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Technical Note: Collimator angle optimization for multiple brain metastases in dynamic conformal arc treatment

Cecilia Battinelli1, Albin Fredriksson1, Kjell Eriksson1

  • 1RaySearch Laboratories, Stockholm, Sweden.

Medical Physics
|July 5, 2021
PubMed
Summary

Optimizing collimator angles in stereotactic radiosurgery for multiple brain metastases significantly reduces healthy tissue exposure. Dynamic trajectories offer greater reductions than fixed angles, improving treatment efficiency.

Keywords:
collimator angle optimizationdynamic collimator trajectorydynamic conformal arcsmultiple metastasestreatment planning

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Neurosurgery

Background:

  • Stereotactic radiosurgery (SRS) for multiple brain metastases often involves single-isocenter dynamic conformal arc (DCA) therapy.
  • Minimizing radiation exposure to healthy tissue between lesions is crucial for treatment efficacy and patient safety.

Purpose of the Study:

  • To reduce the exposed healthy tissue area between multiple brain metastases during single-isocenter DCA therapy.
  • To optimize multileaf collimator (MLC) angle orientation for improved treatment planning.

Main Methods:

  • Developed an algorithm to evaluate arc quality by analyzing target projections.
  • Assigned penalties for healthy tissue exposure at each control point and feasible MLC angle.
  • Generated optimal fixed MLC angles and optimal dynamic MLC angle trajectories using dynamic programming.

Main Results:

  • Optimized dynamic MLC trajectories reduced the total exposed area between lesions by 21.7% to 71.3% compared to fixed optimal angles.
  • Beam-wise reductions in exposed area ranged from 5.83% to over 90%.

Conclusions:

  • MLC angle optimization is an effective strategy to decrease the exposed area between lesions in simultaneous multi-lesion SRS.
  • Dynamic MLC trajectories provide superior reduction of healthy tissue exposure compared to fixed trajectories.
  • The developed algorithm can potentially save time during treatment planning.