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Linac-based radiosurgery for multiple brain metastases: Comparison between two mono-isocenter techniques with
Ruggero Ruggieri1, Stefania Naccarato1, Rosario Mazzola1
1Department of Radiation Oncology, IRCCS 'Sacro Cuore don Calabria', Negrar (VR), Italy.
Summary
HyperArc (HA) and Multiple Brain Mets (MBM) stereotactic radiosurgery techniques offer comparable plan quality for brain metastases. HA demonstrated superior conformity, while both methods showed satisfactory dosimetric consistency in delivering radiation doses.
Area of Science:
- Radiation Oncology
- Medical Physics
- Neurosurgery
Background:
- Stereotactic radiosurgery (SRS) for multiple brain metastases (BM) utilizes mono-isocenter techniques.
- Clinically available techniques include HyperArc (HA), Multiple Brain Mets (MBM), and Monaco-HDRS.
Purpose of the Study:
- To compare the plan quality and dosimetric consistency of HyperArc (HA) and Multiple Brain Mets (MBM) SRS techniques.
- Evaluate the performance of two mono-isocenter volumetric modulated arc therapy (VMAT) techniques for treating multiple brain metastases.
Main Methods:
- Generated HA and MBM plans for 20 patients with multiple BM (2-10 lesions).
- Assessed plan quality using Paddick conformity (CI) and gradient (GI) indices, and dose to healthy brain (mean dose, V12).
- Verified dosimetric consistency using radiochromic films and gamma analysis (γ-analysis).
Main Results:
- HyperArc (HA) plans showed significantly improved conformity (CI) compared to MBM (0.94 vs. 0.75).
- No significant differences were found in gradient index (GI), mean dose, or V12 to healthy brain between HA and MBM.
- Gamma analysis revealed significantly improved passing rates for HA, indicating better dosimetric consistency.
Conclusions:
- HyperArc (HA) provides superior target conformity for SRS of multiple brain metastases.
- Both HA and MBM techniques demonstrate satisfactory dosimetric consistency between planned and delivered doses.
- The study suggests near-equal overall plan quality between HA and MBM SRS techniques, with HA offering improved conformity.
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