining issues in radiotherapy optimization., " Med. Phys. 26, 1212-1221 (1999).
29. O. A. Sauer, D. M. Shepard, and T. R. Mackie, " Application of constrained optimization to radiotherapy planning., " Med. Phys. 26, 2359-2366 (1999).
30. M. Braunstein, R. Levine, Y. Lo, and M. Urie, " Intensity modulated radiation therapy with tomographic reconstruction: MLC leaf width and beam number influence on dose conformation to cranial targets., " Med. Phys. 26, 1134 (1999).
31. M. Oldham, V. S. Khoo, C. G. Rowbottom, J. L. Bedford, and S. Webb, " A case study comparing the relative benefit of optimizing beam weights, wedge angles, beam orientations and tomotherapy in stereotactic radiotherapy of the brain., " Phys. Med. Biol. 43, 2123-2146 (1998).
32. C. G. Rowbottom, " Optimization of beam-orientations in conformal radiotherapy treatment planning., " thesis, University of London, 1999 [abstract in Med. Phys. 26, 1406 (1999)].
33. C. G. Rowbottom, " Optimization of beam-orientations in conformal radiotherapy treatment planning., " thesis, University of London, 1999 [abstract in Med. Phys. 26, 1406 (1999)].
34. O. Jäkel and J. Debus, " Selection of beam angles for radiotherapy of skull base tumours using charged particles., " Phys. Med. Biol. 45, 1229-1241 (2000).
35. M. MacKenzie and D. M. Robinson, " Intensity modulated arc deliveries approximated by a large number of fixed gantry position sliding window dynamic multileaf collimator fields., " Med. Phys. 29, 2359-2365 (2002).
36. V. J. Gonzales, D. J. Buchholz, K. M. Langen, G. H. Olivera, B. Chauhan, S. L. Meeks, K. J. Ruchala, J. Haimerl, W. Lu, and P. A. Kupelian, " Evaluation of two tomotherapy-based techniques for the delivery of whole breast intensity-modulated radiation therapy., " Int. J. Radiat. Oncol., Biol., Phys. 65, 284-290 (2006).
37. D. Desai, C. S. Ramsay, M. Breinig, and S. L. Mahan, " A topographic leaf-sequencing algorithm for delivering intensity modulated radiation therapy., " Med. Phys. 33, 2751-2756 (2006).
38. R. Svensson, " Development of a compact high energy treatment unit combining narrow pencil beam scanning and multileaf collimation., " thesis, Stockholm University, 1998 [abstract in Med. Phys. 25, 1758 (1998)].
39. R. Svensson, " Development of a compact high energy treatment unit combining narrow pencil beam scanning and multileaf collimation., " thesis, Stockholm University, 1998 [abstract in Med. Phys. 25, 1758 (1998)].
40. J. R. Treurniet and D. W. O. Rogers, " EGS_WINDOWS 4.0 User's Manual., " NRCC Report No. PIRS-0669, 1999.
41. D. W. O. Rogers, B. A. Faddegon, G. X. Ding, C.-M. Ma, J. We, and T. R. Mackie, " BEAM: A Monte Carlo code to simulate radiotherapy treatment units., " Med. Phys. 22, 503-524 (1995).
42. W. R. Nelson, H. Hirayma, and D. W. O. Rogers, " The EGS4 Code System., " SLAC Report No. 265, 1985.
43. C.-M. Ma, D. W. O. Rogers, and B. Walters, " DOSXYZ users manual., " NRCC Report No. PIRS-0509B, 1997.
44. B. Libby, J. Siebers, and R. Mohan, " Validation of Monte Carlo generated phase-space descriptions of medical linear accelerators., " Med. Phys. 26, 1476-1483 (1999).
45. C.-M. Ma, E. Mok, A. Kapur, T. Pawlicki, D. Findley, S. Brain, K. Forster, and A. L. Boyer, " Clinical implementation of a Monte Carlo treatment planning system., " Med. Phys. 26, 2133-2143 (1999).
46. J. V. Siebers, P. J. Keall, B. Libby, and R. Mohan, " Comparison of EGS4 and MCNP4b Monte Carlo codes for generation of photon phase space distributions for a Varian 2100C., " Phys. Med. Biol. 44, 3009-3026 (1999).
47. C.-M. Ma, T. Pawlicki, S. B. Jiang, J. S. Li, J. Deng, E. Mok, A. Kapur, L. Xing, L. Ma, and A. L. Boyer, " Monte Carlo verification of IMRT dose distributions from a commercial treatment planning optimization system., " Phys. Med. Biol. 45, 2483-2495 (2000).
48. D. Sheikh-Bagheri, D. W. O. Rogers, C. K. Ross, and J. P. Seuntjens, " Comparison of measured and Monte Carlo calculated dose distributions from the NRC linac., " Med. Phys. 27, 2256-2666 (2000).
49. N. Achterberg, M. Ott, and R. G. Müller, " Evaluierung der Photonen- und Elektronen-3D-Dosisberechnung eines kommerziellen Planungssystems., " Medizinische Physik 99, 189-190 (1999).
50. D. Sheikh-Bagheri and D. W. O. Rogers, " Derivation of the incident electron parameters in photon beam Monte Carlo simulations., " Med. Phys. 26, 1165 (1999).
51. F. Verhaegen and I. J. Das, " Monte Carlo modeling of a virtual wedge., " Phys. Med. Biol. 44, N251-N259 (1999).
52. P. Francescon, C. Cavedon, S. Reccanello, and S. Cora, " Photon dose calculation of a three-dimensional treatment planning system compared to the Monte Carlo code BEAM., " Med. Phys. 27, 1579-1587 (2000).
53. D. Sheikh-Bagheri and D. W. O. Rogers, " Sensitivity of megavoltage photon beam Monte Carlo simulations to electron beam and other parameters., " Med. Phys. 29, 379-390 (2002).
54. D. Sheikh-Bagheri and D. W. O. Rogers, " Monte Carlo calculation of nine megavoltage photon beam spectra using the BEAM code., " Med. Phys. 29, 391-402 (2002).
55. P. C. Williams, " IMRT: Delivery techniques and quality assurance., " Br. J. Radiol. 76, 766-776 (2003).
56. T. Bortfeld, " IMRT: A review and preview., " Phys. Med. Biol. 51, R363-R379 (2006).
57. A. Ahnesjö, B. Hardemark, U. Isacsson, and A. Montelius, " The IMRT information process-mastering the degrees of freedom in external beam therapy., " Phys. Med. Biol. 51, R381-R402 (2006).
58. S. Webb, The Physics of Conformal Radiotherapy-Advances in Technology (IOP, Bristol, 1997), pp. 98, 99.
59. D. J. Convery and M. E. Rosenbloom, " The generation of intensity-modulated fields for conformal radiotherapy by dynamic collimation., " Phys. Med. Biol. 37, 1359-1374 (1992).
60. T. R. Bortfeld, D. L. Kahler, T. J. Waldron, and A. L. Boyer, " X-ray field compensation with multileaf collimators., " Int. J. Radiat. Oncol., Biol., Phys. 28, 723-730 (1994).
61. S. Webb, " Configuration options for intensity-modulated radiation therapy using multiple static fields shaped by multileaf collimator., " Phys. Med. Biol. 43, 241-260 (1998).
62. S. Webb, " Configuration options for intensity-modulated radiation therapy using multiple static fields shaped by multileaf collimator: Constraints and limitations on 2D modulation., " Phys. Med. Biol. 43, 1481-1495 (1998).
63. W. Que, " Comparison of algorithms for multileaf collimator field segmentation., " Med. Phys. 26, 2390-2396 (1999).
64. S. Kamath, S. Sahni, S. Ranka, J. Li, and J. Palta, " A comparison of step-and-shoot leaf sequencing algorithms that eliminate tongue-and-groove effects., " Phys. Med. Biol. 49, 3137-3143 (2004).
65. A. Bel, O. Petrascu, I. Van de Vondel, L. Coppens, D. Verellen, and G. Storme, " A computerized remote table control for fast on-line parient repositioning: Implementation and clinical feasibility., " Med. Phys. 27, 354-358 (2000).
66. K. Li, C. X. Yu, and L. Ma, " Improving a scissor-action couch for conformal arc radiotherapy and radiosurgery., " J. Appl. Clin. Med. Phys. 5, 62-65 (2004).
67. M. Carol, W. H. Grant III, A. R. Bleier, A. A. Kania, H. S. Targovnik, E. B. Butler, and S. W. Woo, " The field matching problem as it applies to the peacock three dimensional conformal system for intensity modulation., " Int. J. Radiat. Oncol., Biol., Phys. 34, 183-187 (1996).
68. N. Linthout and D. Verellen, " Evaluation of the matchline region in tomotherapy., " Med. Phys. 26, 1140 (1999).
69. T. Bortfeld, U. Oelfke, and S. Nill, " What is the optimum leaf width of a multileaf collimator., " Med. Phys. 27, 2494-2502 (2000).
70. R. A. C. Siochi, " Virtual micro-intensity modulated radiation therapy., " Med. Phys. 27, 2480-2493 (2000).
71. R. Siochi, " Simplifying IMRT plans through efficient segmentation., " Med. Phys. 32, 2085 (2005).
72. X. R. Zhu, K. Prado, H. H. Liu, T. M. Guerrero, M. Jeter, Z. Liao, D. Rice, K. Forster, and C. W. Stevens, " Intensity-modulated radiation therapy for mesothelioma: Impact of multileaf collimator leaf width and pencil beam size in planning quality and delivery efficiency., " Int. J. Radiat. Oncol., Biol., Phys. 62, 1525-1534 (2005).
73. Z. Su, C. Liu, J. Li, C. Yang, J. Palta, and S. Kim, " Is 0.5 cm leaf width of MLC beneficial to IMRT?, " Med. Phys. 33, 2116 (2006).
74. C. Cheng and I. Das, " Impact of MLC leaf size on the quality of IMRT Plan., " Med. Phys. 33, 2108-2109 (2006).
75. G. Zhang, Z. Jiang, D. Shepard, M. Earl, and C. Yu, " Effect of beamlet step-size on IMRT plan quality., " Med. Phys. 32, 3448-3454 (2005).
76. J. B. Fiveash, H. Murshed, J. Duan, M. Hyatt, J. Caranto, J. A. Bonner, and R. A. Popple, " Effect of multileaf collimator leaf width on physical dose distributions in the treatment of CNS and head and neck neoplasms with intensity modulated radiation therapy., " Med. Phys. 29, 1116-1119 (2002).
77. P. B. Greer, W. A. Beckham, W. Ansbacher, and R. K. Mann, " Improving the resolution of dynamic intensity modulated radiation therapy delivery by reducing the multileaf collimator sampling distance., " Med. Phys. 30, 2793-2803 (2003).
78. J. M. Galvin, D. D. Leavitt, and A. A. Smith, " Field edge smoothing for multileaf collimators., " Int. J. Radiat. Oncol., Biol., Phys. 35, 89-94 (1996).
79. I. Das and R. Mitra, " Modulation of multileaf collimator dose undulation., " Med. Phys. 26, 1140 (1999).
80. M. Svatos, L. Verhey, and T. Steinberg, " The use of multiple static fields to smooth MLC field edges., " Med. Phys. 26, 1152 (1999).
81. J. Xue, P. Zhang, J. Wu, Z. Wang, and C. Sibata, " Implementation of the isocenter-shift technique for smoothing MLC field edge on a 3D treatment planning system., " Med. Phys. 29, 1413-1420 (2002).
82. Q. Hou, C. Zhang, Z. Wu, and Y. Chen, " A method to improve spatial resolution and smoothness of intensity profiles in IMRT treatment planning., " Med. Phys. 31, 1339-1347 (2004).
83. P. M. Hansen, V. N. Hansen, and W. Swindell, " The optimum intensities for static multileaf collimator field compensation., " Med. Phys. 24, 1147-1156 (1997).
84. G. J. Budgell, " Temporal resolution requirements for intensity modulated radiation therapy delivered by multileaf collimators., " Phys. Med. Biol. 44, 1581-1596 (1999).
85. J. Lehmann and L. Xing, " Role of the number of intensity levels in IMRT., " World Congress on Medical Phyics and Biomedical Engineering, Chicago, 2000.
86. D. M. Shepard, M. A. Earl, X. A. Li, S. Naqvi, and C. Yu, " Direct aperture optimization: A turnkey solution for step-and-shoot IMRT., " Med. Phys. 29, 1007-1018 (2002).
87. Z. Jiang, M. A. Earl, G. W. Zhang, C. X. Yu, and D. M. Shepard, " An examination of the number of required apertures for step-and-shoot IMRT., " Phys. Med. Biol. 50, 5633-5663 (2005).
88. R. Siochi, " Accuracy and time considerations in intensity modulation treatment planning., " Med. Phys. 26, 1086 (1999).
89. C. B. Saw, S. Li, K. M. Ayyangar, M. Yoe-Sein, S. Pillai, and C. A. Enke, " Dose linearity and uniformity of a linear accelerator designed for implementation of multileaf collimation system-based intensity modulated radiation therapy., " Med. Phys. 30, 2253-2256 (2003).
90. V. Y. Kuperman and W.-C. Lam, " Improving delivery of segments with small MU in step-and-shoot IMRT., " Med. Phys. 33, 1067-1073 (2006).
91. J. M. Lydon, " Theoretical and experimental validation of treatment planning for narrow MLC defined photon fields., " Phys. Med. Biol. 50, 2701-2714 (2005).
92. N. Papanikolaou, J. Erb, M. Gehring, and C. Saunders, " Commissioning and acceptance testing of a convolution based 3d rtp system., " World Congress on Medical Physics and Biomedical Engineering, Nice; Medical & Biomedical Engineering & Computing 35, 994 (1997).
93. N. Papanikolaou, J. Erb, M. Gehring, and C. Saunders, " Commissioning and acceptance testing of a convolution based 3d rtp system., " World Congress on Medical Physics and Biomedical Engineering, Nice; Medical & Biomedical Engineering & Computing 35, 994 (1997).
94. J. M. Lydon, " Photon dose calculation in homogeneous media for a treatment planning system using a collapsed cone superposition convolution algorithm., " Phys. Med. Biol. 43, 1813-1822 (1998).
95. J. Wang, " Commissioning of ADAC PINNACLE3 treatment planning system: Inhomogeneity correction., " Med. Phys. 26, 1163 (1999).
96. C. R. Ramsay, I. L. Cordrey, K. M. Spencer, and A. L. Oliver, " Dosimetric verification of two commercially available three-dimensional treatment planning systems using the TG 23 test package., " Med. Phys. 26, 1188-1195 (1999).
97. P. Francescon, S. Cora, and P. Chiovati, " Dose verification of an IMRT treatment planning system with BEAM EGS4-based Monte Carlo code., " Med. Phys. 30, 144-157 (2003).
98. L. Paelinck, N. Reynaert, H. Thierens, W. De Neve, and C. De Wagter, " Experimental verification of lung dose with radiochromic film: Comparison with Monte Carlo simulations and commercially available treatment planning systems., " Phys. Med. Biol. 50, 2055-2069 (2005).
99. J. Löf, " Development of a general framework for optimization of radiation therapy., " Ph.D. thesis, Stockholm University, 2000.
100. K. E. Sixel and B. A. Faddegon, " Calculation of x-ray spectra for radiosurgical beams., " Med. Phys. 22, 1657-1661 (1995).
101. P. C. Lee, " Monte Carlo simulations of the differential beam hardening effect of a flattening filter on a therapeutic x-ray beam., " Med. Phys. 24, 1485-1489 (1997).
102. S. B. Jiang and K. M. Ayyangar, " On compensator design for photon beam intensity-modulated conformal therapy., " Med. Phys. 25, 668-675 (1998).
103. G. Küster, " Monte Carlo studies for the optimization of hardware used in conformal radiation therapy., " thesis, Ruprecht-Karls-Universität, Heidelberg, 1999 [abstract in Med. Phys. 26, 2044 (1999)].
104. R. Jeraj, T. R. Mackie, J. Balog, G. Olivera, D. Pearson, J. Kapatoes, K. Ruchala, and P. Reckwerdt, " Radiation characteristics of helical tomotherapy., " Med. Phys. 31, 396-404 (2004).
105. W. Fu, J. Dai, Y. Hu, D. Han, and Y. Song, " Delivery time comparison for intensity-modulated radiation therapy with/without flattening filter: A planning study., " Phys. Med. Biol. 49, 1535-1547 (2004).
106. S. D. Thomas, M. Mackenzie, D. W. O. Rogers, and B. G. Fallone, " A Monte Carlo derived TG-51 equivalent calibration for helical tomotherapy., " Med. Phys. 32, 1346-1353 (2005).
107. O. N. Vassiliev, U. Titt, S. F. Kry, F. Pönisch, M. T. Gilin, and R. Mohan, " Monte Carlo study of photon fields from a flattening-filter-free accelerator., " Med. Phys. 33, 820-827 (2006).
108. O. N. Vassiliev, U. Titt, F. Pönisch, S. F. Kry, R. Mohan, and M. T. Gilin, " Dosimetric properties of photon beams from a flattening-filter- free clinical accelerator., " Phys. Med. Biol. 51, 1907-1917 (2006).
109. U. Titt, O. N. Vassiliev, F. Pönisch, L. Dong, H. Liu, and R. Mohan, " A flattening-filter-free photon treatment concept evaluation with Monte Carlo., " Med. Phys. 33, 1595-1602 (2006).
110. F. Pönisch, U. Titt, O. N. Vassiliev, S. F. Kry, and R. Mohan, " Properties of unflattened photon beams shaped by multileaf collimator., " Med. Phys. 33, 1738-1746 (2006).
111. U. Titt, O. N. Vassiliev, F. Pönisch, S. F. Kry, and R. Mohan, " Monte Carlo study of backscatter in a flattening-filter-free clinical accelerator., " Med. Phys. 33, 3270-3273 (2006).
112. X. R. Zhu, Y. Kang, and M. T. Gillin, " Measurement of in-air output ratios for a linear accelerator with and without flattening filter., " Med. Phys. 33, 3723-3733 (2006).
113. C. X. Yu, X. Allen Li, L. Ma, D. Chen, S. Naqvi, D. Shepard, M. Sarfaraz, T. W. Holmes, M. Suntharalingam, and C. M. Mansfield, " Clinical implementation of intensity-modulated arc therapy., " Int. J. Radiat. Oncol., Biol., Phys. 53, 453-463 (2002).
114. W. Duthoy, W. De Gersem, K. Vergote, M. Coghe, T. Boterberg, Y. De Deene, C. De Wagter, S. Van Belle, and W. De Neve, " Whole abdominopelvic radiotherapy (WAPRT) using intensity-modulated arc therapy (IMAT): First clinical experience., " Int. J. Radiat. Oncol., Biol., Phys. 57, 1019-1032 (2003).
115. W. Duthoy, W. De Gersem, K. Vergote, T. Boterberg, C. Derie, P. Smeets, C. De Wagter, and W. De Neve, " Clinical implementation of intensity-modulated arc therapy (IMAT) for rectal cancer., " Int. J. Radiat. Oncol., Biol., Phys. 60, 794-806 (2004).
116. R. Nath, E. R. Epp, J. S. Laughlin, W. P. Swanson, and V. P. Bond, " Neutrons from high-energy x-ray medical accelerators: An estimate of risk to the radiotherapy patient., " Med. Phys. 11, 231-241 (1984).
117. D. A. Followill, P. Geis, and A. Boyer, " Estimates of whole-body dose equivalent produced by beam intensity modulated conformal therapy., " Int. J. Radiat. Oncol., Biol., Phys. 38, 667-672 (1997).