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Department of Radiation Oncology, Spectrum Health Lakeland, Saint Joseph, MI
Conformal Dynamic Arcs (CDA) can provide a useful alternative in certain clinical situations which require a higher level of 3-dimensional (3D) conformation than shaped static ﬁelds but for which modulated ﬁelds (ﬁxed or arc) are inappropriate. Due to lack of modulation, the quality of the dose distribution produced by a CDA is highly dependent on the speciﬁc patient geometry. The ideal geometry for a CDA, in terms of achievable conformation and uniformity, is a spherical target perfectly centered in a cylindrical medium or body and utilizing a full 360 degree of rotation. This manuscript will provide or review several methods a treatment planner may employ to improve dose distributions produced by CDA as the patient and/or target geometry or degrees of arc rotation vary from the ideal. These include: