Quality of intensity modulated radiation therapy treatment plans using a 60Co magnetic resonance image guidance radiation therapy system

H. Omar Wooten, Olga Green, Min Yang, Todd Dewees, Rojano Kashani, Jeff Olsen, Jeff Michalski, Deshan Yang, Kari Tanderup, Yanle Hu, H. Harold Li, Sasa Mutic

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


Purpose This work describes a commercial treatment planning system, its technical features, and its capabilities for creating 60Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. Methods and Materials The ViewRay treatment planning system (Oakwood Village, OH) was used to create 60Co IMRT treatment plans for 33 cancer patients with disease in the abdominal, pelvic, thorax, and head and neck regions using physician-specified patient-specific target coverage and organ at risk (OAR) objectives. Backup plans using a third-party linear accelerator (linac)-based planning system were also created. Plans were evaluated by attending physicians and approved for treatment. The 60Co and linac plans were compared by evaluating conformity numbers (CN) with 100% and 95% of prescription reference doses and heterogeneity indices (HI) for planning target volumes (PTVs) and maximum, mean, and dose-volume histogram (DVH) values for OARs. Results All 60Co IMRT plans achieved PTV coverage and OAR sparing that were similar to linac plans. PTV conformity for 60Co was within <1% and 3% of linac plans for 100% and 95% prescription reference isodoses, respectively, and heterogeneity was on average 4% greater. Comparisons of OAR mean dose showed generally better sparing with linac plans in the low-dose range <20 Gy, but comparable sparing for organs with mean doses >20 Gy. The mean doses for all 60Co plan OARs were within clinical tolerances. Conclusions A commercial 60Co MR-IGRT device can produce highly conformal IMRT treatment plans similar in quality to linac IMRT for a variety of disease sites. Additional work is in progress to evaluate the clinical benefit of other novel features of this MR-IGRT system.

Original languageEnglish (US)
Pages (from-to)771-778
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number4
StatePublished - Jul 15 2015

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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