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Is there a volume threshold of brain metastases for Linac-based stereotactic radiotherapy?
| Content Provider | Europe PMC |
|---|---|
| Author | Liu, Chieh-Wen Ahmed, Saeed Gray, Tara Ma, Tianjun Cho, Young-Bin Neyman, Gennady Chao, Samuel Suh, John Xia, Ping |
| Copyright Year | 2021 |
| Abstract | Purpose: To investigate whether there is a volume threshold in target volume of brain metastases below which a small cone size and sharp penumbra in Gamma Knife (GK) may provide improved plan quality when compared to Volumetric Modulated Arc Therapy (VMAT)-based stereotactic radiosurgery (SRS). Methods: For patients treated on GK SRS for brain metastases in 2018-2019 in our institution, 121 patients with two and three targets were identified. Twenty-six patients with two or three brain metastases (total of 76 lesions) were selected for this study. Two VMAT plans, SmartArc (Pinnacle) and HyperArc (Eclipse), were generated retrospectively for each patient. Plan quality was evaluated based on RTOG conformity index (CI), Paddick gradient index (GI), normal tissue (NT) V12Gy and V4.5Gy. By using the receiver operating characteristic (ROC) curve for both VMAT plans (SmartArc and HyperArc) and metrics of RTOG CI and NT V12Gy, we compared GK plans to SmartArc and HyperArc plans separately to determine the threshold volume. Results: For SmartArc plans, both ROC curve analyses showed a threshold volume of 0.4 cc for both CI and NT V12Gy. For HyperArc plans, the threshold volumes were 0.2 cc for the CI and 0.5 cc for NT V12Gy. GK plans produced improved dose distribution compared to VMAT for targets ≤0.4 cc, but HyperArc was found to have competing results with GK in terms of CI and NT V12Gy. For targets > 0.4 cc, both SmartArc and HyperArc showed better plan quality when compared to the GK plans. Conclusions: Target volumes ≤0.4 cc may require a small cone size and sharp penumbra in GK while for target volumes >0.4 cc, VMAT-based SRS can provide improved overall plan quality and faster treatment delivery. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8492046&blobtype=pdf |
| ISSN | 21564639 |
| Volume Number | 7 |
| PubMed Central reference number | PMC8492046 |
| Issue Number | 4 |
| PubMed reference number | 34631232 |
| Journal | Journal of Radiosurgery and SBRT [J Radiosurg SBRT] |
| e-ISSN | 21564647 |
| Language | English |
| Publisher | Old City Publishing, Inc. |
| Publisher Date | 2021-01-01 |
| Access Restriction | Open |
| Rights License | Published by license under the OCP Science imprint, a member of the Old City Publishing Group. © 2021 Old City Publishing, Inc. |
| Subject Keyword | Gamma Knife VMAT Linac SRS radiosurgery brain metastases plan quality |
| Content Type | Text |
| Resource Type | Article |
| Subject | Radiology, Nuclear Medicine and Imaging Surgery Radiological and Ultrasound Technology |
