ArticleJournal of applied clinical medical physics2022
Brain stereotactic radiosurgery using MR-guided online adaptive planning for daily setup variation: An end-to-end test.
Article in Journal of applied clinical medical physics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Adoption of Hybrid MRI-Linac Systems for the Treatment of Brain Tumors: A Systematic Review of the Current Literature Regarding Clinical and Technical Features.Technology in cancer research & treatmentPooled it
- Identification and mitigation of unexplained dose attenuation caused by sub-table water accumulation in an MR-Linac (Elekta Unity).Journal of applied clinical medical physics · 2026Article
- Effectiveness of EPID-based in-vivo dosimetry with EPIgraySaudi medical journal · 2025Article
- Efficacy and safety of online adaptive magnetic resonance-guided fractionated stereotactic radiotherapy for brain metastases in non-small cell lung cancer (GASTO-1075): a single-arm, phase 2 trial.EClinicalMedicine · 2025Article
- Adaptive treatment workflow and dosimetric evaluation of intracranial fractionated stereotactic radiosurgery on a low-field magnetic resonance-linear accelerator.Physics and imaging in radiation oncology · 2025Article
- Geometric accuracy in patient positioning for stereotactic radiotherapy of intracranial tumors.Physics and imaging in radiation oncology · 2023Article
- Fan beam CT-guided online adaptive external radiotherapy of uterine cervical cancer: a dosimetric evaluation.BMC cancer · 2023Article
- MRI-LINAC: A transformative technology in radiation oncology.Frontiers in oncology · 2023Review
- Dosimetric analysis of MR-LINAC treatment plans for salvage spine SBRT re-irradiation.Journal of applied clinical medical physics · 2022Article
- Brain stereotactic radiosurgery using MR-guided online adaptive planning for daily setup variation: An end-to-end test.Journal of applied clinical medical physics · 2022Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
Online magnetic resonance (MR)-guided radiotherapy is expected to benefit brain stereotactic radiosurgery (SRS) due to superior soft tissue contrast and capability of daily adaptive planning. The purpose of this study was to investigate daily adaptive plan quality with setup variations and to perform an end-to-end test for brain SRS with multiple metastases treated with a 1.5-Tesla MR-Linac (MRL). The RTsafe PseudoPatient Prime brain phantom was used with a delineation insert that includes two predefined structures mimicking gadolinium contrast-enhanced brain lesions. Daily adaptive plans were generated using six preset and six random setup variations. Two adaptive plans per daily MR image were generated using the adapt-to-position (ATP) and adapt-to-shape (ATS) workflows. An adaptive patient plan was generated on a diagnostic MR image with simulated translational and rotational daily setup variation and was compared with the reference plan. All adaptive plans were compared with the reference plan using the target coverage, Paddick conformity index, gradient index (GI), Brain V12 or V20, optimization time and total monitor units. Target doses were measured as an end-to-end test with two ionization chambers inserted into the phantom. With preset translational variations, V12 from the ATS plan was 17% lower than that of the ATP plan. With a larger daily setup variation, GI and V12 of the ATS plan were 10% and 16% lower than those of the ATP plan, respectively. Compared to the ATP plans, the plan quality index of the ATS plans was more consistent with the reference plan, and within 5% in both phantom and patient plans. The differences between the measured and planned target doses were within 1% for both treatment workflows. Treating brain SRS using an MRL is feasible and could achieve satisfactory dosimetric goals. Setup uncertainties could be accounted for using online plan adaptation. The ATS workflow achieved better dosimetric results than the ATP workflow at the cost of longer optimization time.
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Registered trials
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