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Establishment of a Novel Method for Dose Distribution Verification in Stereotactic Radiosurgery (SRS) Using General

Shunta Hirano1, Takaaki Ito2, Yuya Yanagi3

  • 1Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osaka, JPN.

Cureus
|November 10, 2025
PubMed
Summary

This study introduces a new patient-specific quality assurance method for stereotactic radiosurgery (SRS) that uses a standard detector and couch movement to achieve film-level accuracy. This approach reduces costs and effort for SRS quality assurance.

Keywords:
dose distributionpatient-specific quality assurancesemiconductor dosimeterstereotactic radiation therapyvmat-srs

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiosurgery Quality Assurance

Background:

  • Stereotactic radiosurgery (SRS) demands high irradiation accuracy due to steep dose gradients and small fields.
  • General semiconductor array detectors offer cost-effectiveness but lack the spatial resolution needed for SRS.
  • Existing quality assurance methods may not provide sufficient accuracy for complex SRS techniques like single-isocenter multiple-target SRS volumetric modulated arc therapy (SIMT-SRS-VMAT).

Purpose of the Study:

  • To develop a novel patient-specific quality assurance (PSQA) method for SIMT-SRS-VMAT.
  • To achieve dose distribution accuracy comparable to radiochromic film using a general semiconductor array detector and couch motion.
  • To reduce the cost and labor associated with SRS PSQA.

Main Methods:

  • A novel PSQA method was established by combining measurements from a general semiconductor array detector (MapCHECK2) with translational couch movement.
  • Virtual detector spacings (5, 4, 3, 2, and 1 mm) were synthesized to enhance spatial resolution.
  • Root mean square error (RMSE) and gamma (γ) analysis were used to evaluate profile shape accuracy and dose distribution agreement, respectively, comparing results against radiochromic film.

Main Results:

  • The RMSE values decreased as virtual detector spacing narrowed, indicating improved profile shape accuracy comparable to radiochromic film.
  • At a virtual detector spacing of 5 mm, γ analysis covered the entire dose range with pass rates comparable to EBT4 film across all tolerances.
  • The novel method demonstrated accuracy equivalent to radiochromic film without requiring specialized high-resolution detectors or disposable films.

Conclusions:

  • A novel, accurate, and cost-effective PSQA method for SIMT-SRS-VMAT was successfully established.
  • The combination of a general semiconductor array detector and couch movement allows for high-resolution dose verification.
  • This approach significantly reduces the need for specialized equipment and consumables, making SRS PSQA more accessible and efficient.