Multileaf Collimators

Rina Taurisia
Medical Physicist
MRCCC Siloam Hospitals

Overview
BEFORE MLCs:
Using jaws to shape x-ray fields (rectangular
shapes)
Creating custom beam blocks for a given field
applied to a specific patient
DISADVANTAGE OF BEAM BLOCKS:
Time consuming
Exposure to toxic fumes during melting time
Heavy prone to patients & RTTs accidents &
injury

Overview
Modern MLC was used in
radiotherapy starting 1980s, first
developed in Japan.
Philips (now Elekta) and Varian
introduced the commercially
available MLC in 1990s in Europe
and in the USA.
Main functions of MLC:
To define any field shapes for radiation
beam
To create beam modulation
May replace collimators or additional to
normal collimators

Ideal MLC
Negligible leakage
Small dosimetric penumbra
Fine leaf width
Maximum leaf speed and good
acceleration / deceleration
(Dynamic)
Excellent mechanical accuracy,
stability and precision

MLC Configurations

Example of MLC leaf with a curved end

and a stepped side

MLC Configurations
MLC configuration may
be categorized as:
Total replacement
Partial replacement
of the upper jaws, the
lower jaws, or are
Tertiary
collimation
configuration

MLC Configurations
Exit window

Exit window

Upper
Jaws

Upper
Jaws

ML
C
DIAPHRAG
M

Exit window

Lowe
r
Jaws
ML
C

ML
C

Lowe
r
Jaws

isocenter

isocenter

isocenter

Elekta

Siemens

Varian

MLC Configurations
Exit window

Exit window

37.3
42.6

MLC
DIAPHRAGM

Elekta

50.9

Exit window

27.8

UPPER
JAWS

35.7
37.9

MLC

UPPER
JAWS

LOWER
JAWS

53.5
LOWER
JAWS

MLC

Siemens

Varian

44.4

1) Upper Jaw Replacement

UPPER JAW
MLC

LOWER JAW

Elekta
MLC system replaces the upper movable jaws inside the
linac head
MLC distance is close to the target minimal range of
motion required for precise field shaping
Advantages:
Less wear and tear on the leaf positioning mechanism
Compact linac head at 62 cm diameter reduce pontential for
gantry and table collisions when non-coplanar beams are used

Disadvantage:
MLC leaves are far from isocenter leaf width must be smaller
and tolerances on the dimensions of the leaves as well as the leaf
travel must be tighter compared to other configurations

Elekta
MLC consists of 40 pairs of tungsten alloy leaves with 7.0
cm thickness (height) and each leaf projecting a 1.0 cm
width and 32.5 cm length at isocenter single focus
with a rounded end
The same computer controls the MLC, the leaves, and
the backup jaws backup jaws automatically follow to
the edge position of the outermost withdrawn leaf
Max. field size = 40 x 40 cm (for conventional treatment)
Each leaf can travel 12.5 cm over the beam central axis
max. field size for IMRT = 25 x 40 cm
IMRT is delivered with step-and-shoot technique

2) Lower Jaw Replacement

Siemens
MLC system replaces the lower movable jaws inside the
linac head
The 82 leaf MLC has 39 pairs of inner leaves with a 1.0
cm width and two pairs of outer leaves with a 0.5 cm
width cover full 40 cm IMRT field length
The 58 leaf MLC consists of 27 pairs of inner leaves with
a 1.0 cm width and two pairs of outer leaves with a 6.5
cm width.
Both MLCs leaf are 31 cm long at isocenter, with a
straight edge facing toward the center of the beam
A double-focus leaf design the end and the side of the
leaves follow the beam divergence in both direction
(along and perpendicular to the leaf motion)

Siemens
Because of the complex design for an arc trajectory, the
leaf position is accurate only to within 2 mm
Each leaf can travel a max distance of 15 cm over the
beam central axis may limit IMRT field to 27 cm
The upper jaws must be positioned no more than 0.5 cm
beyond the boundary of the MLC shape.
Max. field size = 40 x 40 cm (conventional treatment)
The new 160-MLC is a single focused design, consists of
80 pairs, each 9.5 cm thick (high) with a projected leaf
width of 5 mm at isocenter half the size of previous
predecessors

3) Tertiary Collimation System

Varian
MLC system is a tertiary system mounted below the
lower movable jaws inside the linac head
Advantage: reduce downtime during system malfunction
Disadvantage: added bulk to the linac head prone to gantry &
table collision for non-coplanar treatment

MLC consists of 26, 40, or 60 pairs of tungsten alloy

leaves with 6 cm thickness (height)
For the Millennium 120 MLC, there are 40 inner pairs of
leaves, with each leaves projecting 0.5 cm width, and 20
outer pairs of leaves, with a 1.0 cm width at the isocenter
Each leaf is 16 cm long and single focus, with a rounded
end leaf motion is along a straight line in a plane
perpendicular to the beam central axis

Varian
Mechanical design of the MLC is simpler, with a leaf
positional accuracy of 1 mm at the isocenter
The rounded end is used to ensure that the leaf end
transmission is nearly independent of the leaf postion
With two MLC leaf carriages, max. conventional field
size is 40 x 40 cm & travel range of each leaf is 15 cm
from the end of the carriage
The carriage can be retracted up to 20 cm from the beam
axis and can travel up to 2 cm beyond the axis leaf
positions can vary between 20 cm away from the
isocenter to 17 cm beyond the isocenter

Varian
Because the leaf length is 16 cm, the distance between
the most leading and the most retracted leaves from the
same bank is limited to 14.5 cm to avoid radiation leakage
through the tail of the most leading leaf or the tip of the
most retracted leaf
MLC supports all types of IMRT delivery: segmental,
dynamic, combined dynamic & segmental in the same
field, and conformal arc.
During the delivery, the MLC leaf positions are
controlled by the MLC control computer, whereas the
total MU is controlled by console computer.

Interdigitation
Definition: the property whereby the tips of neighboring
leaves on opposed MLC banks are allowed to pass one
another
Varian: full interdigitation is allowed
Siemens: leaf tips from the opposing MLC banks are allowed to
meet, but not pass each other
Elekta: leaf tips from opposing leaf banks must remain 1 cm
apart

Over-travel Distance
Definition: the
distance that each leaf
passes over the
isocenter, without
leaving an uncovered
region
Siemens: 10 cm
Elekta: 12.5 cm
Varian: 17 cm*

Leaf End Shape

Flat edge:
Less penumbra, but
Complex mechanical
arrangement to keep the
flat edge of a conventional
collimator aligned with the
x-ray source

Rounded edge:
Simpler mechanism
The curvature allows some
penetration of the beam
through the edge of each
leaf, but this is the same for
all field sizes

Penumbra:
the distance between the points
receiving 80% and 20% of the dose on
the beam axis

Penumbra
A dosimetric comparison of various multileaf
collimators Huq et.al. (Phys. Med. Biol. 47, 2002)
MLC design with divergent
and non-divergent leaves
produce penumbra within
2% of each other
Distance of the collimator
from the x-ray target plays
an important role Varian
has the smaller width
despite its rounded leafend design

MLC Transmission
Leaf transmission:
Reduction of dose through
the full height of the leaf
Interleaf transmission:
Reduction of dose
measured along a line
passing between leaf sides
Leaf end transmission:
Reduction of dose
measured along a ray
passing between the ends
of opposed leaves in their
most closed position

Inter-leaf Leakage
A dosimetric comparison of various multileaf
collimators Huq et.al. (Phys. Med. Biol. 47, 2002)

Siemens performs slightly

better than others for interleaf leakage

Tongue & Groove Effect

A dosimetric comparison of various multileaf
collimators Huq et.al. (Phys. Med. Biol. 47, 2002)
Siemens produces reduced
tongue & groove effect
compared to the other two
collimators
Paper conclusion:
There is no perfect MLC system that
can be recommended. Each one has
unique advantages & disadvantages
that should be weighed with comfort,
ease and cost effectiveness for clinical
use.

Summary
Elekta

Siemens

Varian

Static

Static

Static / Dynamic

80

82 or 160

80 or 120

10 mm

41 x 10 mm
80 x 5 mm

40 x 10 mm
40x10 mm + 20x5 mm

7.5

7.5

1.8 2.5

0.9 1.25

1.6 1.9

Single;
rounded ends

Double;
flat ends

Single;
rounded ends

Max. Field Size

(cm)

40 x 40

40 x 40

40 x 40

Overtravel (cm)

12.5

10 or 20

20*

Delivery
No. of Leaves
Leaf width @ iso
Thickness (cm)
Transmission (%)
Focus

Speed (cm/s)

PROS

VARIAN

- Interdigitization improves
efficiency of dose delivery
- Interdigitization reduces the MU,
patient dose
- MLC closer to skin improves
penumbra
- Robust design

SIEMENS -

ELEKTA

Small intra and inter-leaf leakage

No need for backup collimators
Record & Verify each segment
Exact light-to-rad calibration
Low leakage

- Smaller and lighter MLC

- Less leaf movement needed,
shorter MLCs
- Compact treatment head

CONS
- Added bulk
- Clearance to the mechanical
isocenter
- Leaf-end leakage
- Rounded MLC worsen penumbra
- No back-up collimator following
MLC edge
- Difficult light-to-rad calibration
-

Mechanical complexity
Lower leaf precision
Overall MLC robustness
Bulky head

Large magnification of MLC

Leaf-end leakage
Rounded MLC worsen penumbra
Tighter tolerance of leaf dimensions

References
AAPM Task Group #50 Radiation Therapy Committee. (2001). Basic
Applications of Multileaf Collimators. Madison: Medical Physics.
Huq, M. S., Das, I. J., Steinberg, T., & Galvin, J. M. (2002). A
dosimetric comparison of various multileaf collimators. Phys. Med.
Biol., 47, N159N170.
Loverock, L. (2007). Linear Accelerator. In Mayles, P., Nahum, A.,
and Rosenwald, J. C. (Eds.). Handbook of Radiotherapy Physics: Theory
and Practice. (pp. 218 225). New York: Taylor & Francis.
Mundt, A. J., & Roeske, J. C. (2005). Intensity Modulated Radiation
Therapy: a Clinical Perspective. Hamilton: BC Decker.
University of California, San Francisco. (January 28, 2009). IMRT
dose planning and delivery with Siemens, Varian and Elekta. Retrieved
November 4, 2011, from
http://radonc.ucsf.edu/links/Video/Physics/.../OM_IMRTtalk.pd
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