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IMRT planning parameter optimization for spine stereotactic radiosurgery.

Gabriel B Ayala1, Kieu A Doan1, Hie Ji Ko1

  • 1School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists
|December 6, 2018
PubMed
Summary
This summary is machine-generated.

Optimizing intensity-modulated radiation therapy (IMRT) for spine stereotactic radiosurgery (SSRS) by adjusting segment parameters improved quality assurance passing rates and reduced delivery time without compromising plan quality or dose accuracy.

Keywords:
Intensity-modulated radiation therapy (IMRT)Parameter optimizationQuality assurance (QA)Spine stereotactic radiosurgery (SSRS)

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Radiotherapy Planning

Background:

  • Spine stereotactic radiosurgery (SSRS) is a noninvasive treatment for metastatic spine lesions.
  • A high quality assurance (QA) failure rate (approaching 15%) in SSRS is hypothesized to stem from dose calculation inaccuracies due to numerous small-area segments.
  • Current clinical SSRS plans often involve 9 beams with an average of 10 segments per beam and minimum segment areas of 2-3 cm².

Purpose of the Study:

  • To identify optimal intensity-modulated radiation therapy (IMRT) planning parameters for SSRS.
  • The goal was to balance QA passing rates, plan quality, dose calculation accuracy, and delivery time.
  • This study aimed to reduce the high QA failure rate associated with SSRS.

Main Methods:

  • Evaluated the impact of maximum segments per beam and minimum segment area using Pinnacle version 9.10.
  • Compared standard clinical plans with modified '5-4-4' plans (5 segments/beam, 4 cm² minimum segment area, 4 MU/segment).
  • Utilized a PTW OCTAVIUS 4D phantom with a 2D detector array for IMRT QA, assessing gamma index passing rates.

Main Results:

  • The '5-4-4' IMRT plan parameters showed no significant degradation in plan quality (GTV/CTV coverage, maximum cord dose).
  • Total plan delivery time decreased by an average of 11.3% for the '5-4-4' plans.
  • IMRT QA gamma index passing rates improved slightly, averaging 91.9% for '5-4-4' plans versus 90.3% for original plans.

Conclusions:

  • Modifying IMRT parameters to 5 segments per beam and a 4 cm² minimum segment area offers an improved balance for SSRS.
  • These parameter adjustments enhance QA passing rates and delivery efficiency.
  • The optimized parameters maintain acceptable plan quality and dose calculation accuracy for SSRS.