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Updated: Feb 3, 2026

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
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Cyberknife Dosimetric Planning Using a Dose-Limiting Shell Method for Brain Metastases.

Kyoung Jun Yoon1, Byungchul Cho2, Jung Won Kwak2

  • 1Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Journal of Korean Neurosurgical Society
|November 7, 2018
PubMed
Summary
This summary is machine-generated.

Optimizing dose-limiting shells in CyberKnife (CK) plans for brain metastases (BMs) significantly improves dose fall-off. This enhancement reduces radiation to normal tissues without compromising tumor coverage or conformity, offering a better treatment option.

Keywords:
BrainNeoplasm metastasisRadiosurgery

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Neurosurgery

Background:

  • Brain metastases (BMs) treatment requires precise radiation delivery to maximize tumor control and minimize toxicity.
  • CyberKnife (CK) and Gamma Knife (GK) are stereotactic radiosurgery systems used for BMs.
  • Dose-limiting shells are crucial for optimizing radiation dose conformity and spillage in treatment planning.

Purpose of the Study:

  • To evaluate the impact of optimizing dose-limiting shells on the dosimetric quality of CK plans for BMs.
  • To compare the dosimetric outcomes of optimized CK plans with original CK plans and GK plans.

Main Methods:

  • Retrospective analysis of 19 BMs treated with CK.
  • Comparison of original CK plans (1-3 shells) with modified CK plans (5 shells, optimized dilation).
  • Dosimetric comparison with Gamma Knife (GK) plans using the same patient contours.

Main Results:

  • No significant differences in conformity indices or tumor coverage were observed among CKoriginal, CKmodified, and GK plans.
  • CKmodified plans achieved significantly smaller volumes of normal tissue receiving 50% of the prescription dose compared to CKoriginal plans.
  • The dose fall-off in CKmodified plans was comparable to GK plans, indicating improved normal tissue sparing.

Conclusions:

  • Optimizing the dose-limiting shell function in CK treatment planning enhances dose fall-off.
  • This optimization allows for steeper dose gradients, reducing radiation exposure to surrounding healthy tissues.
  • The improved dose fall-off is achieved while maintaining high dose conformity to the target tumor.