Dear Dương Thanh Tai,

attached you will find a short collection of paper titles matching your question. Maybe my friend (Dott Mauro Iori: [email protected]) can give to you a more exhaustive information.

My best wishes,

Gianni 

Dear Dương Thanh Tai,

I am sorry for late answer.

We are using MLCs to IMRT plans. I am  Physytion (Medical Oncologyst). But I can contact you to our Medical Physics. I think, that you can get more professional answer.

My best wishes,

Marina Sokolovska

Dear Dương Thanh Tai,

I have consulting with our Medical Physics about your question. 

Its imposible to use jaws to create IMRT! Only MLCs needed for this.

My best wishes,

Marina Sokolovska

Dear Dương Thanh Tai,

there are some publications on that topic (thanks to Giovanni), but in practice, I think that this technique is rarely used since using the MLC leaves for IMRT mostly has some important advantages:

- more flexibility in field shaping,

- higher speed of leaf motion compared to jaw motion,

- smaller penumbra of leaves compared to jaws.

However, jaw motion during IMRT application (using MLC leave motion) plays an important role mainly to reduce the leakage through the MLC.

There is also a technique called "virtual wedge" that can be applied using Siemens  medical linear accelerators. Thereby, continous jaws motion is used instead of a real wedge to create an angled dose distribution. The advantages are, that arbitrary angles are achievable (not only 15/30/45/60° of real wedge) and that the dose rate is not reduced due to additional material of the real wedge. The disadvantage is, that jaw motion direction is only perpendicular to the leaf motion direction. This technique is not, what is usually subsumed under IMRT, but it is indeed a kind of intensity modulation.

Best regards

@ Giovanni Borasi

Dear Dr. Giovanni Borasi,

I would like to thank you very much for your time to collect paper titles matching with my question.

I found and got it.

@ Falk Tillner

@ Marina Sokolovska

Thank you

yes,IMRT  is possible by using dynamic jaws,even with different wedge angles...but from planning side it is tedious job.....