A multi-centre stereotactic radiosurgery planning study of multiple brain metastases using isocentric linear accelerators with 5 and 2.5 mm width multi-leaf collimators, CyberKnife and Gamma Knife.

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. 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. The linacs delivered similar conformity index (CI) values, but the gradient index (GI) for HD MLCs was significantly lower ( 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. 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.

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of the British Institute of Radiology.

Déclaration de conflit d'intérêts

There are no conflicts of interest to declare.