Exploring stereotactic radiosurgery for tremor using the Varian cone planning system

Area of Science:

• Neurosurgery
• Radiation Oncology
• Medical Physics

Background:

• Stereotactic radiosurgery (SRS) is a key treatment for essential tremor (ET) and Parkinsonian tremor (PT).
• Current SRS methods for tremor can be lengthy and involve excessive radiation exposure.
• Investigating the Varian TrueBeam system with Flattening Filter-Free (FFF) beam modes as an optimized SRS solution.

Purpose of the Study:

• To evaluate the Varian TrueBeam system for SRS treatment of tremors.
• To compare treatment parameters, including delivery time and radiation dose, with existing methods.

Main Methods:

• Treatment plans were recreated and analyzed for ten patients using Varian TrueBeam and Eclipse Cone Planning.
• Compared Varian plans with prior Novalis Tx (non-Varian) plans for tremor cessation.
• Evaluated beam-on delivery time, total monitor units (MU), and dose to brain and brainstem tissues.

Main Results:

• Varian TrueBeam demonstrated high accuracy in SRS cone delivery.
• Significantly reduced treatment delivery time (17-26 min beam-on time) compared to non-Varian plans (39 min).
• Achieved improved or similar dose fall-off and radiation dose to normal brainstem tissues.

Conclusions:

• The Varian TrueBeam system is a safe and effective option for SRS tremor treatment.
• Offers reduced treatment times and enhanced patient comfort.
• Represents a promising advancement for future SRS treatments of tremors.