Minimum monitor unit per segment IMRT planning and over-shoot-ratio

The aim of this work is to describe the modulation quality for dose delivery of small Multi-Leaf Collimator (MLC) fields and MU/segment. The results were obtained with Pinnacle (V6) and a Varian Clinac 2100 EX (Varis 6.2) linear accelerator. The over-shoot effect was investigated by comparing integrated multiple segmented exposures to a single exposure with the same number of total MU (1, 2, 3,4, 5 and 6 MU). To present the OS effect the Over-Shoot-Ratio (OSR) was defined as the ratio of the segmented dose for a 1 cm2 field at depth to the static dose for the same field size and depth. OSR was measured as a function of MU/segment and dose rate. Measured results can be used to optimise IMRT planning and also to calculate the surface dose. The dependence of the dose in depth with 1, 2, 3, 4, and 5 MU/segments for 6 MV photon beam, dose rate of 100 MU/min and 1 cm2 beam field at the central axis is presented, where the argument of the function is the depth and parameter of the function is the number of minimum MU/segment. The dependence of the overshoot ratio on the MU/segment with a parameter of the dose rates (100, 400 and 600 MU/min) is also shown. The effect increases with the dose rate and decreases with the increasing of the minimum number of MU/segment. Having measured OSR for the 2100 EX linac it is possible to do correction and calibration of the dose of the first segment of IMRT beam, where the dose to the target and on the surface can increase over the planed dose of 1 MU by 40% and 70% for dose rate of 400 and 600 MU/min respectively. The Over-Shoot-Ratio is an important parameter to be determined as part of the routine quality assurance for IMRT and can be used to significantly improve the agreement between planned and delivered doses to the patient