Physics in medicine and biology
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The multi-leaf collimator (MLC) of a particular linear accelerator vendor (Millennium MLC, Varian Medical Systems, Palo Alto, CA, USA) has a maximum leaf extension of 14.5 cm. To achieve intensity modulated radiotherapy (IMRT) for fields wider than 14.5 cm all closed leaf pairs are restricted to placement inside the field. Due to the rounded leaf end design of the MLC end leaf leakage will occur in the treatment field. ⋯ The ability to deliver IMRT fields wider than 14.5 cm with the Millennium MLC has improved the efficiency and flexibility of IMRT treatments; however, significant extra dose can be introduced due to end leaf leakage. Caution should be exercised when delivering wide field IMRT as it is not a complete panacea. Any significant occurrences of end leaf leakage predicted by the planning system should be independently verified prior to delivery.