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IMRT: What are the Potential Weak Links?
MU-dose relationship is not intuitive
Simple point dose verification calculations do not cover the properties
of the whole dose distribution
Inverse Treatment Planning
The multiple constraints, (competing) objectives, and the numerous
degrees of freedom make plan optimization a large scale multi-
criteria, non-convex, combinatorial, and discrete problem and thereby
not straightforward to solve.
Mechanical accuracy of the linear accelerator
Gantry, collimator, table iso-center (typically < 1 mm)
Ezzell G, Galvin JM, Low D, Palta JR, Rosen I, Sharpe MB, Xia P, Xiao Y, Xing L and Yu CX. Guidance document
on delivery, treatment planning, and clinical implementation of IMRT: Report of the IMRT subcommittee of
the AAPM Radiation Therapy Committee. Med. Phys. 30: 2090 – 2115, 2003