A predictive model for Gamma Knife intermediate dose spill: R50%Analytic-GK

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Applied Clinical Medical Physics Pub Date : 2024-11-29 DOI:10.1002/acm2.14579

Ivan L. Cordrey, Sare Kucuk, Chester Ramsey, Joseph Bowling, Dharmin D. Desai

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Abstract

Purpose

Minimizing intermediate dose spill in stereotactic radiosurgery (SRS) for brain treatment is crucial. Intermediate dose spill correlates with the exposure of normal brain tissue to high doses, which increases the risk of radionecrosis. R50%, defined as the volume of the 50% of prescription isodose cloud/planning target volume, is one metric for intermediate dose spill. A predictive model for R50% in linear accelerator VMAT-delivered SRS has been developed Desai et al. (2020) and is called R50%_Analytic. This study extends the R50%_Analytic model to Gamma Knife (GK) delivered SRS, resulting in the R50%_Analytic-GK model.

Methods

Phantom calculations were performed on 11 spherical target volumes ranging from 0.001 to 44 cm³ to develop the R50%_Analytic-GK model. R50%_Analytic-GK was tested against clinical data from 18 brain metastasis cases with one to 11 targets treated on GK Icon and planned in GammaPlan with lightning dose optimizer. Thirty-five targets with volumes between 0.011 and 27.4 cm³ were analyzed by extracting the R50% achieved clinically (R50%_Clinical) for comparison to the predicted intermediate dose spill from R50%_Analytic-GK.

Results

The predicted R50%_Analytic-GK values generally represent a lower bound for the R50%_Clinical values as the model would predict. The Difference, R50%_Clinical − R50%_Analytic-GK, has a median value of 0.92, which quantifies the lower bound nature of R50%_Analytic-GK. The model reflected the character of intermediate dose spill for the clinical cases. A few outliers were likely due to specific planning complexities.

Conclusion

The R50%_Analytic-GK model for intermediate dose spill successfully extends the theoretical framework of R50%_Analytic to GK-delivered SRS. It provides a method to predict the intermediate dose spill for GK Icon treatments. This model can aid in assessing SRS treatment plans by providing a benchmark for the intermediate dose spill for comparison.

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伽玛刀中间剂量溢出的预测模型：R50%Analytic-GK.

目的：减少立体定向放射治疗（SRS）中剂量泄漏至关重要。中等剂量泄漏与正常脑组织暴露于高剂量有关，这增加了放射性坏死的风险。R50%，定义为处方等剂量云/计划目标体积的50%的体积，是中间剂量溢出的一个度量。德赛等人（2020）开发了线性加速器vmat交付的SRS中R50%的预测模型，称为R50% analytic模型。本研究将R50%Analytic模型扩展到伽玛刀（GK）提供的SRS，从而得到R50%Analytic-GK模型。方法：对11个0.001 ~ 44 cm3的球形靶体积进行幻影计算，建立r50% analysis - gk模型。r50%分析-GK针对18例脑转移病例的临床数据进行了测试，GK Icon治疗1 - 11个靶点，并在GammaPlan中使用闪电剂量优化器进行计划。通过提取临床达到的R50% （R50% clinical）与R50% analysis - gk预测的中间剂量溢出进行比较，对35个体积在0.011 ~ 27.4 cm3之间的靶标进行了分析。结果：预测的r50%分析- gk值通常代表模型预测的r50%临床值的下限。r50%临床- r50%分析- gk的差值中位数为0.92，量化了r50%分析- gk的下限性质。该模型反映了临床病例中剂量溢出的特征。一些异常值可能是由于特定的规划复杂性。结论：中剂量溢出的r50%解析- gk模型成功地将r50%解析的理论框架扩展到gk释放的SRS。它提供了一种预测GK - Icon处理的中间剂量溢出的方法。该模型可以通过为中间剂量泄漏提供一个基准进行比较，从而有助于评估SRS治疗计划。

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来源期刊

Journal of Applied Clinical Medical Physics 医学-核医学

CiteScore

3.60

自引率

19.00%

发文量

331

审稿时长

3 months

期刊介绍： Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission. JACMP will publish: -Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500. -Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed. -Technical Notes: These should be no longer than 3000 words, including key references. -Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents. -Book Reviews: The editorial office solicits Book Reviews. -Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics. -Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic