ArticleJournal of applied clinical medical physics2020
A robust VMAT delivery solution for single-fraction lung SABR utilizing FFF beams minimizing dosimetric compromise.
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 8 papers.
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Who cites it
8 citing papers in PubMed.
- A novel audit methodology to improve detection of planning and delivery errors in passive motion management.Physics and imaging in radiation oncology · 2026Article
- Quantification of the aperture modulation in radiotherapy treatment plans.Medical physics · 2025Article
- Clinical evaluation of the aperture shape controller in volumetric modulated arc therapy: Effects on MLC and jaw motion complexity, plan quality, and deliverability.Journal of applied clinical medical physics · 2025Article
- Treating early-stage centrally-located non-small cell lung cancer with DCAT-SBRT in centers lacking the VMAT technique: a comprehensive study.Frontiers in oncology · 2024Article
- The effects of flattening filter-free beams and aperture shape controller on the complexity of conventional large-field treatment plans.Journal of applied clinical medical physics · 2023Article
- Effect of plan complexity on the dosimetry, delivery accuracy, and interplay effect in lung VMAT SBRT with 6 MV FFF beam.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2022Article
- Selection Strategy of Jaw Tracking in VMAT Planning for Lung SBRT.Frontiers in oncology · 2022Article
- On the reduction of aperture complexity in kidney SABR.Journal of applied clinical medical physics · 2021Article
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Authors and funding
3 authors.
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Abstract
Peripheral lung lesions treated with a single fraction of stereotactic ablative body radiotherapy (SABR) utilizing volumetric modulated arc therapy (VMAT) delivery and flattening filter-free (FFF) beams represent a potentially high-risk scenario for clinically significant dose blurring effects due to interplay between the respiratory motion of the lesion and dynamic multi-leaf collimators (MLCs). The aim of this study was to determine an efficient means of developing low-modulation VMAT plans in the Eclipse treatment planning system (v15.5, Varian Medical Systems, Palo Alto, USA) in order to minimize this risk, while maintaining dosimetric quality. The study involved 19 patients where an internal target volume (ITV) was contoured to encompass the entire range of tumor motion, and a planning target volume (PTV) created using a 5-mm isotropic expansion of this contour. Each patient had seven plan variations created, with each rescaled to achieve the clinical planning goal for PTV coverage. All plan variations used the same field arrangement, and consisted of one dynamic conformal arc therapy (DCAT) plan, and six VMAT plans with varying degrees of modulation restriction, achieved through utilizing different combinations of the aperture shape controller (ASC) in the calculation parameters, and monitor unit (MU) objective during optimization. The dosimetric quality was assessed based on RTOG conformity indices (CI100/CI50), as well as adherence to dose-volume metrics used clinically at our institution. Plan complexity was assessed based on the modulation factor (MU/cGy) and the field edge metric. While VMAT plans with the least modulation restriction achieved the best dosimetry, it was found that there was no clinically significant trade-off in terms of dose to organs at risk and conformity by reducing complexity. Furthermore, it was found that utilizing the ASC and MU objective could reduce plan complexity to near-DCAT levels with improved dosimetry, which may be sufficiently robust to overcome the interplay effect.
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