Variable dose interplay effects across radiosurgical apparatus in treating multiple brain metastases

• DOI: 10.1007/s11548-014-1001-4
• Publication Date: 2014-04-19T04:22:07Z
• Authors: Lijun Ma; Alan Nichol; Sabbir Hossain; Brian Wang; Paula Petti; Rosemin Vellani; Chris Higby; Salahuddin Ahmad; Igor Barani; Dennis C. Shrieve; David A. Larson; Arjun Sahgal
• Keywords: Intensity modulation; Clinical Sciences; Radiotherapy Planning; 610; Clinical sciences; Health Informatics; Radiosurgery; 03 medical and health sciences; Computer-Assisted; 0302 clinical medicine; Humans; Neoplasm Metastasis; Stereotactic radiosurgery; Biomedical and Clinical Sciences; Gamma Knife; Brain Neoplasms; Radiotherapy Planning, Computer-Assisted; Brain metastases; Computer vision and multimedia computation; Radiotherapy Dosage; Nuclear Medicine & Medical Imaging; Radiology Nuclear Medicine and imaging; Surgery; Original Article

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