A preplanning method for stereotactic radiosurgery to improve treatment workflow

Area of Science:

• Medical Physics
• Radiation Oncology
• Neurosurgery

Background:

• Frame-based stereotactic radiosurgery (SRS) necessitates invasive head fixation for precise tumor targeting.
• Minimizing patient waiting times during SRS procedures is crucial for comfort and satisfaction.

Purpose of the Study:

• To introduce and evaluate a practical preplanning solution for the Brainlab iPlan system to reduce SRS treatment planning time.
• To enhance patient comfort and workflow efficiency in frame-based SRS.

Main Methods:

• Developed a preplanning workflow using a phantom's CT image fused with the patient's MRI prior to treatment.
• Created plan templates with optimized beam settings that were applied and refined on the treatment day.
• Bench-tested the preplanning method with multiple planners and diverse clinical cases.

Main Results:

• Demonstrated up to a 10-fold reduction in treatment plan time compared to traditional methods.
• Preplanning allowed thorough exploration of beam configurations and optimization of planning parameters.
• Achieved plan conformity and dose falloff comparable to the original preplan.

Conclusions:

• The implemented SRS preplanning technique for Brainlab iPlan significantly improves efficiency and plan quality.
• This method is particularly beneficial for complex cases, including multiple-isocenter and dosimetrically challenging treatments.
• Preplanning facilitates early identification and resolution of potential challenges, enhancing the overall SRS workflow.