ArticleJournal of applied clinical medical physics2025
Optimizing anisotropic margins in single-isocenter multiple brain metastases radiosurgery using regressor strategies: A multi-institutional validation study.
Article in Journal of applied clinical medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Optimizing anisotropic margins in single-isocenter multiple brain metastases radiosurgery using regressor strategies: A multi-institutional validation study.Journal of applied clinical medical physics · 2025Article
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8 authors.
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Abstract
purposeTo explore a comprehensive method for assigning anisotropic margins in single-isocenter multiple-metastasis radiosurgery (SRS), utilizing regressor strategies with geometric, dosimetric, and mechanical information. Such margins may reduce the volume of the irradiated brain without compromising the dose to lesions, by considering additional treatment variables.
methodsFirst, the impact of slice thickness on the margin was investigated on an anthropomorphic phantom for different lesion volumes. In addition, for clinical cases, the anisotropic margins were assigned using two methods: by geometric margin criterion (GMC) based on clinical protocols and optimized margin criterion (OMC) based on regressor strategies. To evaluate the plans (456 metastases in total), we reported the Paddick conformity, gradient, and efficiency indices, monitor units, the volume of brain receiving at least 12 Gy (V12), and risk of radionecrosis by two radiobiological models (Flickinger and normal tissue control probability models).
resultsAn overestimation of volumes was related (absolute difference of 0.13 ± 0.18 cm
conclusionWhile the feasibility and potential dosimetric benefits of anisotropic margins in SRS-such as improvements in the gradient index and V12-were observed, the magnitude of these differences may be modest in terms of clinical impact. The results suggest that anisotropic margins can be integrated into SRS workflows and may offer advantages in specific scenarios, particularly when minimizing brain dose is a priority.
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