High quality clinical stereotactic radiosurgery planning and delivery with standard resolution (5mm) multileaf collimation and multiple isocentres

<p><strong>Purpose:</strong><br /> Our purpose was to demonstrate the use of novel planning techniques in producing high-quality stereotactic radiosurgery (SRS) plans using a standard 5 mm multileaf collimator (MLC) and multiple isocenters delivered clinically at a local inst...

Full description

Bibliographic Details
Main Authors: Robinson, M, Tunstall, C, Van Den Heuvel, F, Hobbs, C, Padmanaban, S
Format: Journal article
Language:English
Published: Elsevier 2020
_version_ 1797087348198998016
author Robinson, M
Tunstall, C
Van Den Heuvel, F
Hobbs, C
Padmanaban, S
author_facet Robinson, M
Tunstall, C
Van Den Heuvel, F
Hobbs, C
Padmanaban, S
author_sort Robinson, M
collection OXFORD
description <p><strong>Purpose:</strong><br /> Our purpose was to demonstrate the use of novel planning techniques in producing high-quality stereotactic radiosurgery (SRS) plans using a standard 5 mm multileaf collimator (MLC) and multiple isocenters delivered clinically at a local institution.</p><br /> <p><strong>Methods and Materials:</strong><br /> Novel planning techniques consisted of offset isocenter, variable asymmetrical jaws, and Digital Imagine and Communications in Medicine (DICOM) edits to reduce leaf tip transmission, all with the aim of maximizing dose conformity. A local institution clinical cohort was planned (1-4 targets), and plan conformity metrics common to SRS were compared against conformity metrics from selected previous publications comparing Gamma Knife to linear accelerator SRS using high-definition MLC (2.5 mm). Additionally, local institution plan conformity metrics for 2 benchmark SRS planning cases (3 and 7 targets) were compared with metrics from other centers treating SRS clinically in England. Pretreatment quality assurance results, both point dose measurement and film analysis, are presented to demonstrate plan deliverability.</p><br /> <p><strong>Results:</strong><br /> Clinical conformity metrics are shown to be comparable to previously published results using either Gamma Knife or linear accelerator with high-definition MLC. Metrics from benchmark planning cases are shown to be comparable and to have better prescription dose conformity than average nationally in England. Pretreatment quality assurance results demonstrate suitable plan deliverability.</p><br /> <p><strong>Conclusions:</strong><br /> SRS planning using standard 5 mm MLC and multiple isocenters produces high-quality treatment plans for a limited number of targets with a high degree of dose conformity and dose fall off when employing novel planning techniques to compensate for MLC leaf size and multiple isocenters.</p>
first_indexed 2024-03-07T02:34:28Z
format Journal article
id oxford-uuid:a85420fc-f538-4db6-ad49-041870846166
institution University of Oxford
language English
last_indexed 2024-03-07T02:34:28Z
publishDate 2020
publisher Elsevier
record_format dspace
spelling oxford-uuid:a85420fc-f538-4db6-ad49-0418708461662022-03-27T03:00:52ZHigh quality clinical stereotactic radiosurgery planning and delivery with standard resolution (5mm) multileaf collimation and multiple isocentresJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a85420fc-f538-4db6-ad49-041870846166EnglishSymplectic ElementsElsevier2020Robinson, MTunstall, CVan Den Heuvel, FHobbs, CPadmanaban, S<p><strong>Purpose:</strong><br /> Our purpose was to demonstrate the use of novel planning techniques in producing high-quality stereotactic radiosurgery (SRS) plans using a standard 5 mm multileaf collimator (MLC) and multiple isocenters delivered clinically at a local institution.</p><br /> <p><strong>Methods and Materials:</strong><br /> Novel planning techniques consisted of offset isocenter, variable asymmetrical jaws, and Digital Imagine and Communications in Medicine (DICOM) edits to reduce leaf tip transmission, all with the aim of maximizing dose conformity. A local institution clinical cohort was planned (1-4 targets), and plan conformity metrics common to SRS were compared against conformity metrics from selected previous publications comparing Gamma Knife to linear accelerator SRS using high-definition MLC (2.5 mm). Additionally, local institution plan conformity metrics for 2 benchmark SRS planning cases (3 and 7 targets) were compared with metrics from other centers treating SRS clinically in England. Pretreatment quality assurance results, both point dose measurement and film analysis, are presented to demonstrate plan deliverability.</p><br /> <p><strong>Results:</strong><br /> Clinical conformity metrics are shown to be comparable to previously published results using either Gamma Knife or linear accelerator with high-definition MLC. Metrics from benchmark planning cases are shown to be comparable and to have better prescription dose conformity than average nationally in England. Pretreatment quality assurance results demonstrate suitable plan deliverability.</p><br /> <p><strong>Conclusions:</strong><br /> SRS planning using standard 5 mm MLC and multiple isocenters produces high-quality treatment plans for a limited number of targets with a high degree of dose conformity and dose fall off when employing novel planning techniques to compensate for MLC leaf size and multiple isocenters.</p>
spellingShingle Robinson, M
Tunstall, C
Van Den Heuvel, F
Hobbs, C
Padmanaban, S
High quality clinical stereotactic radiosurgery planning and delivery with standard resolution (5mm) multileaf collimation and multiple isocentres
title High quality clinical stereotactic radiosurgery planning and delivery with standard resolution (5mm) multileaf collimation and multiple isocentres
title_full High quality clinical stereotactic radiosurgery planning and delivery with standard resolution (5mm) multileaf collimation and multiple isocentres
title_fullStr High quality clinical stereotactic radiosurgery planning and delivery with standard resolution (5mm) multileaf collimation and multiple isocentres
title_full_unstemmed High quality clinical stereotactic radiosurgery planning and delivery with standard resolution (5mm) multileaf collimation and multiple isocentres
title_short High quality clinical stereotactic radiosurgery planning and delivery with standard resolution (5mm) multileaf collimation and multiple isocentres
title_sort high quality clinical stereotactic radiosurgery planning and delivery with standard resolution 5mm multileaf collimation and multiple isocentres
work_keys_str_mv AT robinsonm highqualityclinicalstereotacticradiosurgeryplanninganddeliverywithstandardresolution5mmmultileafcollimationandmultipleisocentres
AT tunstallc highqualityclinicalstereotacticradiosurgeryplanninganddeliverywithstandardresolution5mmmultileafcollimationandmultipleisocentres
AT vandenheuvelf highqualityclinicalstereotacticradiosurgeryplanninganddeliverywithstandardresolution5mmmultileafcollimationandmultipleisocentres
AT hobbsc highqualityclinicalstereotacticradiosurgeryplanninganddeliverywithstandardresolution5mmmultileafcollimationandmultipleisocentres
AT padmanabans highqualityclinicalstereotacticradiosurgeryplanninganddeliverywithstandardresolution5mmmultileafcollimationandmultipleisocentres