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Volume staging for arteriovenous malformation SRS treatment using VMAT
Volume staging involves dividing the target volume into smaller parts and treating each part separately. In this study, the feasibility of volume‐staged stereotactic radiosurgery (VS‐SRS) on a linear accelerator using volumetric modulated arc therapy (VMAT) and a frameless patient positioning system...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9797165/ https://www.ncbi.nlm.nih.gov/pubmed/36354977 http://dx.doi.org/10.1002/acm2.13815 |
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author | Mendez, Claudia Gete, Ermias |
author_facet | Mendez, Claudia Gete, Ermias |
author_sort | Mendez, Claudia |
collection | PubMed |
description | Volume staging involves dividing the target volume into smaller parts and treating each part separately. In this study, the feasibility of volume‐staged stereotactic radiosurgery (VS‐SRS) on a linear accelerator using volumetric modulated arc therapy (VMAT) and a frameless patient positioning system is investigated. Ten patients, previously treated with hypofractionated stereotactic radiotherapy with arteriovenous malformation (AVM) sized from 1.6 to 4.0 cm in diameter, were selected. VS‐SRS plans were created with the VMAT technique on the Varian Eclipse treatment planning system (TPS) using the TrueBeam STx linear accelerator. For each patient, an AVM‐VMAT set was planned with the AVM as the target and a PTV‐VMAT set using the (PTV = AVM+1 mm) as the target. All targets were divided into two sub‐volumes. The TPS data from the AVM‐VMAT plans was compared to Gamma Knife (GK) VS‐SRS plan data available in the literature. The AVM‐VMAT and PTV‐VMAT plans were compared to investigate the effect of a 1 mm PTV margin on normal brain (NB) dose. End‐to‐end testing was performed using a GaFchromic EBT3 film and point‐dose measurements. Dosimetric effects of multiple setups were investigated through film‐to‐film comparisons. Median target dose coverage, NB V (12Gy), and conformity index for the AVM‐VMAT plans were 97.5%, 17 cm(3), and 0.8, respectively. PTV‐VMAT plans attained comparable target dose coverage, but the average NB V (12Gy) increased by 48.9% when compared to the AVM‐VMAT plans. Agreement of point‐dose measurements with TPS calculations was −0.6% when averaged over all patients. Gamma analysis passing rates were above 90% for all film‐to‐film comparisons (2%/1 mm criteria), and for the film to TPS comparison (5%/1 mm). This work suggests that VMAT is capable of producing VS‐SRS plans with similar dose falloff characteristics as GK plans. NB dose depends on PTV margin size, and two‐stage treatment setups do not appear to contribute additional uncertainty to treatment delivery. |
format | Online Article Text |
id | pubmed-9797165 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97971652022-12-30 Volume staging for arteriovenous malformation SRS treatment using VMAT Mendez, Claudia Gete, Ermias J Appl Clin Med Phys Radiation Oncology Physics Volume staging involves dividing the target volume into smaller parts and treating each part separately. In this study, the feasibility of volume‐staged stereotactic radiosurgery (VS‐SRS) on a linear accelerator using volumetric modulated arc therapy (VMAT) and a frameless patient positioning system is investigated. Ten patients, previously treated with hypofractionated stereotactic radiotherapy with arteriovenous malformation (AVM) sized from 1.6 to 4.0 cm in diameter, were selected. VS‐SRS plans were created with the VMAT technique on the Varian Eclipse treatment planning system (TPS) using the TrueBeam STx linear accelerator. For each patient, an AVM‐VMAT set was planned with the AVM as the target and a PTV‐VMAT set using the (PTV = AVM+1 mm) as the target. All targets were divided into two sub‐volumes. The TPS data from the AVM‐VMAT plans was compared to Gamma Knife (GK) VS‐SRS plan data available in the literature. The AVM‐VMAT and PTV‐VMAT plans were compared to investigate the effect of a 1 mm PTV margin on normal brain (NB) dose. End‐to‐end testing was performed using a GaFchromic EBT3 film and point‐dose measurements. Dosimetric effects of multiple setups were investigated through film‐to‐film comparisons. Median target dose coverage, NB V (12Gy), and conformity index for the AVM‐VMAT plans were 97.5%, 17 cm(3), and 0.8, respectively. PTV‐VMAT plans attained comparable target dose coverage, but the average NB V (12Gy) increased by 48.9% when compared to the AVM‐VMAT plans. Agreement of point‐dose measurements with TPS calculations was −0.6% when averaged over all patients. Gamma analysis passing rates were above 90% for all film‐to‐film comparisons (2%/1 mm criteria), and for the film to TPS comparison (5%/1 mm). This work suggests that VMAT is capable of producing VS‐SRS plans with similar dose falloff characteristics as GK plans. NB dose depends on PTV margin size, and two‐stage treatment setups do not appear to contribute additional uncertainty to treatment delivery. John Wiley and Sons Inc. 2022-11-10 /pmc/articles/PMC9797165/ /pubmed/36354977 http://dx.doi.org/10.1002/acm2.13815 Text en © 2022 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Radiation Oncology Physics Mendez, Claudia Gete, Ermias Volume staging for arteriovenous malformation SRS treatment using VMAT |
title | Volume staging for arteriovenous malformation SRS treatment using VMAT |
title_full | Volume staging for arteriovenous malformation SRS treatment using VMAT |
title_fullStr | Volume staging for arteriovenous malformation SRS treatment using VMAT |
title_full_unstemmed | Volume staging for arteriovenous malformation SRS treatment using VMAT |
title_short | Volume staging for arteriovenous malformation SRS treatment using VMAT |
title_sort | volume staging for arteriovenous malformation srs treatment using vmat |
topic | Radiation Oncology Physics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9797165/ https://www.ncbi.nlm.nih.gov/pubmed/36354977 http://dx.doi.org/10.1002/acm2.13815 |
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