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Effect of setup error in the single-isocenter technique on stereotactic radiosurgery for multiple brain metastases

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Title: Effect of setup error in the single-isocenter technique on stereotactic radiosurgery for multiple brain metastases
Authors: Nakano, Hisashi Browse this author
Tanabe, Satoshi Browse this author
Utsunomiya, Satoru Browse this author
Yamada, Takumi Browse this author
Sasamoto, Ryuta Browse this author
Nakano, Toshimichi Browse this author
Saito, Hirotake Browse this author
Takizawa, Takeshi Browse this author
Sakai, Hironori Browse this author
Ohta, Atsushi Browse this author
Abe, Eisuke Browse this author
Kaidu, Motoki Browse this author
Aoyama, Hidefumi Browse this author →KAKEN DB
Keywords: multiple brain metastases
setup error
single-isocenter technique
stereotactic radiosurgery
volumetric modulated arc therapy
Issue Date: Dec-2020
Publisher: John Wiley & Sons
Journal Title: Journal of applied clinical medical physics
Volume: 21
Issue: 12
Start Page: 155
End Page: 165
Publisher DOI: 10.1002/acm2.13081
Abstract: In conventional stereotactic radiosurgery (SRS), treatment of multiple brain metastases using multiple isocenters is time-consuming resulting in long dose delivery times for patients. A single-isocenter technique has been developed which enables the simultaneous irradiation of multiple targets at one isocenter. This technique requires accurate positioning of the patient to ensure optimal dose coverage. We evaluated the effect of six degrees of freedom (6DoF) setup errors in patient setups on SRS dose distributions for multiple brain metastases using a single-isocenter technique. We used simulated spherical gross tumor volumes (GTVs) with diameters ranging from 1.0 to 3.0 cm. The distance from the isocenter to the target's center was varied from 0 to 15 cm. We created dose distributions so that each target was entirely covered by 100% of the prescribed dose. The target's position vectors were rotated from 0 degrees-2.0 degrees and translated from 0-1.0 mm with respect to the three axes in space. The reduction in dose coverage for the targets for each setup error was calculated and compared with zero setup error. The calculated margins for the GTV necessary to satisfy the tolerance values for loss of GTV coverage of 3% to 10% were defined as coverage-based margins. In addition, the maximum isocenter to target distance for different 6DoF setup errors was calculated to satisfy the tolerance values. The dose coverage reduction and coverage-based margins increased as the target diameter decreased, and the distance and 6DoF setup error increased. An increase in setup error when a single-isocenter technique is used may increase the risk of missing the tumor; this risk increases with increasing distance from the isocenter and decreasing tumor size.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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