Variable circular collimator in robotic radiosurgery: a time-efficient alternative to a mini-multileaf collimator?

Purpose: Compared with many small circular beams used in CyberKnife treatments, beam's eye view-shaped fields are generally more time-efficient for dose delivery. However, beam's eye view-shaping devices, such as a mini-multileaf collimator (mMLC), are not presently available for CyberKnife, althoug...

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Publicado en:International Journal of Radiation Oncology, Biology, Physics Vol. 81; no. 3; pp. 863 - 871
Autores principales: van de Water S, Hoogeman MS, Breedveld S, Nuyttens JJ, Schaart DR, Heijmen BJ, van de Water, Steven, Hoogeman, Mischa S, Breedveld, Sebastiaan, Nuyttens, Joost J M E, Schaart, Dennis R, Heijmen, Ben J M
Formato: Journal Article
Publicado: Pergamon Press - An Imprint of Elsevier Science Nov2011
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: International Journal of Radiation Oncology, Biology, Physics
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      dt: Nov2011
      vid: 81
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      pub: Pergamon Press - An Imprint of Elsevier Science
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        NLM21377286
        2011311674
        10.1016/j.ijrobp.2010.12.052
        NLM21377286
        104587101
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        atl: Variable circular collimator in robotic radiosurgery: a time-efficient alternative to a mini-multileaf collimator?
      aug:
        au:
          van de Water S
          Hoogeman MS
          Breedveld S
          Nuyttens JJ
          Schaart DR
          Heijmen BJ
          van de Water, Steven
          Hoogeman, Mischa S
          Breedveld, Sebastiaan
          Nuyttens, Joost J M E
          Schaart, Dennis R
          Heijmen, Ben J M
        affil: Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
      sug:
        subj:
          Algorithms
          Lung Neoplasms Surgery
          Radiosurgery Methods
          Radiotherapy, Computer-Assisted Methods
          Robotics Methods
          Equipment Design
          Lung Neoplasms Radiography
          Middle Age
          Body Regions Radiography
          Radiosurgery Equipment and Supplies
          Radiosurgery Standards
          Radiation Dosage
          Radiotherapy, Computer-Assisted Standards
          Radiotherapy Methods
          Robotics Equipment and Supplies
          Robotics Standards
          Therapy, Computer Assisted Equipment and Supplies
          Therapy, Computer Assisted Methods
          Therapy, Computer Assisted Standards
          Time Factors
          Middle Aged: 45-64 years
      ab: Purpose: Compared with many small circular beams used in CyberKnife treatments, beam's eye view-shaped fields are generally more time-efficient for dose delivery. However, beam's eye view-shaping devices, such as a mini-multileaf collimator (mMLC), are not presently available for CyberKnife, although a variable-aperture collimator (Iris, 12 field diameters; 5-60 mm) is available. We investigated whether the Iris can mimic noncoplanar mMLC treatments using a limited set of principal beam orientations (nodes) to produce time-efficient treatment plans. Methods and Materials: The data from 10 lung cancer patients and the beam-orientation optimization algorithm "Cycle" were used to generate stereotactic treatment plans (3 × 20 Gy) for a CyberKnife virtually equipped with a mMLC. Typically, 10-16 favorable beam orientations were selected from 117 available robot node positions using beam's eye view-shaped fields with uniform fluence. Second, intensity-modulated Iris plans were generated by inverse optimization of nonisocentric circular candidate beams targeted from the same nodes selected in the mMLC plans. The plans were evaluated using the mean lung dose, lung volume receiving ≥20 Gy, conformality index, number of nodes, beams, and monitor units, and estimated treatment time. Results: The mMLC plans contained an average of 12 nodes and 11,690 monitor units. For a comparable mean lung dose, the Iris plans contained 12 nodes, 64 beams, and 21,990 monitor units. The estimated fraction duration was 12.2 min (range, 10.8-13.5) for the mMLC plans and 18.4 min (range, 12.9-28.5) for the Iris plans. In contrast to the mMLC plans, the treatment time for the Iris plans increased with an increasing target volume. The Iris plans were, on average, 40% longer than the corresponding mMLC plans for small targets (<80 cm(3)) and ≤121% longer for larger targets. For a comparable conformality index, similar results were obtained. Conclusion: For stereotactic lung irradiation, time-efficient and high-quality plans were obtained for robotic-controlled noncoplanar treatments using a mMLC. Iris is a time-efficient alternative for small targets, with similar or better plan quality.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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