{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T14:58:40Z","timestamp":1791125920876,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2009,6,19]],"date-time":"2009-06-19T00:00:00Z","timestamp":1245369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2009,7]]},"abstract":"<jats:p>The objective determination of performance standards for radiation therapy equipment requires, ideally, establishing the quantitative relationship between performance deviations and clinical outcome or some acceptable surrogate. In this simulation study the authors analyzed the dosimetric impact of random (leaf by leaf) and systematic (entire leaf bank) errors in the position of the MLC leaves on seven clinical prostate and seven clinical head and neck IMRT plans delivered using a dynamic MLC. In\u2010house software was developed to incorporate normally distributed errors of up to \u00b12 mm in individual leaf position or systematic errors (\u00b11 and \u00b10.5 mm in all leaves of both leaf banks or <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/mp4244-math-0001.png\" xlink:title=\"urn:x-wiley:00942405:media:mp4244:mp4244-math-0001\"\/> in one bank only) into the 14 plans, thus simulating treatment delivery using a suboptimally performing MLC. The dosimetric consequences of suboptimal MLC performance were quantified using the equivalent uniform doses (EUDs) of the clinical target volumes and important organs at risk (OARs). The deviation of the EUDs of the selected structures as the performance of the MLC deteriorated was used as the objective surrogate of clinical outcome. Random errors of 2 mm resulted in negligible changes for all structures of interest in both sites. In contrast, systematic errors can lead to potentially significant dosimetric changes that may compromise clinical outcome. If a 2% change in EUD of the target and 2 Gy for the OARs were adopted as acceptable levels of deviation in dose due to MLC effects alone, then systematic errors in leaf position will need to be limited to 0.3 mm. This study provides guidance, based on a dosimetric surrogate of clinical outcome, for the development of one component, leaf position accuracy of performance standards for multileaf collimators.<\/jats:p>","DOI":"10.1118\/1.3134244","type":"journal-article","created":{"date-parts":[[2009,6,26]],"date-time":"2009-06-26T22:24:03Z","timestamp":1246055043000},"page":"3304-3309","source":"Crossref","is-referenced-by-count":106,"title":["Tolerances on MLC leaf position accuracy for IMRT delivery with a dynamic MLC"],"prefix":"10.1002","volume":"36","author":[{"given":"Alejandra","family":"Rangel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Dunscombe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,6,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1410123"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.598381"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.597699"},{"key":"e_1_2_7_5_1","unstructured":"AAPM Radiation Therapy Committee Task Group 50 Report No. 72 \u201cBasic applications of multileaf collimators \u201d Medical Physics Publishing 2001."},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1564091"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/50\/7\/003"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/52\/1\/N03"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2919560"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/53\/1\/005"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1449496"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/45\/5\/310"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1413517"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.598063"},{"key":"e_1_2_7_15_1","first-page":"1100","article-title":"A generalized concept of equivalent uniform dose","volume":"26","author":"Niemierko A.","year":"1999","journal-title":"Med. 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