Automated noncoplanar treatment planning strategy in stereotactic radiosurgery of multiple cranial metastases: HyperArc and CyberKnife dose distributions

Noriyuki Kadoya, Yoshitomo Abe, Tomohiro Kajikawa, Kengo Ito, Takaya Yamamoto, Rei Umezawa, Takahito Chiba, Yoshiyuki Katsuta, Yoshiki Takayama, Takahiro Kato, Yasuhiro Kikuchi, Keiichi Jingu

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)

Abstract

The purpose of this study was to evaluate and compare the dosimetric effects of HyperArc-based stereotactic radiosurgery (SRS) and a robotic radiosurgery system-based planning using CyberKnife for multiple cranial metastases. In total, 11 cancer patients with multiple cranial metastases (3 to 5 tumors) treated with CyberKnife were examined. These patients were replanned using HyperArc (Varian Medical Systems, Palo Alto, USA). HyperArc plan were designed using 4 noncoplanar arc single-isocenter VMAT in 6 MV flattening filter free mode for simulated delivery with the True beam STx (Varian). The prescription dose was 23 Gy at single fraction. Dosimetric differences and blinded clinician scoring differences were evaluated. Conformity index (CI) and gradient index (GI) were 0.60 ± 0.11 and 3.94 ± 0.74, respectively, for the CyberKnife plan and 0.87 ± 0.08 and 5.31 ± 1.42, respectively, for the HyperArc plan (p < 0.05). Total brain V12-gross tumor volumes (GTVs) for the CyberKnife and HyperArc plans were 5.26 ± 2.83 and 4.02 ± 1.71 cm3, respectively. These results indicate that HyperArc plan showed better CI and total brain V12-GTV, while CyberKnife plan showed better GI. A blinded physician scoring evaluation did not show significant differences between CyberKnife and HyperArc plans. The HyperArc-based SRS plan is comparable with the CyberKnife plan, suggesting a greater potential to emerge as a suitable tool for SRS of multiple brain metastases.

Original languageEnglish
Pages (from-to)394-400
Number of pages7
JournalMedical Dosimetry
Volume44
Issue number4
DOIs
Publication statusPublished - 2019 Dec 1

Keywords

  • Brain metastases
  • Cyberknife
  • Noncoplanar treatment planning
  • Radiotherapy
  • Stereotactic radiosurgery

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