Int J Comput Assist Radiol Surg - Variable dose interplay effects across radiosurgical apparatus in?treating multiple brain metastases.

Tópicos

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Resumo

RPOSE: Normal brain tissue doses have been shown to be strongly apparatus dependent for multi-target stereotactic radiosurgery. In this study, we investigated whether inter-target dose interplay effects across contemporary radiosurgical treatment platforms are responsible for such an observation.METHODS: For the study, subsets ([Formula: see text] and 12) of a total of 12 targets were planned at six institutions. Treatment platforms included the (1) Gamma Knife Perfexion (PFX), (2) CyberKnife, (3) Novalis linear accelerator equipped with a 3.0-mm multi-leaf collimator (MLC), and the (4) Varian Truebeam flattening-filter-free (FFF) linear accelerator also equipped with a 2.5?mm MLC. Identical dose-volume constraints for the targets and critical structures were applied for each apparatus. All treatment plans were developed at individual centers, and the results were centrally analyzed.RESULTS: We found that dose-volume constraints were satisfied by each apparatus with some differences noted in certain structures such as the lens. The peripheral normal brain tissue doses were lowest for the PFX and highest for TrueBeam FFF and CyberKnife treatment plans. Comparing the volumes of normal brain receiving 12 Gy, TrueBeam FFF, Novalis, and CyberKnife were 180-290?% higher than PFX. The mean volume of normal brain-per target receiving 4-Gy increased by approximately 3.0 cc per target for TrueBeam, 2.7 cc per target for CyberKnife, 2.0 cc per target for Novalis, and 0.82 cc per target for PFX. The beam-on time was shortest with the TrueBeam FFF (e.g., 6-9?min at a machine output rate of 1,200 MU/min) and longest for the PFX (e.g., 50-150 mins at a machine output rate of 350?cGy/min).CONCLUSION: The volumes of normal brain receiving 4 and 12 Gy were higher, and increased more swiftly per target, for Linac-based SRS platforms than for PFX. Treatment times were shortest with TrueBeam FFF.

Resumo Limpo

rpose normal brain tissu dose shown strong apparatus depend multitarget stereotact radiosurgeri studi investig whether intertarget dose interplay effect across contemporari radiosurg treatment platform respons observationmethod studi subset formula see text total target plan six institut treatment platform includ gamma knife perfexion pfx cyberknif novali linear acceler equip mm multileaf collim mlc varian truebeam flatteningfilterfre fff linear acceler also equip mm mlc ident dosevolum constraint target critic structur appli apparatus treatment plan develop individu center result central analyzedresult found dosevolum constraint satisfi apparatus differ note certain structur len peripher normal brain tissu dose lowest pfx highest truebeam fff cyberknif treatment plan compar volum normal brain receiv gy truebeam fff novali cyberknif higher pfx mean volum normal brainper target receiv gy increas approxim cc per target truebeam cc per target cyberknif cc per target novali cc per target pfx beamon time shortest truebeam fff eg min machin output rate mumin longest pfx eg min machin output rate cgyminconclus volum normal brain receiv gy higher increas swift per target linacbas srs platform pfx treatment time shortest truebeam fff

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