Scott Hanvey, Philippa Hackett, Lucy Winch, Elizabeth Lim, Robin Laney, Liam Welsh
{"title":"一项多中心立体定向放射外科规划研究,使用带有 5 毫米和 2.5 毫米宽多叶准直器的等中心直线加速器、CyberKnife 和伽玛刀对多发性脑转移瘤进行治疗。","authors":"Scott Hanvey, Philippa Hackett, Lucy Winch, Elizabeth Lim, Robin Laney, Liam Welsh","doi":"10.1093/bjro/tzae003","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study compared plans of high definition (HD), 2.5 mm width multi-leaf collimator (MLC), to standard, 5 mm width, isocentric linear accelerator (linacs), CyberKnife (CK), and Gamma Knife (GK) for stereotactic radiosurgery (SRS) techniques on multiple brain metastases.</p><p><strong>Methods: </strong>Eleven patients undergoing SRS for multiple brain metastases were chosen. Targets and organs at risk (OARs) were delineated and optimized SRS plans were generated and compared.</p><p><strong>Results: </strong>The linacs delivered similar conformity index (CI) values, but the gradient index (GI) for HD MLCs was significantly lower (<i>P</i>-value <.001). Half the OARs received significantly lower dose using HD MLCs. CK delivered a significantly lower CI than HD MLC linac (<i>P</i>-value <.001), but a significantly higher GI (<i>P</i>-value <.001). CI was significantly improved with the HD MLC linac compared to GK (<i>P</i>-value = 4.591 × 10<sup>-3</sup>), however, GK delivered a significantly lower GI (<i>P</i>-value <.001). OAR dose sparing was similar for the HD MLC TL, CK, and GK.</p><p><strong>Conclusions: </strong>Comparing linacs for SRS, the preferred choice is HD MLCs. Similar results were achieved with the HD MLC linac, CK, or GK, with each delivering significant improvements in different aspects of plan quality.</p><p><strong>Advances in knowledge: </strong>This article is the first to compare HD and standard width MLC linac plans using a combination of single isocentre volumetric modulated arc therapy and multi-isocentric dynamic conformal arc plans as required, which is a more clinically relevant assessment. Furthermore, it compares these plans with CK and GK, assessing the relative merits of each technique.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10873585/pdf/","citationCount":"0","resultStr":"{\"title\":\"A multi-centre stereotactic radiosurgery planning study of multiple brain metastases using isocentric linear accelerators with 5 and 2.5 mm width multi-leaf collimators, CyberKnife and Gamma Knife.\",\"authors\":\"Scott Hanvey, Philippa Hackett, Lucy Winch, Elizabeth Lim, Robin Laney, Liam Welsh\",\"doi\":\"10.1093/bjro/tzae003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study compared plans of high definition (HD), 2.5 mm width multi-leaf collimator (MLC), to standard, 5 mm width, isocentric linear accelerator (linacs), CyberKnife (CK), and Gamma Knife (GK) for stereotactic radiosurgery (SRS) techniques on multiple brain metastases.</p><p><strong>Methods: </strong>Eleven patients undergoing SRS for multiple brain metastases were chosen. Targets and organs at risk (OARs) were delineated and optimized SRS plans were generated and compared.</p><p><strong>Results: </strong>The linacs delivered similar conformity index (CI) values, but the gradient index (GI) for HD MLCs was significantly lower (<i>P</i>-value <.001). Half the OARs received significantly lower dose using HD MLCs. CK delivered a significantly lower CI than HD MLC linac (<i>P</i>-value <.001), but a significantly higher GI (<i>P</i>-value <.001). CI was significantly improved with the HD MLC linac compared to GK (<i>P</i>-value = 4.591 × 10<sup>-3</sup>), however, GK delivered a significantly lower GI (<i>P</i>-value <.001). OAR dose sparing was similar for the HD MLC TL, CK, and GK.</p><p><strong>Conclusions: </strong>Comparing linacs for SRS, the preferred choice is HD MLCs. Similar results were achieved with the HD MLC linac, CK, or GK, with each delivering significant improvements in different aspects of plan quality.</p><p><strong>Advances in knowledge: </strong>This article is the first to compare HD and standard width MLC linac plans using a combination of single isocentre volumetric modulated arc therapy and multi-isocentric dynamic conformal arc plans as required, which is a more clinically relevant assessment. Furthermore, it compares these plans with CK and GK, assessing the relative merits of each technique.</p>\",\"PeriodicalId\":72419,\"journal\":{\"name\":\"BJR open\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10873585/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BJR open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/bjro/tzae003\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJR open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/bjro/tzae003","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
A multi-centre stereotactic radiosurgery planning study of multiple brain metastases using isocentric linear accelerators with 5 and 2.5 mm width multi-leaf collimators, CyberKnife and Gamma Knife.
Objectives: This study compared plans of high definition (HD), 2.5 mm width multi-leaf collimator (MLC), to standard, 5 mm width, isocentric linear accelerator (linacs), CyberKnife (CK), and Gamma Knife (GK) for stereotactic radiosurgery (SRS) techniques on multiple brain metastases.
Methods: Eleven patients undergoing SRS for multiple brain metastases were chosen. Targets and organs at risk (OARs) were delineated and optimized SRS plans were generated and compared.
Results: The linacs delivered similar conformity index (CI) values, but the gradient index (GI) for HD MLCs was significantly lower (P-value <.001). Half the OARs received significantly lower dose using HD MLCs. CK delivered a significantly lower CI than HD MLC linac (P-value <.001), but a significantly higher GI (P-value <.001). CI was significantly improved with the HD MLC linac compared to GK (P-value = 4.591 × 10-3), however, GK delivered a significantly lower GI (P-value <.001). OAR dose sparing was similar for the HD MLC TL, CK, and GK.
Conclusions: Comparing linacs for SRS, the preferred choice is HD MLCs. Similar results were achieved with the HD MLC linac, CK, or GK, with each delivering significant improvements in different aspects of plan quality.
Advances in knowledge: This article is the first to compare HD and standard width MLC linac plans using a combination of single isocentre volumetric modulated arc therapy and multi-isocentric dynamic conformal arc plans as required, which is a more clinically relevant assessment. Furthermore, it compares these plans with CK and GK, assessing the relative merits of each technique.