ArticleJournal of applied clinical medical physics2020
Strategies to optimize stereotactic radiosurgery plans for brain tumors with volumetric-modulated arc therapy.
Article in Journal of applied clinical medical physics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed.
- Automatic single-isocenter multiple-target cranial stereotactic treatment plan optimization via planning system scripting.Journal of applied clinical medical physics · 2026Article
- Benchmarking intermediate dose spillage in single target stereotactic radiosurgery for brain metastases.Physics and imaging in radiation oncology · 2026Article
- Comparative evaluation of normal tissue objective functions in robotic radiosurgery planning for solitary brain tumors.Journal of applied clinical medical physics · 2025Article
- A Radiogenomic Deep Ensemble Learning Model for Identifying Radionecrosis Following Brain Metastases (BM) Stereotactic Radiosurgery in Patients With Non-small Cell Lung Cancer BM.Advances in radiation oncology · 2025Article
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- AFI manual planning versus HyperArc auto-planning: A head-to-head comparison of SRS plan quality.Journal of applied clinical medical physics · 2024Article
- Planning issues on linac-based stereotactic radiotherapy.World journal of clinical cases · 2022Review
- A measure of SRS/SRT plan quality: Quantitative limits for intermediate dose spill (R50%) in linac-based delivery.Journal of applied clinical medical physics · 2022Article
- Efficient optimization of R50% when planning multiple cranial metastases simultaneously in single isocenter SRS/SRT.Journal of applied clinical medical physics · 2021Article
- An analytical expression for R50% dependent on PTV surface area and volume: A cranial SRS comparison.Journal of applied clinical medical physics · 2021Article
- Optimal prescription isodose line in SBRT for lung tumor treatment with volumetric-modulated arc therapy.Journal of radiosurgery and SBRT · 2020Article
- Effects of Institutional Experience on Plan Quality in Stereotactic Radiotherapy Using HyperArc for Brain Metastases.In vivo (Athens, Greece)Article
- Evaluation of Normal Tissue Objective Function for Treatment Planning of Solitary Brain Metastasis Using Intensity-modulated Radiosurgery Techniques.Journal of medical physicsArticle
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3 authors.
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Abstract
purposePrescription practice in SRS plans for brain tumors differs significantly for different modalities. In this retrospective study, the strategies to optimize SRS plans for brain tumors with volumetric arc therapy (VMAT) were presented.
methodsFifty clinically treated cases were stratified by the maximum target size into two groups (≥ 2 cm in 25 cases and <2 cm but ≥1 cm in 25 cases), which were optimized using traditional LINAC MLC-based approaches with the average prescription isodose line (P-IDL) of (91.4 ± 0.6)%. Four to five plans have been created for each case with variation of the P-IDL from 65% to 90%. The optimization strategies to select an optimal P-IDL, to use tuning structures within the target and beyond as well as to use NTO (normal tissue objectives), were applied to all new plans.
resultsThe optimal P-IDL was found to be around 75%. After applying the new optimization strategies with an average P-IDL of 74.8%, the mean modified gradient index (mGI) and V12 were reduced by 25% and 35%, respectively for both groups. The Paddick conformity index (PCI) was averagely improved by 8%. The average homogeneity index (HI) and focal index (FI) were increased by 22% and 50%, respectively. The mGI was inversely proportional to the PTV volumes. The shape of the dose distribution in target was also changed from concave to convex. The comparison of PCI with historical data from other institutes and modalities shows that the plans in this study have the best conformity near the target.
conclusionsWith the new optimization strategies for VMAT SRS plan of brain tumor more conformal plans in both high and intermediate dose region (~50% of the PD) were created, in which the dose in the core of the target was notably increased while V12 and mGI were significantly decreased, and PCI was improved. The mGI was inversely proportional to the PTV volumes. The optimal P-IDL is around 75%. The average PCI is the best in this study compared with the published historical data. These strategies are applicable to treatment planning for multiple brain and liver tumors where sparing the tissue peripheral to the target is critical.
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