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Multicenter multiplatform pattern-of-practice analysis of single-isocenter multitarget stereotactic radiosurgery.

Benedikt Thomann1,2,3,4, Tobias Fechter5,6,7,8, Johannes Fischer6,9

  • 1Klinik für Strahlenheilkunde, Abteilung Medizinische Physik, Universitätsklinikum Freiburg, Freiburg, Germany. benedikt.thomann@uniklinik-freiburg.de.

Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft ... [Et Al]
|July 10, 2025
PubMed
Summary
This summary is machine-generated.

Single-isocenter multitarget stereotactic radiosurgery (SIMT SRS) shows variability in clinical practices. This study highlights a lack of standardization in SIMT SRS, paving the way for future recommendations to ensure safe and consistent treatment delivery.

Keywords:
Anthropomorphic phantomBrain metastasesEnd-to-end testRing trialSIMT SRS

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Radiotherapy Technology

Background:

  • Single-isocenter multitarget stereotactic radiosurgery (SIMT SRS) enhances efficiency for treating multiple brain metastases.
  • However, SIMT SRS presents challenges including off-center dose uncertainties, beam profile inaccuracies, and quality assurance (QA) complexities.

Purpose of the Study:

  • To evaluate diverse SIMT SRS approaches by analyzing protocols and infrastructure across multiple radiotherapy centers.
  • To identify areas of consensus and variability in current SIMT SRS practices.

Main Methods:

  • Analysis of SIMT SRS protocols and infrastructure from 23 centers in Germany, Austria, and Switzerland.
  • Assessment of immobilization, CT protocols, linear accelerators, treatment planning systems, beam configurations, imaging, and QA practices.
  • Evaluation of consensus, deviations, and guideline compliance, with future plans for on-site measurements and outcome correlation.

Main Results:

  • Consensus exists on CT slice thickness (≤1 mm), six-degree-of-freedom setup correction, and noncoplanar treatment.
  • Significant variability observed in intrafraction imaging, planning target volume size, SRS QA, photon energy, number of fields, linear accelerators, and treatment planning systems.

Conclusions:

  • Current SIMT SRS practices demonstrate a lack of standardization.
  • Future research correlating protocols with treatment quality will inform recommendations for safe and standardized SIMT SRS implementation.