Virtual micro-intensity modulated radition therapy

Virtual micro-intensity modulated radiation therapy (VMIMRT) combines a 10 x 5 mm(2) intensity map with a 5 x 10 mm(2) intensity map, delivered at orthogonal collimator settings. The superposition of these component maps (CM) yields a 5 x 5 mm(2) virtual micro-intensity map (VMIM) that can be delivered with a 1 cm leaf width MLC. A pair of CMs with optimal delivery efficiency and quality must be chosen, since a given VMIM can be delivered using several different pairs. This is possible since, for each group of four VMIM cells that can be covered by an MLC leaf in either collimator orientation, the minimum intensity can be delivered from either collimator setting. By varying the proportions of the minimum values that go into each CM, one can simultaneously minimize the number of potential junction effects and the number of segments required to deliver the VMIM. The minimization is achieved by reducing high leaf direction gradients in the CMs. Several pseudo-clinical and random VMIMs were studied to determine the applicability of this new technique. A nine level boost map was also studied to investigate dosimetric and spatial resolution issues. Finally, clinical issues for this technique are discussed. (C) 2000 American Association of Physicists in Medicine. [S0094-2405(00)00311-4].