Does intensity modulation improve healthy tissue sparing in stereotactic radiosurgery of complex arteriovenous...

This planning study evaluates the potential of intensity modulated treatment fields and inverse planning techniques in stereotactic radiosurgery to reduce healthy tissue dose. Twenty patients previously treated with stereotactic radiosurgery for arteriovenous malformation (AVM) were replanned with each of 4 techniques: circular non-coplanar arcs, dynamic arcs, static conformal fields, and intensity modulated radiosurgery (IMRS). Patients were selected having a maximum AVM dimension at least 20 mm, or volume greater than 10 cm(3). Target volumes ranged from 2.12 cm(3) to 13.87 cm(3) with a median of 6.03 cm(3). Resulting dose distributions show a statistically significant improvement in target conformality between circular arcs and all other techniques (p