Quantifying risk of radiation necrosis: Normal tissue complication probability modeling following stereotactic radiosurgery for small brain metastases in the modern era

To estimate radiation necrosis (RN) risk, dose received by specific at-risk normal brain volumes (V8-22 Gy) was recorded for small brain metastases treated with single-fraction stereotactic radiosurgery. V15Gy was the best predictor with <2.52 cc and <4.65 cc associated with less than 5% risk of any grade RN and Grade 2+ RN, respectively.