PDF(Pubmed)
Abstract：
UNASSIGNED: This study compared plans of high definition (HD), 2.5 mm width multi-leaf collimator (MLC), to standard, 5 mm width, isocentric linear accelerator (linacs), CyberKnife (CK), and Gamma Knife (GK) for stereotactic radiosurgery (SRS) techniques on multiple brain metastases.
UNASSIGNED: Eleven patients undergoing SRS for multiple brain metastases were chosen. Targets and organs at risk (OARs) were delineated and optimized SRS plans were generated and compared.
UNASSIGNED: The linacs delivered similar conformity index (CI) values, but the gradient index (GI) for HD MLCs was significantly lower (P-value <.001). Half the OARs received significantly lower dose using HD MLCs. CK delivered a significantly lower CI than HD MLC linac (P-value <.001), but a significantly higher GI (P-value <.001). CI was significantly improved with the HD MLC linac compared to GK (P-value = 4.591 × 10-3), however, GK delivered a significantly lower GI (P-value <.001). OAR dose sparing was similar for the HD MLC TL, CK, and GK.
UNASSIGNED: Comparing linacs for SRS, the preferred choice is HD MLCs. Similar results were achieved with the HD MLC linac, CK, or GK, with each delivering significant improvements in different aspects of plan quality.
UNASSIGNED: This article is the first to compare HD and standard width MLC linac plans using a combination of single isocentre volumetric modulated arc therapy and multi-isocentric dynamic conformal arc plans as required, which is a more clinically relevant assessment. Furthermore, it compares these plans with CK and GK, assessing the relative merits of each technique.
UNASSIGNED: Eleven patients undergoing SRS for multiple brain metastases were chosen. Targets and organs at risk (OARs) were delineated and optimized SRS plans were generated and compared.
UNASSIGNED: The linacs delivered similar conformity index (CI) values, but the gradient index (GI) for HD MLCs was significantly lower (P-value <.001). Half the OARs received significantly lower dose using HD MLCs. CK delivered a significantly lower CI than HD MLC linac (P-value <.001), but a significantly higher GI (P-value <.001). CI was significantly improved with the HD MLC linac compared to GK (P-value = 4.591 × 10-3), however, GK delivered a significantly lower GI (P-value <.001). OAR dose sparing was similar for the HD MLC TL, CK, and GK.
UNASSIGNED: Comparing linacs for SRS, the preferred choice is HD MLCs. Similar results were achieved with the HD MLC linac, CK, or GK, with each delivering significant improvements in different aspects of plan quality.
UNASSIGNED: This article is the first to compare HD and standard width MLC linac plans using a combination of single isocentre volumetric modulated arc therapy and multi-isocentric dynamic conformal arc plans as required, which is a more clinically relevant assessment. Furthermore, it compares these plans with CK and GK, assessing the relative merits of each technique.
摘要：
■本研究比较了高清晰度(HD)的计划，2.5毫米宽的多叶准直器（MLC），为了标准，5毫米宽，等中心直线加速器（直线加速器），射波刀(CK),和伽玛刀（GK）用于多种脑转移瘤的立体定向放射外科（SRS）技术。
■选择11例因多发性脑转移而接受SRS的患者。描绘目标和风险器官（OAR），并生成和比较优化的SRS计划。
■直线加速器提供了类似的合格指数（CI）值，但HDMLC的梯度指数（GI）明显较低（P值<.001）。一半的OAR使用HDMLC接受了明显较低的剂量。CK的CI明显低于HDMLC直线加速器（P值<.001），但GI显著较高（P值<.001）。与GK相比，HDMLC直线加速器的CI显着改善（P值=4.591×10-3），然而,GK的GI显著降低(P值<.001)。HDMLCTL的OAR剂量节省类似，CK,还有GK.
■比较SRS的直线加速器，首选是HDMLC。HDMLC直线加速器也取得了类似的结果，CK,或GK，每个都在计划质量的不同方面提供了显著的改进。
■本文首次根据需要使用单等中心体积调制电弧治疗和多等中心动态适形电弧计划的组合来比较HD和标准宽度MLC直线加速器计划，这是一个临床相关的评估。此外，它将这些计划与CK和GK进行比较，评估每种技术的相对优点。
■选择11例因多发性脑转移而接受SRS的患者。描绘目标和风险器官（OAR），并生成和比较优化的SRS计划。
■直线加速器提供了类似的合格指数（CI）值，但HDMLC的梯度指数（GI）明显较低（P值<.001）。一半的OAR使用HDMLC接受了明显较低的剂量。CK的CI明显低于HDMLC直线加速器（P值<.001），但GI显著较高（P值<.001）。与GK相比，HDMLC直线加速器的CI显着改善（P值=4.591×10-3），然而,GK的GI显著降低(P值<.001)。HDMLCTL的OAR剂量节省类似，CK,还有GK.
■比较SRS的直线加速器，首选是HDMLC。HDMLC直线加速器也取得了类似的结果，CK,或GK，每个都在计划质量的不同方面提供了显著的改进。
■本文首次根据需要使用单等中心体积调制电弧治疗和多等中心动态适形电弧计划的组合来比较HD和标准宽度MLC直线加速器计划，这是一个临床相关的评估。此外，它将这些计划与CK和GK进行比较，评估每种技术的相对优点。
