Exploring stereotactic radiosurgery for tremor using the Varian cone planning system

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Physica Medica-European Journal of Medical Physics Pub Date : 2024-11-08 DOI:10.1016/j.ejmp.2024.104858

Kyra N. McComas , Guozhen Luo , George X. Ding , Stephen Martinez , Michael J. Price , Austin N. Kirschner

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Abstract

Background

Stereotactic radiosurgery (SRS) is an effective treatment for essential tremor (ET) and Parkinsonian tremor (PT). However, current treatment methods can be time-consuming and expose patients to unnecessary radiation. This study investigates the use of the Varian TrueBeam system with FFF beam modes as a potential solution for these issues.

Methods

We recreated and evaluated treatment plans using the Varian TrueBeam and Eclipse Cone Planning system for ten patients previously treated for tremor cessation using a Novalis Tx linear accelerator with Brainlab planning system prescribed a maximum dose of 160 Gy. Analyses included beam-on delivery time, total MU, dose to brain and brainstem tissues, and confirmation of SRS cone accuracy.

Results

The TrueBeam cone delivery system is highly accurate. Our results demonstrated a significant reduction in monitor units (MU) and treatment delivery time shortened to 17-26 min beam-on time for all-Varian plans compared to 39 min for non-Varian (iPlan) plans (p < 0.0001). Furthermore, the Varian plans showed improved or similar dose fall-off and radiation dose to brainstem normal tissue.

Conclusion

Our findings suggest that the Varian TrueBeam system offers a safe and effective option for SRS tremor treatment, providing similar or superior treatment parameters compared to other LINAC-based SRS treatments. The reduced treatment times and improved patient comfort offered by this system make it a promising solution for future tremor treatments.

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探索使用瓦里安锥形规划系统进行震颤的立体定向放射外科治疗。

背景：立体定向放射手术（SRS）是治疗本质性震颤（ET）和帕金森震颤（PT）的有效方法。然而，目前的治疗方法可能会耗费大量时间，并使患者遭受不必要的辐射。本研究探讨了使用瓦里安 TrueBeam 系统的 FFF 射束模式作为解决这些问题的潜在方案：我们使用瓦里安TrueBeam和Eclipse锥形规划系统重新创建并评估了10名患者的治疗计划，这些患者之前使用Novalis Tx直线加速器和Brainlab规划系统接受过震颤停止治疗，最大剂量为160 Gy。分析内容包括光束发射时间、总MU、大脑和脑干组织的剂量，以及SRS锥体准确性的确认：结果：TrueBeam锥体投射系统的精确度很高。我们的结果表明，所有瓦里安计划的监测单位（MU）显著减少，治疗投放时间缩短至17-26分钟，而非瓦里安（iPlan）计划的投放时间为39分钟（P 结论：我们的研究结果表明，瓦里安TrueBeam锥体投放系统能显著减少监测单位（MU），治疗投放时间缩短至17-26分钟：我们的研究结果表明，瓦里安 TrueBeam 系统为震颤 SRS 治疗提供了一个安全有效的选择，与其他基于 LINAC 的 SRS 治疗相比，它能提供相似或更优越的治疗参数。该系统缩短了治疗时间，提高了患者的舒适度，是未来震颤治疗的理想解决方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physica Medica-European Journal of Medical Physics 生物-生物物理

CiteScore

6.80

自引率

14.70%

发文量

493

审稿时长

78 days

期刊介绍： Physica Medica, European Journal of Medical Physics, publishing with Elsevier from 2007, provides an international forum for research and reviews on the following main topics: Medical Imaging Radiation Therapy Radiation Protection Measuring Systems and Signal Processing Education and training in Medical Physics Professional issues in Medical Physics.