ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2022
Single-isocenter stereotactic non-coplanar arc treatment of 200 patients with brain metastases: multileaf collimator size and setup uncertainties.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Evaluation of EPID-Based Transmission and DLG Correction Methods for Dosimetric Verification in HyperArc Single-Isocenter Multiple Target Radiosurgery.Diagnostics (Basel, Switzerland) · 2026Article
- Dosimetric intercomparison for stereotactic radiotherapy of multiple brain metastases.Physics and imaging in radiation oncology · 2026Article
- To shift or not to shift: identifying and correcting patient motion after couch rotations in non-coplanar intracranial radiosurgery with stereoscopic X-ray imaging.Journal of applied clinical medical physics · 2026Article
- Improvement in positional accuracy with integrated surface- and X-ray imaging for intracranial stereotactic radiosurgery patients.Physics and imaging in radiation oncology · 2026Article
- Quality and Dosimetric Accuracy of Linac-Based Single-Isocenter Treatment Plans for Four to Eighteen Brain Metastases.Cancers · 2025Article
- Analysis of the impact of rotation error on PTV margins in multiple brain metastases fractionated stereotactic radiotherapy based on single-isocenter multi-target technique.Frontiers in oncology · 2025Article
- Dosimetric Comparison between the HyperArc and Conventional VMAT in Cervical Spine Stereotactic Radiosurgery.Journal of clinical medicine · 2024Article
- Article
- Split-filter dual energy computed tomography radiotherapy: From calibration to image guidance.Physics and imaging in radiation oncology · 2023Article
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Authors and funding
9 authors.
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Abstract
purposeThe purpose of this study was to evaluate our 2 years' experience with single-isocenter, non-coplanar, volumetric modulated arc therapy (VMAT) for brain metastasis (BM) stereotactic radiosurgery (SRS).
methodsA total of 202 patients treated with the VMAT SRS solution were analyzed retrospectively. Plan quality was assessed for 5 mm (120) and 2.5 mm (high-definition, HD) central leaf width multileaf collimators (MLCs). For BMs at varying distances from the plan isocenter, the geometric offset from the ideal position for two image-guided radiotherapy workflows was calculated. In the workflow with ExacTrac (BrainLAB, München, Germany; W‑ET), patient positioning errors were corrected at each couch rotation. In the workflow without ExacTrac (W-noET), only the initial patient setup correction was considered. The dose variation due to rotational errors was simulated for multiple-BM plans with the HD-MLC.
resultsPlan conformity and quality assurance were equivalent for plans delivered with the two MLCs while the HD-MLC plans provided better healthy brain tissue (BmP) sparing. 95% of the BMs had residual intrafractional setup errors ≤ 2 mm for W‑ET and 68% for W‑noET. For small BM (≤1 cc) situated >3 cm from the plan isocenter, the dose received by 95% of the BM decreased in median (interquartile range) by 6.3% (2.8-8.8%) for a 1-degree rotational error.
conclusionThis study indicates that the HD-MLC is advantageous compared to the 120-MLC for sparing healthy brain tissue. When a 2-mm margin is applied, W‑noET is sufficient to ensure coverage of BM situated ≤ 3 cm of the plan isocenter, while for BM further away, W‑ET is recommended.
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