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Title: SU-F-T-510: Single Isocenter Radiosurgery for the Simultaneous Treatment of Multiple Brain Metastases: Volumetric Modulated Arc Therapy Or Dynamic Conformal Arc?

Abstract

Purpose: This study evaluates a novel algorithm that can be used with any treatment planning system for simple and rapid generation of stereotactic radiosurgery (SRS) plans for treating multiple brain metastases using a single isocenter dynamic conformal arc (DCA) approach. This technique is compared with a single isocenter volumetric modulated arc therapy (VMAT) technique in terms of delivery time, conformity, low dose spread and delivery accuracy. Methods: Five patients, with a total of 37 (5 – 11) targets were planned using a previously published method for generating optimal VMAT plans and using the proposed DCA algorithm. All planning target volumes (PTVs) were planned to 20 Gy, meeting a minimum 99% coverage and maximum 135 % hot spot for both techniques. Quality assurance was performed using radiochromic film, with films placed in the high dose regions of each PTV. Normal tissue volumes receiving 12 Gy and 6 Gy (V12 and V6) were computed for each plan. Conformity index (CI) and gamma evaluations (95% of points passing 4%/0.5mm) were computed for each PTV. Results: Delivery times, including beam on and table rotation times, were comparable: 17 – 22 minutes for all deliveries. V12s for DCA plans were (18.5±15.2 cc) vs. VMAT (19.7±14.4more » cc). V6s were significantly lower for DCA (69.0±52.0 cc) compared with VMAT (154.0±91.0 cc) (p <<0.05). CIs for VMAT targets were (1.38±0.50) vs. DCA (1.61±0.41). 36 of 37 DCA planned targets passed gamma tests, while 29 of 37 VMAT planned targets passed. Conclusion: Single isocenter DCA plans were easily achieved. The evaluation suggests that DCA may represent a favorable technique compared with VMAT for multiple target SRS by reducing dose to normal tissue and more accurately depicting deliverable dose.« less

Authors:
; ; ; ;  [1]
  1. Cone Health Cancer Center, Greensboro, NC (United States)
Publication Date:
OSTI Identifier:
22649097
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; BRAIN; DELIVERY; DOSES; HOT SPOTS; METASTASES; PLANNING; QUALITY ASSURANCE; RADIOTHERAPY; SURGERY

Citation Formats

Maurer, J, Sintay, B, Manning, M, Wiant, D, and Liu, H. SU-F-T-510: Single Isocenter Radiosurgery for the Simultaneous Treatment of Multiple Brain Metastases: Volumetric Modulated Arc Therapy Or Dynamic Conformal Arc?. United States: N. p., 2016. Web. doi:10.1118/1.4956695.
Maurer, J, Sintay, B, Manning, M, Wiant, D, & Liu, H. SU-F-T-510: Single Isocenter Radiosurgery for the Simultaneous Treatment of Multiple Brain Metastases: Volumetric Modulated Arc Therapy Or Dynamic Conformal Arc?. United States. doi:10.1118/1.4956695.
Maurer, J, Sintay, B, Manning, M, Wiant, D, and Liu, H. Wed . "SU-F-T-510: Single Isocenter Radiosurgery for the Simultaneous Treatment of Multiple Brain Metastases: Volumetric Modulated Arc Therapy Or Dynamic Conformal Arc?". United States. doi:10.1118/1.4956695.
@article{osti_22649097,
title = {SU-F-T-510: Single Isocenter Radiosurgery for the Simultaneous Treatment of Multiple Brain Metastases: Volumetric Modulated Arc Therapy Or Dynamic Conformal Arc?},
author = {Maurer, J and Sintay, B and Manning, M and Wiant, D and Liu, H},
abstractNote = {Purpose: This study evaluates a novel algorithm that can be used with any treatment planning system for simple and rapid generation of stereotactic radiosurgery (SRS) plans for treating multiple brain metastases using a single isocenter dynamic conformal arc (DCA) approach. This technique is compared with a single isocenter volumetric modulated arc therapy (VMAT) technique in terms of delivery time, conformity, low dose spread and delivery accuracy. Methods: Five patients, with a total of 37 (5 – 11) targets were planned using a previously published method for generating optimal VMAT plans and using the proposed DCA algorithm. All planning target volumes (PTVs) were planned to 20 Gy, meeting a minimum 99% coverage and maximum 135 % hot spot for both techniques. Quality assurance was performed using radiochromic film, with films placed in the high dose regions of each PTV. Normal tissue volumes receiving 12 Gy and 6 Gy (V12 and V6) were computed for each plan. Conformity index (CI) and gamma evaluations (95% of points passing 4%/0.5mm) were computed for each PTV. Results: Delivery times, including beam on and table rotation times, were comparable: 17 – 22 minutes for all deliveries. V12s for DCA plans were (18.5±15.2 cc) vs. VMAT (19.7±14.4 cc). V6s were significantly lower for DCA (69.0±52.0 cc) compared with VMAT (154.0±91.0 cc) (p <<0.05). CIs for VMAT targets were (1.38±0.50) vs. DCA (1.61±0.41). 36 of 37 DCA planned targets passed gamma tests, while 29 of 37 VMAT planned targets passed. Conclusion: Single isocenter DCA plans were easily achieved. The evaluation suggests that DCA may represent a favorable technique compared with VMAT for multiple target SRS by reducing dose to normal tissue and more accurately depicting deliverable dose.},
doi = {10.1118/1.4956695},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}