Dose distributions in dynamic stereotactic radiosurgery

A treatment planning technique for calculation of dose distributions in dynamic stereotactic "radiosurgery" with a 10-MV isocentrically mounted linear accelerator is presented. The treatment planning for dynamic radiosurgery is a three-dimensional problem, since during treatment both the gantry and the couch rotate simultaneously, the gantry from 30 degrees to 330 degrees and the couch from 75 degrees to - 75 degrees. The patient surface and anatomical information is obtained from a family of computed tomography or magnetic resonance scans, and a stereotactic frame is used for target localization, treatment setup, and patient immobilization during the treatment. The dose calculational algorithm follows the gantry and couch rotation in an incremental fashion, and relies on measured stationary beam central axis percentage depth doses and dose profiles to calculate the normalized tissue-maximum-ratio distributions over a matrix of points defined on one of three orthogonal planes (transverse, sagittal, or coronal). The dose calculation algorithm is discussed in detail and calculated dose distributions for single plane and dynamic radiosurgery compared with measured data.