ArticleScientific reports2025
Spatial accuracy of dose delivery significantly impacts the planning target volume margin in linear accelerator-based intracranial stereotactic radiosurgery.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Minimization of Geometric Uncertainties and Setup Errors Improves Tumor Control for Intracranial Stereotactic Radiosurgery.Advances in radiation oncology · 2026Article
- Beam-axis stability during gantry rotation measured with scintillation dosimetry.Journal of applied clinical medical physics · 2026Article
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28 authors.
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Abstract
The impact of three-dimensional (3D) dose delivery accuracy of C-arm linacs on the planning target volume (PTV) margin was evaluated for non-coplanar intracranial stereotactic radiosurgery (SRS). A multi-institutional 3D starshot test using beams from seven directions was conducted at 22 clinics using Varian and Elekta linacs with X-ray CT-based polymer gel dosimeters. Variability in dose delivery accuracy was observed, with the distance between the imaging isocenter and each beam exceeding 1 mm at one institution for Varian and nine institutions for Elekta. The calculated PTV margins for Varian and Elekta linacs that could cover the gross tumor volume with 95% probability at 95% of the institutions were 2.3 and 3.5 mm, respectively, in the superior-inferior direction. However, with multifactorial system management (i.e., high-accuracy 3D dose delivery with rigorous linac quality assurance, strict patient immobilization, and high intra-fractional positioning accuracy), these margins could be reduced to 1.0 mm and 1.5 mm, respectively. The findings indicate significant millimeter-level variability in 3D dose delivery accuracy among linacs installed in clinical settings. Thus, maximizing a linac's 3D dose delivery accuracy is essential to achieve the required PTV margin in intracranial SRS.
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