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Dosimetric Comparison of Robotic and Linear Accelerator Multi-Leaf Collimator-Based Stereotactic Radiosurgery for Arteriovenous Malformation
PURPOSE: To investigate the dosimetric comparison of different collimators which are used in robotic radiosurgery (cyberknife-CK) and linear accelerator (LINAC) for stereotactic radiosurgery (SRS) in arteriovenous malformation (AVM). MATERIALS AND METHODS: Twenty-five AVM patients were planned in CK...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Wolters Kluwer - Medknow
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240906/ https://www.ncbi.nlm.nih.gov/pubmed/34267485 http://dx.doi.org/10.4103/jmp.JMP_79_20 |
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author | Kaliyaperumal, Venkatesan Abraham, Susan Veni, Maragatha Banerjee, Susovan Tamilselvan, S Gupta, Deepak Dayanithi, K. Manigandan, D. Mishra, Saumyaranjan Bisht, Shyam Singh Kataria, Tejinder |
author_facet | Kaliyaperumal, Venkatesan Abraham, Susan Veni, Maragatha Banerjee, Susovan Tamilselvan, S Gupta, Deepak Dayanithi, K. Manigandan, D. Mishra, Saumyaranjan Bisht, Shyam Singh Kataria, Tejinder |
author_sort | Kaliyaperumal, Venkatesan |
collection | PubMed |
description | PURPOSE: To investigate the dosimetric comparison of different collimators which are used in robotic radiosurgery (cyberknife-CK) and linear accelerator (LINAC) for stereotactic radiosurgery (SRS) in arteriovenous malformation (AVM). MATERIALS AND METHODS: Twenty-five AVM patients were planned in CK using FIXED cone, IRIS collimator, and multi-leaf collimator (MLC) based in LINAC. Dosimetric comparison was performed using Paddick conformity index (CI(Paddick)) and International Commission on Radiation Units and measurements (ICRU) homogeneity index (HI(ICRU)), gradient score (GS), normal brain dose received by 10cc (D(10cc)) and critical structure (brain stem, optic chiasma, optic nerves) doses. Paired sample t-test was used for statistical analysis. RESULTS: Mean treatment volume was 3.16cc (standard deviation ± 4.91cc). No significant deviation (P =0.45, 0.237 for FIXED vs. IRIS and FIXED vs. MLC, respectively) was found in target coverage. For CI(Paddick), the mean difference (MD) between FIXED- and MLC-based plans was 0.16(P = 0.001); For HI(ICRU), difference between FIXED and IRIS was insignificant (0.5, P = 0.823); but, when FIXED versus MLC, the deviation was 7.99% (P = 0.002). In FIXED- and MLC-based plans, significant difference was found in GS70 and GS40 (P < 0.041 and 0.005, respectively). MD between FIXED- and MLC-based plans for normal brain for 5Gy, 10Gy, 12Gy, and 20Gy were 36.08cc (P = 0.009), 7.12cc (P = 0.000), 5.84cc (P = 0.000) and 1.56cc (P = 0.000), respectively. AVM volume <0.7cc should be treated with CK FIXED and >0.7cc were treated by using FIXED or IRIS collimators. AVM volume > 1.4cc can be treated by either LINAC MLC-based SRS or CK. CONCLUSION: Our study shows CK collimator (IRIS and FIXED) could be able to treat brain AVMs in any size. Linac MLC-based SRS has some limitations in terms of conformity and low-dose spillage, and advantages like reduced treatment time and MU. |
format | Online Article Text |
id | pubmed-8240906 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-82409062021-07-14 Dosimetric Comparison of Robotic and Linear Accelerator Multi-Leaf Collimator-Based Stereotactic Radiosurgery for Arteriovenous Malformation Kaliyaperumal, Venkatesan Abraham, Susan Veni, Maragatha Banerjee, Susovan Tamilselvan, S Gupta, Deepak Dayanithi, K. Manigandan, D. Mishra, Saumyaranjan Bisht, Shyam Singh Kataria, Tejinder J Med Phys Original Article PURPOSE: To investigate the dosimetric comparison of different collimators which are used in robotic radiosurgery (cyberknife-CK) and linear accelerator (LINAC) for stereotactic radiosurgery (SRS) in arteriovenous malformation (AVM). MATERIALS AND METHODS: Twenty-five AVM patients were planned in CK using FIXED cone, IRIS collimator, and multi-leaf collimator (MLC) based in LINAC. Dosimetric comparison was performed using Paddick conformity index (CI(Paddick)) and International Commission on Radiation Units and measurements (ICRU) homogeneity index (HI(ICRU)), gradient score (GS), normal brain dose received by 10cc (D(10cc)) and critical structure (brain stem, optic chiasma, optic nerves) doses. Paired sample t-test was used for statistical analysis. RESULTS: Mean treatment volume was 3.16cc (standard deviation ± 4.91cc). No significant deviation (P =0.45, 0.237 for FIXED vs. IRIS and FIXED vs. MLC, respectively) was found in target coverage. For CI(Paddick), the mean difference (MD) between FIXED- and MLC-based plans was 0.16(P = 0.001); For HI(ICRU), difference between FIXED and IRIS was insignificant (0.5, P = 0.823); but, when FIXED versus MLC, the deviation was 7.99% (P = 0.002). In FIXED- and MLC-based plans, significant difference was found in GS70 and GS40 (P < 0.041 and 0.005, respectively). MD between FIXED- and MLC-based plans for normal brain for 5Gy, 10Gy, 12Gy, and 20Gy were 36.08cc (P = 0.009), 7.12cc (P = 0.000), 5.84cc (P = 0.000) and 1.56cc (P = 0.000), respectively. AVM volume <0.7cc should be treated with CK FIXED and >0.7cc were treated by using FIXED or IRIS collimators. AVM volume > 1.4cc can be treated by either LINAC MLC-based SRS or CK. CONCLUSION: Our study shows CK collimator (IRIS and FIXED) could be able to treat brain AVMs in any size. Linac MLC-based SRS has some limitations in terms of conformity and low-dose spillage, and advantages like reduced treatment time and MU. Wolters Kluwer - Medknow 2021 2021-05-05 /pmc/articles/PMC8240906/ /pubmed/34267485 http://dx.doi.org/10.4103/jmp.JMP_79_20 Text en Copyright: © 2021 Journal of Medical Physics https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Kaliyaperumal, Venkatesan Abraham, Susan Veni, Maragatha Banerjee, Susovan Tamilselvan, S Gupta, Deepak Dayanithi, K. Manigandan, D. Mishra, Saumyaranjan Bisht, Shyam Singh Kataria, Tejinder Dosimetric Comparison of Robotic and Linear Accelerator Multi-Leaf Collimator-Based Stereotactic Radiosurgery for Arteriovenous Malformation |
title | Dosimetric Comparison of Robotic and Linear Accelerator Multi-Leaf Collimator-Based Stereotactic Radiosurgery for Arteriovenous Malformation |
title_full | Dosimetric Comparison of Robotic and Linear Accelerator Multi-Leaf Collimator-Based Stereotactic Radiosurgery for Arteriovenous Malformation |
title_fullStr | Dosimetric Comparison of Robotic and Linear Accelerator Multi-Leaf Collimator-Based Stereotactic Radiosurgery for Arteriovenous Malformation |
title_full_unstemmed | Dosimetric Comparison of Robotic and Linear Accelerator Multi-Leaf Collimator-Based Stereotactic Radiosurgery for Arteriovenous Malformation |
title_short | Dosimetric Comparison of Robotic and Linear Accelerator Multi-Leaf Collimator-Based Stereotactic Radiosurgery for Arteriovenous Malformation |
title_sort | dosimetric comparison of robotic and linear accelerator multi-leaf collimator-based stereotactic radiosurgery for arteriovenous malformation |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240906/ https://www.ncbi.nlm.nih.gov/pubmed/34267485 http://dx.doi.org/10.4103/jmp.JMP_79_20 |
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