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Article Abstract

Purpose: This study investigated the impact of lung density on the isolated lung tumor dose for volumetric modulated arc therapy (VMAT) in an inline magnetic resonance linear accelerator (MR-Linac) using the Monte Carlo (MC) simulation.

Methods: CT images of the thorax phantoms with lung tumors of 1, 2, and 3 cm diameters were converted into voxel-base phantoms with lung densities of 0.1, 0.2, and 0.3 g/cm, respectively. The dose distributions were calculated for partial-arc VMAT. The dose distributions were compared using dose differences, dose volume histograms, and dose volume indices.

Results: In all cases, the inline magnetic field significantly enhanced the lung tumor dose compared to that at 0 T. For the 1 cm lung tumor, the inline magnetic field of 1 T increased the minimum dose of 95% of the Planning target volume (PTV D) by 14.0% in 0.1 g/cm lung density as compared to that in 0.3 g/cm at 0 T. In contrast, at 0 and 0.5 T, the PTV D in 0.3 g/cm lung density was larger than that in lung density of 0.1 g/cm. For the 2 cm lung tumor, a similar tendency to 1 cm was observed, whereas the dose impact of lung density was smaller than that for 1 cm. For the 3 cm lung tumor, the lung tumor dose was independent of lung density at 0.5 T and 1.0 T.

Conclusion: The inline MR-Linac with the magnetic field over 1 T can enhance the PTV D for VMAT regardless of the lung density.

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http://dx.doi.org/10.1016/j.ejmp.2020.10.009DOI Listing

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