120 leaf millennium multileaf collimator

Manufactured by Agilent Technologies

Sourced in United States

The 120-leaf Millennium multileaf collimator is a medical device used in radiation therapy. It consists of 120 individually-controlled leaves that can be positioned to shape the radiation beam, allowing for precise targeting of the treatment area.

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Lab products found in correlation

Cl21ix linear accelerator, by Agilent Technologies (2 mentions) Rapidarc system, by Agilent Technologies (1 mentions) Acuros xb, by Agilent Technologies (1 mentions) Pinnacle v 9, by Philips (1 mentions) Linear accelerator, by Agilent Technologies (1 mentions) Truebeam linac, by Agilent Technologies (1 mentions)

5 protocols using 120 leaf millennium multileaf collimator

Simultaneous Integrated Boost IMRT for Cancer

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The SIB-IMRT plans used 15-MV photon beams from a Varian CL21iX linear accelerator fitted with a Millennium 120-leaf multileaf collimator (Varian Medical Systems, Palo Alto, CA, USA). Nine static coplanar fields were used to treat 4 patients from September 2011 to May 2012. Thereafter, volumetric IMRT featuring coplanar double arcs was used to treat 6 patients (RapidArc system; Varian Medical Systems). One arc rotated clockwise from 181° to 179° and the other rotated counterclockwise from 179° to 181°.
The SIB-IMRT prescribed 54 Gy to the PTV54 and 45 Gy to the PTV45 in 30 fractions. The planning goals were to create homogenous target coverage and reduce the doses to organs at risk by reference to the dose constraints of the RTOG 0529 protocol [5 (link)]. The dose calculation algorithm used was the anisotropic analytical analysis of Acuros XB, with a 2.5-mm grid size (Varian Medical Systems). The dose distributions included corrections for tissue heterogeneity.

Sakanaka K., Itasaka S., Ishida Y., Fujii K., Horimatsu T., Mizowaki T., Sakai Y, & Hiraoka M. (2017). Dosimetric advantages and clinical outcomes of simultaneous integrated boost intensity-modulated radiotherapy for anal squamous cell carcinoma. Radiation Oncology Journal, 35(4), 368-379.

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Radiation Therapy Planning Optimization

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DCAT, coVMAT, and ncVMAT plans were created for each of 10 cases. Six-megavolt photon beams delivered by a Varian CL21iX linear accelerator through a Millennium 120-leaf multileaf collimator (Varian Medical Systems) were used in all plans. The Acuros XB dose Acurous calculation algorithm was employed; the calculation grid size was 2.5 mm x 2.5 mm. The dose prescribed for the PTV was 52.2 Gy in 29 fractions, and all plans were normalized to ensure that V90 = 99 % (thus, 99 % of the PTV was covered by 90 % of the prescribed dose). The maximum doses to the brainstem, optic nerves/chiasm, and lens were set at less than 54, 55, and 10 Gy, respectively.

Uto M., Mizowaki T., Ogura K, & Hiraoka M. (2016). Non-coplanar volumetric-modulated arc therapy (VMAT) for craniopharyngiomas reduces radiation doses to the bilateral hippocampus: a planning study comparing dynamic conformal arc therapy, coplanar VMAT, and non-coplanar VMAT. Radiation Oncology (London, England), 11, 86.

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Evaluation of TrueBeam Flattening Filter-Free Beams

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All measurements were performed with conventional (6X and 15X) and flattening filter‐free 10X (10XFFF) beams from a TrueBeam v 2.0 linear accelerator equipped with a 120‐leaf Millennium multileaf collimator (MLC) from Varian Medical Systems, Palo Alto, CA. The treatment planning system (TPS) was Pinnacle v. 9.8 (Philips Radiation Oncology Systems, Fitchburg, WI).
The AC features an array of 1,386 point detectors that form a 10.4 cm radius cylindrical active surface inside a doughnut‐shaped PMMA phantom. The phantom has an outer diameter of 26.6 cm and a 15 cm diameter inner hole that can be plugged with a PMMA cylinder.⁽⁵⁾ All tests in this work were performed with the plug inserted, as this is the configuration necessary for 3D dose reconstruction.⁽⁷⁾ The phantom was represented in the TPS by a cylinder with a uniform relative density of 1.15, which was shown previously to provide adequate agreement between the ion chamber measurements and TPS calculations.⁽⁵⁾ArcCHECK measurement data were collected using SNC Patient software v. 6.6 (Sun Nuclear Corp). Statistical analyses were performed with GraphPad Prism software package (v. 6, GraphPad Software, La Jolla, CA).

Ahmed S., Nelms B., Kozelka J., Zhang G., Moros E, & Feygelman V. (2016). Validation of an improved helical diode array and dose reconstruction software using TG‐244 datasets and stringent dose comparison criteria. Journal of Applied Clinical Medical Physics, 17(6), 163-178.

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VMAT Dosimetry for Head and Neck Cancer

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To perform a challenging test of the AP algorithm, we applied it to some of the most dosimetrically difficult cases encountered in our practice — locoregionally advanced head and neck cancers. Ten consecutive, previously treated cases were selected according to the following criteria: all were treated with 6 MV VMAT beams for 35 fractions, with 70 Gy to the primary target (PTV_70) and simultaneously 56 Gy to the elective bilateral neck nodes (PTV_56); all patients were under the care of the same radiation oncologist and planned by the same dosimetrist. All original plans employed two or three full VMAT arcs and were designed for a Varian linear accelerator with a 120‐leaf Millennium multileaf collimator (Varian Medical Systems, Palo Alto, CA). The physician manually drew the primary gross tumor volume (GTV) and the elective nodes clinical tumor volume (CTV). The GTV was expanded uniformly by 5 mm to create the 70 Gy CTV. This was manually edited to remove bone, fascia, and air. Both CTVs were expanded uniformly by 3 mm to arrive at the corresponding planning target volumes (PTV). The primary (PTV_70) average target volume was 338±262 (1 SD) cm3 with the range from 85 to 1035 cm3. The bilateral elective nodes (PTV_56) had the average volume of 352±94 cm3, with the range from 182 to 490 cm3.

Gintz D., Latifi K., Caudell J., Nelms B., Zhang G., Moros E, & Feygelman V. (2016). Initial evaluation of automated treatment planning software. Journal of Applied Clinical Medical Physics, 17(3), 331-346.

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Hypofractionated SBRT Using FFF Photons

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Each patient plan was replanned using the DCA, IMRT and RA techniques, based on 6 MV FFF photons with a dose rate of 1400 MU/min. All plans were created to be delivered using the TrueBeam linac (Varian Medical Systems, Inc., Palo Alto, CA) with a 120-leaf Millennium multileaf collimator (MLCs). All plans were designed in Eclipse external beam planning system (Version 10.0.42, Varian Medical System, Inc., Palo Alto, CA). The final dose calculations were carried out with a grid of 2.5 mm using the Anisotropic Analytical Algorithm (AAA). All patients were treated with a prescribed dose of 48 Gy in four fractions covering 95% of the PTV, and 99% of the PTV was covered by least 90% of the prescription dose. The dose constraints of OARs were set to follow the dosimetric parameters of the RTOG 0915 protocol.

Zhang J.Y., Lu J.Y., Wu L.L., Hong D.L., Ma C.C., Peng X, & Lin Z.X. (2016). A dosimetric and treatment efficiency evaluation of stereotactic body radiation therapy for peripheral lung cancer using flattening filter free beams. Oncotarget, 7(45), 73792-73799.

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