ArticleQuantitative imaging in medicine and surgery2025
The feasibility of using coplanar-only VMAT combined with "Treat" function to replace non-coplanar VMAT for SRS of 2 to 6 brain metastases.
Article in Quantitative imaging in medicine and surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Recent advancements in radiotherapy technology have made it possible to implement single-isocenter noncoplanar volumetric modulated arc therapy (NC-VMAT) for stereotactic radiosurgery (SRS) of multiple brain metastases (BMs). This study aimed to demonstrate the dosimetric feasibility of combining coplanar-only single-isocenter VMAT with the "Treat" function as a potential alternative to conventional single-isocenter NC-VMAT for intracranial multitarget SRS. Methods: Eleven patients with 2-6 BMs previously treated with conventional single-isocenter NC-VMAT SRS were retrospectively selected. In NC-VMAT, the collimator angle of each arc was manually adjusted to mitigate the "island blocking" problem. For comparison, each NC-VMAT plan was replanned via coplanar-only single-isocenter VMAT combined with the "Treat" function of the RayStation treatment planning system with a fixed collimator angle of 0°, referred to as TREAT-CO-VMAT, of which each arc only irradiated a single target. Plan comparisons between two plan techniques were performed regarding the gradient index (GI), conformity index (CI), normal brain tissue (NBT) dose exposure, absolute dose volume (V Results: Compared with the NC-VMAT plan, the TREAT-CO-VMAT plan achieved comparable median CI and HI but with a significantly improved GI [median (range): 5.09 (4.13-6.75) Conclusions: TREAT-CO-VMAT provides high-quality treatment plans and accurate delivery for SRS in patients with 2-6 BMs, making it a promising alternative to conventional NC-VMAT.
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