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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiosurgery

Background:

  • CyberKnife treatments traditionally use many small circular beams.
  • Beam's eye view-shaped fields are more time-efficient but require specialized devices like mini-multileaf collimators (mMLC).
  • The Iris variable-aperture collimator is available for CyberKnife, but its use for mimicking mMLC treatments is unexplored.

Purpose of the Study:

  • To investigate if the Iris collimator can replicate noncoplanar mMLC treatments.
  • To assess the time efficiency and plan quality of Iris-based plans compared to mMLC plans.
  • To determine the feasibility of using Iris with limited beam orientations for efficient CyberKnife treatments.

Main Methods:

  • Generated stereotactic treatment plans for 10 lung cancer patients using CyberKnife.
  • Created mMLC plans with beam's eye view-shaped fields from selected nodes.
  • Generated intensity-modulated Iris plans from the same nodes using inverse optimization.
  • Evaluated plans based on dose, conformity, treatment time, and monitor units.

Main Results:

  • mMLC plans averaged 12 nodes and 11,690 monitor units.
  • Iris plans required more monitor units (21,990) and had longer estimated treatment times (18.4 min vs. 12.2 min).
  • Iris treatment time increased with target volume; plans were 40-121% longer than mMLC plans.

Conclusions:

  • Robotic-controlled noncoplanar treatments with mMLC yield time-efficient, high-quality stereotactic lung irradiation plans.
  • The Iris collimator is a viable, time-efficient option for small targets, offering similar or superior plan quality in CyberKnife treatments.